Effect of electroacupuncture at conception vessel and governor vessel on correlative signals of stress-injury-repair in cerebral ischemia reperfusion rats

Objective To explore the effect of electroacupuncture at conception vessel and governor vessel on correlative signals of inflammatory response stressinjury-repair in cerebral ischemia reperfusion rats. Methods A total of 216 rats were included in the experiment, of which 192 rats were randomly divided into four groups, including sham operation group（group A）, model group（group B）, governor vessel group（group C）, and conception vessel and governor vessel group（group D）, 48 rats in each group. The rats in each group were further divided into six sub-groups, including 12 h group, 24 h group, 48 h group, 72 h group, 96 h group and 144 h group. MCAO operation course was simulated in group A, and the common carotid artery, internal carotid artery and external carotid artery on the right side were exposed, without insertion of suture or treatment. After completion of modeling in group B, treatment was not conducted. After completion of modeling in group C, ＂Shuǐgōu（水沟 GV 26）＂, ＂Bǎihuì（百会 GV 20）＂ and ＂Dàzhuī（大椎 GV 14）＂ of governor vessel were selected, and electroacupuncture device was connected with ＂GV 14＂ and ＂GV 20＂. After completion of modeling in group D, ＂GV 26＂, ＂GV 20＂ and ＂GV 14＂ of governor vessel, and ＂Qìhǎi（气海 CV 6）＂, ＂Guānyuán（关元 CV 4）＂ and ＂Chéngjiāng（承浆 CV 24）＂ of conception vessel were selected; electroacupuncture device was connected with ＂GV 14＂ and ＂GV 20＂, ＂CV 4＂ and ＂CV 6＂. Neurological severity score was conducted.Enzyme linked immunosorbent assay（ELISA） was applied to determine the concentration of peripheral serum adrenocorticotropic hormone（ACTH） of rats, and immunohistochemical method was adopted to detect the expression levels of tumor necrosis factor α（TNF-α） and transforming growth factor β1（TGF-β1） in brain tissue of rats. The other 24 rats were also randomly divided into four groups mentioned above, 6 rats in each group, to detect cerebral ischemie volume. Results Compared with group B, the ischemia volume in brain tissue at 144 h after cerebral ischemia reperfusion decreased significantly in group C and group D（P〈0.05）, and the ischemia volume in group D was less than that in group C（P〈0.05）. The neurological impairment scores of group C and group D at all time points were lower than those of group B, and the differences were statistically significant（all P〈0.05）. The scores of group D at all time points were lower than those of group C, and the differences since 24 h were statistically significant（all P〈0.05）. Compared with group B, the excessive expression of ACTH was suppressed dynamically and generally in group C and group D（P〈0.05）; the expression level of TNF-α was down-regulated and TGF-β1 was up-regulated as well in group C and group D（P〈0.05）. The effect in group D was superior to that in group C. Conclusion Electroacupuncture at conception vessel and governor vessel can protect brain through the intervention of the expression of correlative signals of inflammatory response stress-injury-repair of cerebral ischemia reperfusion.

Electro-acupuncture at Conception and Governor vessels and transplantation of umbilical cord bloodderived mesenchymal stem cells for treating cerebral ischemia/reperfusion injury

Mesenchymal stem cell transplantation is a novel means of treating cerebral ischemia/reper- fusion, and can promote angiogenesis and neurological functional recovery. Acupuncture at Conception and Governor vessels also has positive effects as a treatment for cerebral ischemia/ reperfusion. Therefore, we hypothesized that electro-acupuncture at Conception and Governor vessels plus mesenchymal stem cell transplantation may have better therapeutic effects on the promotion of angiogenesis and recovery of neurological function than either treatment alone. In the present study, human umbilical cord blood-derived mesenchymal stem cells were isolated, cultured, identified and intracranially transplanted into the striatum and subcortex of rats at 24 hours following cerebral ischemia/reperfusion. Subsequently, rats were electro-acupunctured at Conception and Governor vessels at 24 hours after transplantation. Modified neurological severity scores and immunohistochemistry findings revealed that the combined interventions of electro-acupuncture and mesenchymal stem cell transplantation clearly improved neurological impairment and up-regulated vascular endothelial growth factor expression around the isch- emic focus. The combined intervention provided a better outcome than mesenchymal stem cell transplantation alone. These findings demonstrate that electro-acupuncture at Conception and Governor vessels and mesenchymal stem cell transplantation have synergetic effects on promot- ing neurological function recovery and angiogenesis in rats after cerebral ischemia/reperfusion.

