Proposal of translation of commonly-used acupuncture and moxibustion terminology by Beijing University of Chinese Medicine

General Secretary Xi Jinping points out“traditional Chinese medicine(TCM)is a treasure of the Chinese nation.We must pro-tect,explore,develop and inherit it well.”According tothe latest in-formation,1 TCM has spread to 196 countries and regions around the world,indicating that it enjoys a good development abroad,especially the development of acupuncture and moxibustion.

Clinical Study on the Effect of Acupuncture and Moxibustion with the Method of Acupoints on the Treatment of Chronic Gastritis with Sleep Disorder

Objective:To explore the clinical effect of acupuncture and moxibustion with acupoints on the treatment of chronic gastritis with sleep disorders.Methods:Sixty patients with chronic gastritis and sleep disorders in our hospital from January 2018 to January 2019 were selected and recruited.These patients were divided into two groups,namely the control group and experimental group by using random number table method.Each group consisted of 30 cases.The control group was treated with conventional drugs,whereas the observation group was treated with acupuncture and moxibustion with acupoints on top of the treatment prescribed for the patients in control group.The TCM syndrome score,gastrin level,and sleep quality level were compared between the two groups.Results:After four weeks of treatment,the Traditional Chinese Medicine(TCM)symptom score,gastrin level,and Pittsburgh Sleep Quality Index(PSQI)score in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Acupuncture and moxibustion with acupoints can improve TCM symptom scores,reduce gastrin levels,and improve sleep quality in patients with chronic gastritis and sleep disorders.

Efficacy of suspended moxibustion in stroke rats is associated with a change in tail temperature

Suspended moxibustion-produced heat can transfer from the acupoint to other sites of the body. The suspended moxibustion should be terminated when clinical propagated sensation disappears, because this implies that the quantity of moxibustion is sufficient. We wanted to investigate if this phenomenon also occurs in experimental animals. In the present study, a rat model of stroke was established and treated with suspended moxibustion at Dazhui （DU14）for 60 minutes. Results showed that the increase in tail temperature began at 15 minutes after suspended moxibustion and decreased gradually at 40 minutes. In addition, neurological function was significantly improved in stroke rats with tail temperature increase following suspended moxibustion, and this effect was associated with significantly reduced tumor necrosis factor a and interleukin 113 mRNA. However, there was no significant difference between 40- and 60-minute suspended moxibustion. The findings indicate that elevated tail temperature began to decrease at 40 minutes after suspended moxibustion, and further suspended moxibustion was not useful in the recovery of stroke rats.

Acupuncture at Waiguan (TE5) influences activation/deactivation of functional brain areas in ischemic stroke patients and healthy people A functional MRI study

In the present study, 10 patients with ischemic stroke in the left hemisphere and six healthy controls were subjected to acupuncture at right Waiguan （TE5）. In ischemic stroke subjects, functional MRI showed enhanced activation in Broadmann areas 5, 6, 7, 18, 19, 24, 32, the hypothalamic inferior lobe, the mamiilary body, and the ventral posterolateral nucleus of the left hemisphere, and Broadmann areas 4, 6, 7, 18, 19 and 32 of the right hemisphere, but attenuated activation of Broadmann area 13, the hypothalamic inferior lobe, the posterior lobe of the tonsil of cerebellum, and the culmen of the anterior lobe of hypophysis, in the left hemisphere and Broadmann area 13 in the right hemisphere. In ischemic stroke subjects, a number of deactivated brain areas were enhanced, including Broadmann areas 6, 11,20, 22, 37, and 47, the culmen of the anterior lobe of hypophysis, alae lingulae cerebella, and the posterior lobe of the tonsil of cerebellum of the left hemisphere, and Broadmann areas 8, 37, 45 and 47, the culmen of the anterior lobe of hypophysis, pars tuberalis adenohypophyseos, inferior border of lentiform nucleus, lateral globus pallidus, inferior temporal gyrus, and the parahippocampal gyrus of the right hemisphere. These subjects also exhibited attenuation of a number of deactivated brain areas, including Broadmann area 7. These data suggest that acupuncture at Waiguan specifically alters brain function in regions associated with sensation, vision, and motion in ischemic stroke patients. By contrast, in normal individuals, acupuncture at Waiguan generally activates brain areas associated with insomnia and other functions.

