Theoretical Discussion on Treatment of Cubital Tunnel Syndrome Based on Theory of Liver,Spleen and Kidney

Cubital tunnel syndrome is a disease in which ulnar nerve is compressed by its surrounding tissues,and its main clinical manifestations are pain,sensory disturbance and dyskinesia.Its incidence rate is the second highest among peripheral nerve entrapment diseases,and it is one of the common clinical diseases.The theory of liver,spleen and kidney can guide the treatment of cubital tunnel syndrome with traditional Chinese medicine and acupuncture.By discussing the traditional Chinese medicine(TCM)pathogenesis and treatment principles of cubital tunnel syndrome,it provides modern medical theoretical support for TCM treatment of cubital tunnel syndrome.

Effects of Soothing Liver and Invigorating Spleen Recipe on Lipid Metabolism Disorders in Kupffer Cells of NAFLD Rats by LXRα/SREBP-1c Signal Pathway

Objective To investigate the mechanism of lipid metabolism disorders in Kupffer cells （KCs） of non-alcoholic fatty liver disease （NAFLD） rats mediated by LXRα-SREBP-lc pathway and the interference of soothing liver and invigorating spleen recipe （SLISR） on it. Methods SD male rats were randomly divided into five groups： normal, model, soothing liver recipe （SLR）, invigorating spleen recipe （ISR）, and soothing liver and invigorating spleen recipe （SLISR） groups. The rats in treatment groups were administered for 8 weeks. The liver tissue was stained with H＆E and oil red O. The levels of hepatic lipid and blood lipid were measured by biochemical analyzer. KCs were isolated from the livers of rats to evaluate the expression of LXRα, SREBP-1 C, and FAS mRNA by real-time fluorescence quantitative PCR tests; LXRα, SREBP-1C, and FAS proteins were measured by Western blotting. Results The H＆E and oil red O staining results showed that the model rats successfully reproduced typical pathogenetic and histopathological features of NAFLD. The levels of hepatic lipid and blood lipid in the model rats were dramatically increased. Compared with the model group, the values of hepatic lipid and blood lipid in the treatment groups were significantly ameliorated （P〈 0.05, 0.01 ）. The yields of purified KCs from each rat were 2×10^7-3×10^7. The viability of KCs was higher than 95%, with the purity over 90.18%. Compared with the model group, the expression of LXRα, SREBP-1C, and FAS mRNA and proteins was decreased in all treatment groups, especially in the SLR group （P〈 0.05）. Conclusion SLISR may protect liver against injury included by lipid metabolism disorders in KCs through LXRα/ SREBP-1 c signaling pathway, which may be an important mechanism for the prevention and treatment of NAFLD.

Effect of soothing liver therapy on oocyte quality and growth differentiation factor-9 in patients undergoing in vitro fertilization and embryo transfer

OBJECTIVE:To investigate the effect of Soothing liver therapy on infertile women undergoing in vitro fertilization and embryo transfer(IVF-ET)and to explore its mechanism.METHODS:Fifty-eight women with tubal infertility were randomized into two groups:30 in an experimental group treated with Xiaoyao powder(Shugan)plus gonadotropin-releasing hormone analog(GnRHa)/follicle-stimulating hormone(FSH)/human chorionic gonadotropin(hCG)and 28 in the control group who were treated with GnRHa/FSH/hCG only.The total gonadotropin(Gn)doses required,endometrial thickness,oocyte numbers,high quality embryo production rate and pregnancy rate of the two groups were compared.The concentration of growth differentiation factor-9(GDF-9)in follicular fluid was detected by western blotting and the expression of GDF-9 mRNA in granulosa cells was measured using reverse tran-scription-polymerase chain reaction amplification.RESULTS:In the experimental group,the Gn dose was significantly lower than that in the control group;the endometrial thickness,high quality embryo production and pregnancy rates were significantly higher and the expression of GDF-9 mRNA was also significantly higher than in the control group(all P<0.05).CONCLUSION:Shugan treatment can improve the pregnancy rate of women with tubal infertility;its mechanism is possibly related to the increased expression of GDF-9 in granulosa cells.

Clinical observation on Governor Vessel-regulating,liver-soothing and mind-calming needling for insomnia due to liver fire disturbing the heart

Objective： To compare the therapeutic effects between the Governor Vessel-regulating, liver-soothing and mind-calming needling and the routine acupuncture therapy for Methods： A total of 50 cases with insomnia were nsomnia due to liver fire disturbing the heart randomly divided by the random numberl table into the two groups, 25 cases in each group. The observation group was treated with the Governor Vessel-regulating, liver-soothing and mind-calming needling, while the control group was treated with the routine acupuncture therapy. The two groups were treated for five sessions per week, ten sessions as a course. After 3-course treatment, the therapeutic effects and the improvement of Pittsburgh sleep quality index （PSQI） were observed. Results： After treatment for three courses, the total effective rate was 100% in the treatment group and 92% in the control group. The difference in the therapeutic effect between the two groups was statistically significant （P〈0.05）. After the treatment, the sleep latency, sleep duration, habitual sleep efficiency, subjective sleep quality, sleeping disturbances, daytime dysfunction, and total PSQI scores in the patients of the two groups were obviously improved in comparing those before treatment, with significant differences （all P〈O.01）. After treatment, the inter-group differences in the sleep latency, sleep duration, habitual sleep efficiency, subjective sleep quality, and total PSO, I scores were statistically significant （all P〈0.02）; the differences in the scores of sleeping disturbances and daytime dysfunction is not statistical significant （all P〉0.05）. Conclusion： The therapeutic effect of Governor Vessel-regulating, liver-soothing and mind-calming needling is better for insomnia due to liver fire disturbing the heart than the routine acupuncture therapy.