Distribution and Permeability of Capillaries at the Skin of the Conception Vessel and the Governor Vessel in Healthy Rabbits

Objective: To investigate the distribution and permeability of blood vessels on the Conception Vessel and the Governor Vessel in the physiological state. Methods: Evans blue (EB) solution was injected into the marginal ear vein of healthy rabbits. Three hours after injection, the rabbits were sacrificed and the skin on the Conception Vessel and the Governor Vessel and the corresponding bilateral non-channels was collected. EB was extracted with 7:3 acetone: physiological saline, and the absorbance of EB at each skin tissue was measured with a spectrophotometer. Results: The A value of EB absorbance at the Conception Vessel on the abdominal skin was lower than that of the corresponding bilateral non-channels with a statistically significant difference (P<0.01). The A value of EB absorbance at the Governor Vessel on the back was higher than that of the corresponding bilateral non-channels (P<0.05). There was no statistical difference in the A value of EB absorbance between the bilateral non-channels of the abdomen and the back (P>0.05). Conclusion: There were differences in capillary distribution and permeability between the Conception Vessel, the Governor Vessel and the corresponding bilateral non-meridians.

Therapeutic effect of cross-shaped moxibustion on the conception vessel and belt vessel for 23 cases of dysmenorrhea due to qi and blood deficiency

Objective:Objective:To observe the therapeutic effect of cross-shaped moxibustion on the conception vessel and belt vessel for dysmenorrhea due to qi and blood deficiency.Methods:Taking Shenque(神阙CV8)as the center,up to Zhongwan(中脘CV12),down to Zhongji(中极CV3),and both sides to Daimai(带脉GB26),the above mentioned were treated area.The patient’s umbilicus was filled with the herbal powder for moxibustion and the powder was also scattered in a straight line along the treated area.The two sheets of mulberry paper were put in a cross way on the herbal powder for moxibustion,and the cross-shaped moxibustion box was put on the paper.The ginger paste was put into the box to a height of 3 cm and pressed tightly with a tongue depressor,the margin of the ginger paste should be clinged to the moxibustion box.The moxa cones were put end to end in the groove on the median of the ginger paste and ignited orderly.When the cones were burnt completely,the new cones were used and ignited.Three cones were adopted in succession in each treatment.The treatment was given once a week,and three treatments as one course,the therapeutic effect was evaluated after two courses of treatment.Results:There were 16 cases cured,5 cases effective and 2 cases non-effective in all.The total effective rate was 91.3%.Conclusion:Coss-shaped moxibustion on the conception vessel and belt vessel has sound effect for dysmenorrhea due to qi and blood deficiency.

CLINICAL OBSERVATION ON TREATMENT OF 205 CASES OF CERVICAL SPONDYLOPATHY BY ACUPUNCTURE AND MOXIBUSTION ON THE GOVERNOR VESSEL OF THE NECK

This article involves 325 patients suffering from cervical spondylopathy,amongthem 205 cases were treated by acupuncture and moxibustion on the governor vessel of the neck（treatment group）,the other 120 cases were treated by common acupuncture（control group）.Itwas observed that the cure rate,the total effective rate was 91.2％,98.5％ in the treatmentgroup,and 55.8％,87.5％ in the control group.There were statistically significant differences（P【0.01）in the cure rate and total effective rate between the two groups.It is concluded thatacupuncture and moxibustion on the governor vessel of the neck may improve Yang Qi circulationwithin the Dumai and promote the micro-circulation in the diseased areas.Thus it evidently in-creases the therapeutic effects.