Electroacupuncture at points Baliao and Huiyang (BL35) for post-stroke detrusor overactivity

Acupuncture is used extensively in China for the treatment of stroke and other neurological disorders. The National Institutes of Health recommends acupuncture as an adjunctive therapy for stroke recovery. This study included patients with post-stroke detrusor overactivity who were treated in the Department of Neurology, Fourth Hospital of Harbin Medical University, China. Subjects received either electroacupuncture or sham electroacupuncture at points Baliao [including bilateral Shangliao （BL31）, bilateral Ciliao （BL32）, bilateral Zhongliao （BL33）, and bilateral Xialiao （BL34）] and Huiyang （BL35）. Our results showed that electroacupuncture significantly improved cystometric capacity and bladder compliance, decreased detrusor leak point pressure, ameliorated lower urinary tract symptoms, and decreased the risk of upper urinary tract damage. These findings indicate that electroacupuncture at points Bafiao and Huiyang is an effective treatment for post-stroke detrusor overactivity.

中医适宜技术治疗脑卒中后偏瘫的循证临床实践指南

脑卒中是成年人死亡和残疾的主要原因之一。中医适宜技术在脑卒中后偏瘫的康复治疗中广泛应用,然而尚缺乏系统的、高质量的循证指南来指导这些实践。本指南根据《世界卫生组织指南制订手册》和《中西医结合诊疗指南制订手册》制定,遵循卫生保健实践指南的报告要求,并参照推荐分级的评估、制定与评价系统对证据质量及推荐强度进行分级。本指南组建了包括5个小组在内的跨学科工作团队,通过问卷、面对面专家会议和问题解构方法来选择指南中需要回答的关键临床问题。从25个关键问题中筛选出10个进行研究。基于系统评价的结果,考虑到证据的优缺点、干预成本、证据质量、患者偏好及价值观、多学科专家的反馈和共识,本指南提出了20条关于中医适宜技术在脑卒中后偏瘫康复治疗中应用的推荐意见。本指南主要面向中国各级医院和康复机构的医务工作者,专注于中医适宜技术在脑卒中后偏瘫康复治疗中的临床应用。

针灸治疗中风病的病例注册登记研究——数据元及定义

中风病防治一直是全球医学界关注的焦点,针灸治疗中风病的独特优势日益突出,《中国急性缺血性脑卒中指南2018》推荐急性脑梗死患者进行针刺治疗(Ⅱ级推荐,B级证据)。标准化、规范化临床研究数据可以保证临床研究的数据质量,为数据的整理和挖掘提供保障,病例注册登记属于真实世界研究,数据元素的一致性是保证计划实施、数据质量高效、临床研究证据可信的必备要素之一。因此,课题组基于国家重点研发计划课题“针灸治疗中风病的病例注册登记研究”制订了本课题的数据元及定义,以期优化针灸防治中风病临床研究范式。

基于外部和内部因素评价矩阵的圣彼得堡中医中心发展策略研究

目的:研究圣彼得堡中医中心发展中存在的问题,分析制约和影响其发展的内外部因素,为中医中心在俄罗斯的进一步良好发展提供一定的策略和建议。方法:通过环境因素评价矩阵的方法,分别使用外部因素评价(EFE)矩阵和内部因素评价(IFE)矩阵对影响圣彼得堡中医中心发展的重要制约因素进行定量评价分析,对海外中医中心的未来发展进行科学而系统的研究,利用SWOT模型并由此判断中医中心发展所处的阶段,从而选择适宜的发展策略。结果:利用EFE和IFE矩阵中计算出的力度值,通过SWOT模型运算可得,重心P坐标是(0.2,0.41),可知P位于第一象限,位于机会型策略区。结论:目前适合圣彼得堡中医中心发展的应选择开拓型策略中的机会型,进而提出相应对策与建议,以保障发展策略落实,推进中医中心在俄罗斯的健康长远发展。