疏肝调神针法结合择时耳穴压豆治疗阈下抑郁

ObjectiveTo observe the clinical therapeutic effect on subthreshold depression of liver stagnation and spleen deficiency treated with acupuncture therapy for soothing the liver and regulating the mind combined with the well-timed auricular acupressure.MethodsA total of 34 patients were treated with acupuncture therapy for soothing the liver and regulating the mind combined with well-timed auricular acupressure.In acupuncture therapy for soothing the liver and regulating the mind,main acupoints included Baihui(BL20),Neiguan(PC6)and Taichong(LR3),and supplementary acupoints included Sishencong(EX-HN1),Shenting(GV24),Benshen(GB13),Zusanli(ST36),Ganshu(BL18)and Pishu(BL20).Acupuncture was given three times a week as one course and 4 courses of treatment were required.In well-timed auricular acupressure,auricular points included Xin(CO15),Pizhixia(AT4),Shenmen(TF4),Gan(CO12)and Pi(CO13).Acupressure with herbal seeds at those auricular points was applied at three time divisions,i.e.9:00 to 11:00,11:00 to 13:00 and 15:00 to 17:00 successively.The auricular acupressure with herbal seeds was given once every 3 days,the treatment for 1 week was 1 course and 4 courses were required.At the end of treatment and in 3 months of follow-up,the score of Hamilton depression scale-24(HAMD-24),syndrome score of traditional Chinese medicine(TCM),the score of Center for epidemiologic studies depression scale(CES-D)and the score of Short-form 36 item health survey(SF-36)were adopted to evaluate clinical therapeutic effect.ResultsAfter treatment and in three months of follow-up,HAMD-24 score,TCM syndrome score and CES-D score were all reduced as compared with the scores before treatment(all P<0.05)and SF-36 score was higher than the score before treatment,respectively(both P<0.05).In comparison of the scores after treatment with those in 3 months of follow-up,differences were not statistically significant(all P>0.05).Of 34 patients with subthreshold depression,8 cases were cured,15 cases effective remarkably,9 cases improved and 2 cases no effect.The total effective rate was 94.12%.ConclusionThe combined treatment of acupuncture therapy for soothing the liver and regulating the mind with the well-timed auricular acupressure can be benefit for relieving the symptoms and improves the quality of life in the patients with subthreshold depression of liver stagnation and spleen deficiency.

Controlled observation on the efficacy of acupuncture and western medicine on diarrhea-type irritable bowel syndrome

Objective To compare the difference in the therapeutic effects on diarrhea- type irritable bowel syndrome （D-IBS） between acupuncture based on soothing the liver and strengthening the spleen and western medicine. Methods Seventy cases were randomized into an acupuncture group and a western medicine group, 35 cases in each one. In the acupuncture group, the conventional acupuncture was applied at Tianshu {天枢 ST 25）, Zusanli （足三里 ST 36）, Shangjuxu {上巨虚 ST 37）, Sanyinjiao （三阴交 SP 6）, Taichong （太冲 LR 3） and so on. Electric stimulation was supplemented at bilateral ST 25. The treatment was given once a day, 3-4 treatments in a week. In the western medicine group, pinaverium bromide （dicetel） was prescribed for oral administration, 50 mg each time, three times a day. Four weeks made one session in the two groups. Separately, before treatment and after 1 session treatment, the integral of clinical symptom and the score in the scale of the quality of life measure for irritable bowel syndrome （IBS-Q OL） were observed for the patients in the two groups. The efficacy and recurrence rate were assessed in the two groups. Results The symptom integral and IBS-QOL score in the two groups were improved significantly after treatment Call P〈0.01）, and the improvements in the acupuncture group were superior to that in the western medicine group （P〈0.01）. The effective rate was 94.3% {33/35） in the acupuncture group, which was superior to 77.1% （27/35） in the western medicine group （P〈0.01）. In 3 months, the recurrence rate was 36.4% （12/33） in the acupuncture group, which was lower apparently than 72.0% （18/25） in the western medicine group （P〈O.01）. Conclusion Acupuncture therapy based on soothing the liver and strengthening the spleen achieves the superior efficacy on D-IBS as compared with western medication, pinaverium bromide. This therapy improves apparently the quality of life of the patients and is lower in recurrence rate.