Effects of decompression joint Governor Vessel electro-acupuncture on rats with acute upper cervical spinal cord injury

Decompression is the major therapeutic strategy for acute spinal cord injury,but there is some debate about the time window for decompression following spinal cord injury.An important goal and challenge in the treatment of spinal cord injury is inhibiting or reversing secondary injury.Governor Vessel electroacupuncture can improve symptoms of spinal cord injury by inhibiting cell apoptosis and improving the microenvironment of the injured spinal cord.In this study,Governor Vessel electroacupuncture combined with decompression at different time points was used to treat acute spinal cord injury.The rat models were established by inserting a balloon catheter into the atlanto-occipital space.The upper cervical spinal cord was compressed for 12 or 48 hours prior to decompression.Electroacupuncture was conducted at the acupoints Dazhui（GV14） and Baihui（GV 20）（2 Hz,15 minutes） once a day for 14 consecutive days.Compared with decompression alone,hind limb motor function recovery was superior after decompression for 12 and 48 hours combined with electroacupuncture.However,the recovery of motor function was not significantly different at 14 days after treatment in rats receiving decompression for 12 hours.Platelet-activating factor levels and caspase-9 protein expression were significantly reduced in rats receiving electroacupuncture compared with decompression alone.These findings indicate that compared with decompression alone,Governor Vessel electroacupuncture combined with delayed decompression（48 hours） is more effective in the treatment of upper cervical spinal cord injury.Governor Vessel electroacupuncture combined with early decompression（12 hours） can accelerate the recovery of nerve movement in rats with upper cervical spinal cord injury.Nevertheless,further studies are necessary to confirm whether it is possible to obtain additional benefit compared with early decompression alone.

Combinatorial effects of conception and governor vessel electroacu-puncture and human umbilical cord blood-derived mesenchymal stem cells on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion

OBJECTIVE: To investigate the combinatorial effects of conception and governor vessel electroacupuncture(EA) and human umbilical cord blood-derived mesenchymal stem cells(HUCB-MSCs) on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion. METHODS: With the HUCB-MSCs isolated, cultured and identified and the models of cerebral ischemia-reperfusion established, the HUCB-MSCs of passage three were intracranially transplanted and the EA at conception and governor vessels was applied. The pathomorphologic lesion by hematoxylin-eosin staining and the cellular apoptosis by terminal deoxynucleotidyl transferase-mediated nick-end labeling method around the ischemic focus were observed. RESULTS: The cultured adherent HUCB-MSCs exhibited a spindle shape and expressed MSC-specific markers, with the cell purity and proliferation rate significantly increasing after the primary passage. HE staining showed that there were no pathological changes observed in the sham surgery group. However, in the PBS transplantation group, degeneration and necrosis of a great number of nerve cells were seen. In both the HUCB-MSCs transplantation group and the HUCB-MSCs transplantation + EA group, reparative changes of the pathomorphism of the tissue were found. Both combination treatment and simple MSCs treatment were able to improve the pathomorphorlogic lesion following cerebral ischemia and reduce the abnormal TUNEL-positive numbers, with former better than latter. CONCLUSION: HUCB-MSCs improve pathological lesions and inhibit the cellular apoptosis around the cerebral ischemic area. EA at conception and governor vessels also improve pathological lesion and inhibit the cellular apoptosis in rats treated with HUCB-MSCs transplantation, which effects were superior to that of simple HUCB-MSCs transplantation.

Clinical observation of cerebral palsy treated with Chinese massage for promoting the Governor Vessel, benefiting the kidney and strengthening the spleen combined with music therapy