麦粒灸配合头穴久留针对卒中恢复期非痴呆型认知障碍认知功能及血清标志物的影响

目的 观察五脏俞麦粒灸配合头穴久留针治疗脑卒中恢复期非痴呆型认知障碍的临床疗效及其对血清标志物超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、同型半胱氨酸(homocysteine, Hcy)的影响。方法 将78例脑卒中恢复期合并蒙特利尔认知评估量表(Montreal cognitive assessment, MoCA)评分为18~26分的患者随机分成治疗组40例和对照组38例。治疗组以五脏俞麦粒灸配合头穴久留针治疗,对照组采用单纯头穴久留针治疗。观察两组治疗前后MoCA评分及血清标志物各项指标(hs-CRP、Hcy水平)的变化情况。结果两组治疗后Mo CA评分较同组治疗前均显著提高,血清hs-CRP、Hcy水平均显著降低,差异均具有统计学意义(P<0.05)。治疗组治疗后Mo CA评分明显高于对照组,血清hs-CRP水平明显低于对照组,差异均具有统计学意义(P<0.05)。结论 五脏俞麦粒灸联合头穴久留针的综合疗法能改善脑卒中恢复期非痴呆型认知障碍患者的认知功能,有效降低血清Hcy、hs-CRP水平。

针灸治疗中风后遗症的临床研究进展

中风后遗症是指中风发生6个月以上,患者经过积极有效地治疗后,仍遗留某些不适症状或体征,统称为中风后遗症。针灸是中医外治法的重要组成部分,包括针刺、灸法、刺络放血、穴位贴敷、穴位埋针等多种治疗方法,在治疗中风后遗症方面具有独特优势。文章通过检索、梳理近些年关于针灸治疗中风后遗症的文献资料,探讨针灸对中风后遗症的可行性及有效性,期望为中风后遗症患者提供最佳治疗方案以及为临床治疗中风后遗症开拓新思路。

医针实物遗存的医学考古学解读--兼论中医对民族医学内容的影响

中医学与民族医学中普遍存在针刺法的治疗手段,不同地域与时段的考古发现中,医用针具逐渐增多,以已确认的医针遗存为参照,从医学考古学角度科学识别和深入解读民族医用针具成为可能。结合考古学研究方法、中医针灸学知识及民族医学的调查研究可以发现,民族医学文化中的医针形制存在一些地方性特色,这与当地的自然资源条件、医疗理念及民族间的文化交流脱不开干系。中医理论及中医九针体系对民族地域的医药文化构成了一定影响。民族医学的医针选用因病症的地域性而存在差异,中医九针体系则最终实现了不同医针功能与医疗技术的整合。该命题的设置与研究实施,有望使具有悠久历史的中医文化经典与学术信息为大众所知晓,从而共同推进中华传统医药文化的保护与弘扬。

以针康法为主的中医整合康复技术对脑卒中偏瘫肢体肌力、运动功能的干预效果分析

目的探讨以针康法为主的中医整合康复技术对脑卒中后偏瘫患者的干预效果及对患者肢体肌力、肢体运动功能的影响。方法将医院针灸科、康复科收治的脑卒中后偏瘫患者90例纳入研究,随机分为对照组与中医整合康复组,各45例。两组均给予脑卒中常规西药治疗,对照组在此基础上给予常规康复训练,中医整合康复组在常规治疗基础上给予针康法、易筋经联合推拿治疗,共治疗8周后判定疗效。比较两组的中医证候积分,比较治疗前后患者肢体肌力[徒手肌力检查(Manual muscle testing,MMT)]、肌张力[改良Ashworth分级标准(MAS)]、肢体运动功能[Fug-Meyer运动功能量表(Fugl-Meyer assessment scale,FMA)]、神经功能[美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)]及生活质量[脑卒中专用生活质量量表(Stroke Specific Quality of Life,SS-QOL)]。彩色多普勒超声测定颈总动脉收缩期最大流速(Peak systolic velocity,PSV)、舒张末期最低流速(End diastolic velocity,EDV)及阻力指数(Resistance index,RI)等脑血流动力学参数。结果两组治疗后半身不遂、偏身麻木、口舌歪斜、言语謇涩、步履不稳、气短乏力等中医证候积分及总积分均较治疗前显著降低(P<0.05),中医整合康复组显著低于对照组(P<0.05)。中医整合康复组的显效率(51.1%,23/45)和有效率(95.5%,43/45)均明显优于对照组[24.4%(11/45)和82.2%(37/45)],组间比较差异有统计学意义(P<0.05)。两组治疗后MMT、FAM、SS-QOL评分及PSV、EDV值均较治疗前显著升高(P<0.05),中医整合康复组显著高于对照组(P<0.05);两组治疗后MAS、NIHSS评分及RI值均较治疗前显著降低(P<0.05),中医整合康复组显著低于对照组(P<0.05)。结论以针康法为主的中医整合康复技术治疗脑卒中后偏瘫效果显著,能够明显增强患者肢体肌力,降低肌张力,改善患者的肢体运动功能和神经功能,提高患者生活质量。