Objective To observe the effects on the range of motion （ROM） of ankle joint and muscular spasm of the lower limbs treated with Chinese massage for promoting the Governor Vessel, benefiting the kidney and strengthening the spleen combined with music therapy in infantile cerebral palsy （CP）. Methods In 286 cases of spasmodic CP, 7 kinds of Chinese massage were adopted, named massage on acupoints to promote circulation of the Governor Vessel, massage for strengthening the spleen and benefiting qi, spine-pinching therapy, segmental massage, foot massage, massage for promoting the recovery of muscle strength and massage for promoting ROM of joints. Chinese massage was applied in musical background. Buddha music and five-element music of Chinese medicine （music of the Heart, Liver and Kidney Meridians） were optioned. The treatment was given once or twice a day and 30 days made one course. The angles of femoral adductor and dorsal flexion of foot as well as the score of composite spasticity scale （CSS） were observed before and after treatment so that the therapeutic effect was assessed. Results In 30 days of treatment, 106 cases （37. 1%） were effective markedly, 172 cases （60. 1%） effective and 8 cases （2.8%） failed. The angle of dorsal flexion of foot was （105.64± 12.66）° and （76.58± 9.89）° before and after treatment respectively; the angle of femoral adductor was （119.89±25.47）° and （158.99± 18.66）° before and after treatment respectively; the score of CSS was （12.39±2.56） and （7. 069 ± 2.97） before and after treatment respectivel, there was significant difference before and after treatment （all P〈0.01）. Conclusion Chinese massage for promoting the Governor Vessel, benefiting the kidney and strengthening the spleen combined with music therapy brings the extremely active effect into play on the recovery of sitting, kneeling, standing and walking for children with CP.

基于“任主胞宫”理论探讨针灸治疗薄型子宫内膜不孕症临床疗效

目的:探究基于“任主胞宫”理论针灸治疗薄型子宫内膜不孕症患者临床疗效。方法:选取薄型子宫内膜不孕症患者80例,根据患者意愿纳入对照组(40例)与观察组(40例)。对照组常规服用拜耳戊酸雌二醇片治疗,观察组在对照组基础上采用基于“任主胞宫”理论针灸治疗,评估治疗后两组子宫内膜厚度、A型子宫内膜形态占比、子宫内膜血流微循环[子宫内膜下血流搏动指数(PI)与阻力指数(RI)]、雌激素含量[黄体期雌激素(E2)、孕酮(P)和促卵泡生成素(FSH)、黄体生成素(LH)等性激素]及1年内妊娠情况。结果:治疗后观察组子宫内膜厚度高于对照组(P<0.05);治疗后观察组A型子宫内膜形态比例高于对照组(P<0.05);两组治疗前PI与RI比较无统计学差异(P>0.05),治疗后观察组PI与RI水平低于对照组(P<0.05);治疗后观察组E2、P与LH水平高于对照组,而FSH水平低于对照组(P<0.05);观察组一年内妊娠率50.00%,对照组为25.00%,观察组明显高于对照组(P<0.05)。结论:基于“任主胞宫”理论针灸可提升薄型子宫内膜不孕症患者的子宫内膜厚度,促进子宫内膜生长,并可改善患者子宫内膜内血流微循环及生殖相关激素水平,提高1年内妊娠率,可优化临床疗效。

超声影像组学模型鉴别肝郁痰凝型与冲任失调型乳腺癌中医证型的价值

目的探讨超声影像组学模型鉴别肝郁痰凝型与冲任失调型乳腺癌中医证型的价值,寻求有助于中医辨证分型的客观指标。方法回顾性收集2018年1月—2021年12月于福建中医药大学附属第二人民医院行术前超声检查并经病理确诊且有完整中医辨证资料的231例(247个病灶)乳腺癌患者资料,获取术前超声图像,用ITK-SNAP软件勾画感兴趣区(ROI),利用Pyradiomics 3.0软件提取超声影像组学特征,病灶按7∶3比例分为训练集(175个)和测试集(72个),使用最小绝对收缩与选择算法(LASSO)进行特征降维筛选,采用支持向量机(SVM)构建影像组学模型,通过受试者工作特征(ROC)曲线评估模型的鉴别诊断效能。结果纳入病例中肝郁痰凝型107例115个病灶,冲任失调型124例132个病灶。LASSO算法筛选出17个可鉴别肝郁痰凝型和冲任失调型乳腺癌的超声影像组学特征,其中前7个特征权重系数较大,分别为Dependence Variance,Correlation,Sphericity,Center Of MassIndex2,Bounding Box5,Large Dependence High Gray Level Emphasis和Short Run Emphasis。利用上述17个有效特征构建的影像组学模型在训练集和测试集上的曲线下面积(AUC)分别为0.797(95%CI:0.730~0.864)和0.775(95%CI:0.666~0.883)。该模型训练集的敏感度、特异度、准确率分别为72.3%(60/83)、73.0%(65/89)、72.7%(125/172);该模型测试集的敏感度、特异度、准确率分别为75.5%(37/49)、65.4%(17/26)、72.0%(54/75)。结论超声影像组学模型能够有效鉴别肝郁痰凝型与冲任失调型乳腺癌,筛选出的影像组学特征可作为乳腺癌中医辨证分型的微观指标。

艾灸督脉组穴对血管性痴呆大鼠海马p38 MAPK信号通路及细胞凋亡的影响

目的基于p38丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)通路探究艾灸督脉组穴对血管性痴呆(vascular dementia,VD)大鼠的脑保护机制。方法将60只SPF级健康雄性SD大鼠随机分为假手术组(12只)和实验组(48只);实验组大鼠采用双侧颈总动脉永久结扎法复制VD大鼠模型,随后将模型复制成功的大鼠分为模型组、艾灸组、阻滞剂组、艾灸+阻滞剂组,每组12只;艾灸组大鼠取“百会”“大椎”“风府”穴,采用温和灸法治疗,每次30 min,每日1次,治疗6 d,休息1 d,连续治疗4周;阻滞剂组在模型复制前30 min腹腔注射p38 MAPK阻滞剂(10μmol/L SB203580),模型复制成功后隔日注射1次,每次每只大鼠按1 mL/kg注射10μmol/L SB203580,连续注射4周;艾灸+阻滞剂组大鼠在阻滞剂组干预方法基础上进行艾灸治疗。采用Morris水迷宫实验检测大鼠认知功能,TUNEL法检测大鼠海马组织CA1区神经元凋亡率,Western blot法和RT-qPCR法分别检测大鼠海马组织CA1区p38 MAPK、Bcl-2、Caspase-3、Caspase-9蛋白及mRNA表达水平。结果与模型组比较,艾灸组、阻滞剂组、艾灸+阻滞剂组大鼠平均逃避潜伏期均显著缩短(P<0.05),穿越平台次数显著增加(P<0.05),海马组织CA1区神经元凋亡率显著降低(P<0.05),p38 MAPK、Caspase-3、Caspase-9蛋白及mRNA表达水平均显著降低(P<0.05),Bcl-2蛋白及mRNA表达水平均显著升高(P<0.05);艾灸+阻滞剂组大鼠平均逃避潜伏期较艾灸组、阻滞剂组显著缩短(P<0.05),穿越平台次数显著增加(P<0.05),海马组织CA1区神经元凋亡率显著降低(P<0.05),p38 MAPK、Caspase-3、Caspase-9蛋白及mRNA表达水平均显著降低(P<0.05),Bcl-2蛋白及mRNA表达水平均显著升高(P<0.05)。结论艾灸督脉组穴对VD大鼠的认知功能具有一定的改善作用,其作用机制可能与调控p38 MAPK信号通路抑制海马神经元凋亡有关。

Effect of sliding-cup along governor vessel on tcpO_2 and tapCO_2 in Mìngmén(命门 GV 4) point of sub-healthy humans: observation on different cupping pressure

Objective To explore the effects of sliding-cup with different parameters on energy metabolism in the body by observing the effect of sliding-cup along the governor vessel on transcutaneous partial pressures of oxygen and carbon dioxide in Mìngmén（命门 GV 4） in sub-healthy people. Methods A total of 10 sub-healthy adults at rest were observed and sliding-cup along the governor vessel were conducted with three different parameters, jar-pressure of –0.01~ –0.02 MPa with sliding-cup for 5 min, jar-pressure of –0.02~ –0.03 MPa with sliding-cup for 5 min and jar-pressure of –0.02~ –0.03 MPa with slidingcup for 3 min. Peri Flux System5000 PF5040 module was employed to monitor the changes of transcutaneous partial pressures of oxygen（tcp O2） and carbon dioxide（tcp CO2） in GV 4 at 0 min, 5 min, 10 min, 15 min, 20 min, 25 min and 30 min after sliding-cup with above different interventions in sub-healthy subjects. Results After sliding-cup, tcp O2 increased at first and then decreased over time; there was no difference in tcp O2 after sliding-cupping with different parameters（all P0.05）. After sliding-cup, tcp CO2 decreased; there was no difference in tcp CO2 after sliding-cup with different parameters（all P0.05）. Conclusion Sliding-cup has a sustained effect on the body and can speed up the energy metabolism in the body.