中医综合疗法结合康复运动训练治疗脑卒中后肩痛的临床观察

目的观察一种操作简单、易于推广的中医综合治疗方法结合康复运动训练对治疗脑卒中后肩痛的临床疗效。方法收集2021年7月—2022年12月间上海交通大学医学院附属仁济医院浦南分院中医科收治的脑卒中肩痛患者共80例,随机分配入组,最终脱落剔除6例,观察组36例,对照组38例。观察组予针刺、中药熏蒸、拔罐的中医综合疗法结合常规康复运动训练治疗,对照组予常规康复运动训练治疗,疗程为4周。主要观察两组病例的肩关节被动关节活动度(PROM)、视觉模拟评分法(VAS)评分;次要观察两组病例的上肢Fugl-Meyer运动及日常生活活动能力(Barthel指数)。结果治疗后,两组的肩关节PROM、VAS评分、BI评分均较治疗前改善(P<0.01,P<0.05),两组Fugl-Meyer评分与治疗前比较,差异无统计学意义(P>0.05)。治疗后,观察组在后伸、外旋2个方向疗效均优于对照组(P<0.01,P<0.05),观察组VAS评分低于对照组(P<0.01);观察组Fugl-Meyer及BI评分与对照组比较,差异无统计学意义(P>0.05)。结论中医综合疗法结合康复运动训练对治疗脑卒中后肩痛确有疗效,且在止痛及后伸、外旋方向的肩关节活动方面疗效优于单用基础治疗方案治疗,因其操作简单,可应用于临床推广。

Effects of fuzhengbutu acupuncture-moxibustion therapy on walking function in the patients with post-stroke hemiplegia

Objective: To observe the effects of fuzhengbutu(strengthening antipathogenic qi and tonifying the earth)acupuncture-moxibustion therapy on walking function in the patients with post-stroke hemiplegia.Methods: A total of 57 patients with hemiplegia after ischemic stroke treated in our hospital from January2018 through to October 2018 were collected as the study objects. According to random number table,they were divided into a treatment group(29 cases) and a control group(28 cases). In the treatment group, the fuzhengbutu acupuncture-moxibustion therapy combined with rehabilitation treatment was adopted. In the control group, the rehabilitation treatment was given. The persistent walking time and pause time in PIERENSTEP gait measurable training and test system as well as the score of Berg balance scale(BBS) were compared between the two groups.Results: In the treatment group, the persistent walking time after treatment 1.47 ±0.28) s was shorter obviously versus before treatment(2.12 ± 0.38)s, indicating the significant difference(P<0.05). The pause time after treatment was not different obviously versus before treatment(P> 0.05). In the control group,the persistent walking time after treatment(1.88 ± 0.22) s was shorter obviously versus before treatment(2.18 ± 0.30)s, indicating the significant difference(P<0.05). The pause time after treatment was not different obviously versus before treatment(P> 0.05). Before treatment, the differences were not significant in the persistent walking time and pause duration in the patients of either group(P>0.05). After treatment, the persistent walking time in the treatment group was shorter obviously than the control group(P<0.05) and the difference in pause time was not significant between the two groups(P>0.05). Before treatment, there was no difference in BBS score between the two groups(P>0.05). In the treatment group, BBS score(42.79 ±2.78) after treatment was higher than(35.86 ±2.64) before treatment, indicating the significant difference(P<0.05). In the control group, BBS score(39.07 ±2.67) after treatment was higher than(35.86 ±2.64) before treatment, indicating the significant difference(P<0.05). In comparison of BBS score after treatment between the two groups, the score in the treatment group was higher than the control group, indicating the significant difference(P<0.05).Conclusion: Based on rehabilitation treatment, Fuzhengbutu acupuncture-moxibustion therapy effectively improves the walking function of the patients with hemiplegia after ischemic stroke.