分期针刺任督经穴治疗早发性卵巢功能不全的临床观察

目的观察分期针刺任督经穴治疗早发性卵巢功能不全(POI)的临床疗效。方法选取2021年6月至2022年12月就诊于上海市静安区中医医院的104例POI患者作为研究对象,按照完全随访化方法分为分期组、任脉组、督脉组、西药组,各26例。比较各组患者治疗前后血清性激素水平、窦卵泡计数(AFC),以及治疗和随访过程中共5个访视点的Kupperman(K)表和月经不调症状分级量化(MDQ)表评分。结果治疗后,四组血清卵泡刺激素(FSH)水平下降,雌二醇(E_(2))水平上升(P<0.05);西药组、督脉组和分期组AFC升高(P<0.01),分期组AFC改善优于任脉组(P<0.05)。西药组K表和MDQ表评分在治疗期间下降(P<0.01);随访期间K表不再下降(P>0.05),MDQ表上升(P<0.01)。任脉组K表评分在1MC和随访期间下降(P<0.05),MDQ表评分在3MC下降(P<0.01)。督脉组K表和MDQ表评分在3MC下降(P<0.01);随访期间MDQ表评分下降(P<0.05)。分期组K表评分在每个访视点均下降(P<0.05),MDQ表评分在3MC和随访期间下降(P<0.01)。结论分期针刺任督经穴治疗POI的临床疗效显著。

督灸配合中药治疗重症肌无力的疗效观察

目的 观察督灸配合益髓健肌颗粒治疗重症肌无力的临床疗效。方法 将94例重症肌无力患者随机分为治疗组和对照组,每组47例。治疗组采用督灸配合益髓健肌颗粒治疗,对照组采用口服甲泼尼龙片治疗。观察两组治疗前后英国医学研究理事会(Medical Research Council, MRC)肌力评测表评分、重症肌无力肌群耐力评分量表(myasthenia gravis muscular endurance scale, MGMES)评分、肌肉含量及各项实验室指标[滤泡辅助性T细胞(T follicular helper cells, Tfh)、滤泡调节性T细胞(T follicular regulatory cells, Tfr)、Tfr/Tfh比值、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)、白细胞介素-2(interleukin-2, IL-2)、白细胞介素-17(interleukin-17, IL-17)、鸢尾素(irisin)、过氧化物酶体增殖物激活受体-γ共激活因子-1α(peroxisome proliferator-activated receptor-γ coactivator 1-α, PGC-1α)、Ⅲ型纤连蛋白结构域蛋白5(fibronectin typeⅢdomain-containing protein 5, FNDC5)、磷脂酰肌醇-3-激酶(phosphoinositide3-kinase, PI3K)、蛋白激酶B(AKT)、雷帕霉素靶蛋白(mammalian target of rapamycin, mTOR)]的变化情况,比较两组临床疗效、不良反应发生率及随访6个月复发率。结果 治疗组总有效率为95.7%,明显高于对照组的81.4%(P<0.05)。两组治疗后MRC肌力评测表评分及肌肉含量均较同组治疗前显著上升,MGMES评分均显著下降,差异均具有统计学意义(P<0.05)。治疗组治疗后Tfr、Tfr/Tfh、irisin水平均较同组治疗前显著上升,Tfh、TNF-α、IL-2、IL-17、PGC-1α、FNDC5、PI3K、AKT、mTOR水平均显著下降,差异均具有统计学意义(P<0.05)。对照组治疗后Tfr、Tfr/Tfh水平均较同组治疗前显著上升,Tfh、TNF-α、IL-2、IL-17水平均显著下降,差异均具有统计学意义(P<0.05)。治疗组治疗后MRC肌力评测表评分、MGMES评分、肌肉含量及各项实验室指标与对照组比较,差异均具有统计学意义(P<0.05)。治疗组治疗期间不良反应发生率和随访6个月复发率分别为2.2%和6.8%,明显低于对照组的32.6%和42.9%(均P<0.05)。结论 督灸配合益髓健肌颗粒可增强重症肌无力患者的肌肉张力,调节Tfh、Tfr平衡,拮抗血清促炎因子分泌,改善血清肌肉调节因子和PI3K/AKT/mTOR通路水平,安全性好。

基于“督脉入络脑”探讨针刺督脉经穴治疗脑病的神经传导机制

“督脉入络脑”理论阐释了督脉无论在循行还是功能上都与脑有着密切联系。基于该理论,古今医者治疗脑病首选督脉穴位。针刺督脉效应的产生依赖于穴位下的感受器将针刺刺激转换为神经信号传导至中枢各级水平,然而针刺督脉经穴治疗脑病从外周到中枢的神经传导途径尚未全面总结。从现代神经生物学角度归纳外周感觉传入神经和中枢核团的诸多研究,分析了针刺督脉体表刺激治疗脑病相关联的神经生物学基础及调控途径。

针刺联合督灸治疗强直性脊柱炎的疗效观察

目的 观察针刺联合督灸治疗强直性脊柱炎的临床疗效及对AKT/PI3K/mTOR信号通络的影响。方法将96例强直性脊柱炎患者随机分为两组(观察组和对照组),每组48例。对照组口服美洛昔康治疗,观察组予针刺联合督灸治疗。观察两组治疗前后巴氏强直性脊柱炎病情评测指数(Bath ankylosing spondylitis disease activity index,BASDAI)和巴氏强直性脊柱炎活动能力量表(Bath ankylosing spondylitis functional index,BASFI)评分、血清炎性因子[核因子-κB(nuclear factor-κB,NK-κB)、巨噬细胞移动抑制因子(macrophage migration inhibitory factor,MIF)、CC趋化因子受体6(CC chemokine receptor 6,CCR6)和单核细胞趋化蛋白-4(monocyte chemokine protein-4,MCP-4)]水平、骨化相关蛋白[基质金属蛋白酶组织抑制剂-2(matrix metalloproteinase tissue inhibitor-2,TIMP-2)、高迁移率族蛋白B1(high mobility group protein box 1,HMGB1)、Dickkopf相关蛋白-1(dickkopf-related protein-1,DKK-1)和骨硬化蛋白(sclerostin,SOST)]水平以及AKT/PI3K/mTOR信号通路[蛋白激酶B(protein kinase B,AKT)、磷脂酰肌醇-3-激酶(phosphatidylinositol-3-kinase,PI3K)和雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)]水平的变化。比较两组临床疗效及不良反应发生情况。结果 观察组总有效率为97.9%,高于对照组的81.8%(P<0.05)。观察组治疗后、随访3个月及6个月BASDAI和BASFI评分均低于对照组(P<0.05)。观察组治疗后血清NK-κB、MIF、CCR6、MCP-4、TIMP-2、HMGB1、AKT、PI3K和mTOR水平均低于对照组(P<0.05),DKK-1和SOST水平高于对照组(P<0.05)。结论 针刺联合督灸可明显缓解强直性脊柱炎患者的临床症状,疗效优于口服美洛昔康治疗,并可调节AKT/PI3K/mTOR信号通络的表达。

热敏灸联合督灸治疗对不孕症心理状态的临床疗效观察

目的:观察热敏灸联合督灸治疗对不孕症患者心理状态的临床疗效。方法:采取随机对照原则,以50例不孕症伴焦虑抑郁状态患者为研究对象,分为两组。试验组25例,采用热敏灸联合督灸治疗;对照组25例,采用督灸治疗。通过分析治疗前后患者的月经情况、焦虑抑郁状态及临床妊娠率,探究热敏灸联合督灸治疗对不孕症患者心理状态的临床效果。结果:治疗前,试验组与对照组各项指标比较,差异均无统计学意义(P>0.05)。与治疗前比较,治疗1个月后试验组抑郁自评量表(SDS)评分降低,差异具有统计学意义(P<0.05);治疗2个月后对照组与试验组SDS评分较治疗前均降低,且试验组降低更明显,差异有统计学意义(P<0.01,P<0.05);治疗3个月后,对照组与试验组SDS评分较治疗前降低,差异有统计学意义(P<0.01)。与治疗前比较,试验组治疗1个月后焦虑自评量表(SAS)评分降低,差异具有统计学意义(P<0.05);治疗2个月后,对照组与试验组SAS评分与治疗前比较均降低,差异有统计学意义(P<0.05)。治疗3个月后,对照组与试验组SAS评分较治疗前明显降低,且试验组SAS评分降低更明显,差异有统计学意义(P<0.01,P<0.05)。治疗3个月后两组患者月经量、周期与治疗前比较,差异具有统计学意义(P<0.05)。治疗后3个月,两组患者临床妊娠比较,差异具有统计学意义(P<0.05)。结论:联合热敏灸与督灸治疗对不孕症患者心理状态具有一定的临床疗效,且起效快,积累效应更强。

基于督脉理论探讨“通督益髓”针法治疗脊髓损伤的研究进展

脊髓损伤是一种严重的神经系统疾病,属于中医“痿证”“体惰”范畴,“督脉受损、肾阳不足”是脊髓损伤的主要病因病机,从督脉论治脊髓损伤是中医治疗的关键。文章基于督脉理论,介绍了中医学对脊髓损伤的认识以及“通督益髓”法理论的形成,简述了“通督益髓”法电针治疗脊髓损伤的临床应用及机制研究,以期为脊髓损伤的中医理论及临床研究提供新思路。

田元生四联疗法治疗强直性脊柱炎经验

总结田元生教授四联疗法治疗强直性脊柱炎经验。田元生教授认为强直性脊柱炎病机属肾虚督瘀,治疗以补肾祛瘀通督为大法,创新性地总结了四联疗法系列治疗方案,将任督周天大艾灸、刺络放血、穴位埋线及内服药物4法相结合,多法合用、内外兼顾、标本合治,从而提高了临床疗效。

Influence of electroacupuncture therapy of tonifying the kidney and regulating governor vessel on Aβ related degradation enzymes in the hippocampus of a rat model of Alzheimer's disease induced by Aβ_(1-42)

Objective： To explore influence of electroacupuncture（EA） therapy of tonifying the kidney and regulating governor vessel on amyloid beta（Aβ） related degradation enzymes in the hippocampus of a rat model of Alzheimer＇s disease（AD） induced by Aβ（1-42）.Methods： Forty Wistar male rats were randomly divided into 4 groups： a normal group, a sham operation group, a model group and an EA group, 10 rats in each one. The rats in normal group were normally fed. The rats in sham operation group were bilaterally injected in the hippocampus with 5 μL of saline and they were normally fed after the injection. The rats in the model group and the EA group were bilaterally injected in the hippocampus with 5 μL of Aβ（1-42） on each side. Rats in the EA group received EA of 5 Hz continuous wave at the ＂Bǎihuì（百会 GV20）＂ and bilateral ＂Shènshū（肾俞 BL23）＂ for a duration of 15 min per time every day and continuously for 15 days. After 15 days, the hippocampal expression levels of insulin degrading enzyme（IDE）, lipoprotein（LPL）, transthyretin（TTR）, apolipoprotein E（APoE）,a2 macroglobulin（a2 M） and Aβ（1-42） of the 4 groups were tested by Western blot.Results： Compared with the sham operation group, the expression levels of IDE, LPL, TTR, APoE and a2 M in the hippocampus were significantly lower（P〈 0.05, P〈 0.01） and the expression of Aβ（1-42） was significantly higher（P〈 0.01） in the model group. Compared with the model group, the expression levels of IDE, LPL, TTR,APoE and a2 M in the hippocampus of these rats were significantly lower（P〈 0.05,P〈 0.01）, the expression of Aβ（1-42） was significantly higher（P〈 0.01） in the EA group.Conclusion： EA therapy of tonifying the kidney and regulating governor vessel can enhance the expression of IDE, LPL, TTR, APoE, and a2 M in the hippocampus of AD rats injected by Aβ（1-42）, and may consequently promote the degradation of aβ（1-42） to help improve the pathological manifestations of AD and therefore delay its progression.