针灸联合精细化体位管理治疗脑卒中后肩手综合征Ⅰ期患者的效果

目的探讨针灸联合精细化体位管理治疗脑卒中后肩手综合征Ⅰ期患者的效果。方法选取2021年7月至2023年1月于江西省人民医院康复医学科就诊的128例脑卒中后肩手综合征Ⅰ期患者为研究对象,按照随机数字表法分为对照组与观察组,每组各64例。对照组患者给予西药联合精细化体位管理治疗,观察组患者实施针灸联合精细化体位管理治疗,两组均治疗4周。比较两组患者的临床疗效、疼痛程度、上肢运动功能、生活自理能力。结果观察组的临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的Fugl-Meyer评测法(FMA)、关节活动度、改良巴氏指数(BI)、视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);治疗后,观察组的FMA[(59.44±5.82)分]、关节活动度[(90.35±13.14)°]、BI[(84.79±8.44)分]均高于对照组[(50.14±5.03)分、(80.52±11.97)°、(65.18±7.21)分],观察组的VAS评分[(1.14±0.22)分]低于对照组[(2.36±0.35)分],差异有统计学意义(P<0.05)。结论针灸联合精细化体位管理可有效缓解脑卒中后肩手综合征Ⅰ期患者患肢肿胀、疼痛症状,有利于提升患者的上肢运动功能,促进患者生活自理能力提升。

基于真实世界研究探讨针灸对不同OCSP分型缺血性脑卒中患者肢体功能的影响

目的:探讨真实世界视角下针灸综合疗法对不同牛津郡社区卒中项目(OCSP)分型的缺血性脑卒中患者肢体功能的改善程度效应规律及相关因素。方法:纳入2021年2月至2022年12月天津市科技计划项目所搭建的“临床研究数据管理平台”的针灸干预中风病队列构建研究数据库的病历数据。收集符合标准的病历数据进行数据处理和统计,评估针灸改善不同OCSP分型的缺血性脑卒中患者肢体功能的效应规律及相关因素。结果:经针灸疗法干预后缺血性脑卒中患者的残疾水平得到改善(Z=-15.764,P<0.001),针灸对不同OCSP分型患者肢体功能的疗效比较,差异有统计学意义(χ2=12.530,P=0.006),对后循环梗死患者效果更优;针灸次数对改良Runkin量表(mRS)评分改善程度差异无统计学意义(P>0.05);针灸介入时机对mRS评分改善程度差异有统计学意义(P<0.05),介入时机在≤7 d、8~14 d、15~28 d的患者相较于在≥29 d介入的患者肢体功能改善程度较高;入院残疾水平在针灸对患者mRS评分改善程度差异有统计学意义(P<0.05),中/重度-重度残疾患者接受针灸干预后肢体功能恢复的程度较高;不同年龄段在针灸对患者mRS评分改善程度差异有统计学意义(P<0.05),年龄≤70岁的患者中,接受针灸干预后肢体功能恢复的程度越高;患者首/复发情况对针灸疗法改善mRS评分差异无统计学意义(P>0.05);性别对针灸改善mRS评分差异无统计学意义(P>0.05)。结论:针灸对改善后循环梗死患者的肢体功能效果更优;针灸在急性期介入对降低残疾水平的效果较好;针灸对降低脑卒中后中/重度-重度残疾患者残疾水平的疗效较优;针灸干预后年龄段为≤70岁的患者肢体功能恢复情况较好;针灸次数、患者性别及首/复发情况对针灸疗效的影响无明显差异。

基于数据挖掘探讨针灸治疗卒中后丘脑痛的选穴规律

目的:基于数据挖掘探讨针灸治疗卒中后丘脑痛的选穴组方规律。方法:电子检索中国期刊全文数据库(CNKI)、万方数据知识服务平台(Wanfang)、维普资讯中文期刊服务平台(VIP)、中国生物医学文献数据库(SinoMed)和PubMed数据库中针灸治疗卒中后丘脑痛的文献,通过纳排标准对数据进行筛选。利用Microsoft Excel 2019建立数据库;应用SPSS 21.0软件、SPSS Modeler 18.0软件及Cytoscape3.9.1软件进行腧穴频次与归经、特定穴分析、关联规则分析及聚类分析。结果:共纳入34篇有效文献,提取针灸处方34条,涉及腧穴91个,总频次368次;使用频次最高的腧穴为曲池、三阴交;最常涉及的经脉为足少阳胆经、手少阳三焦经与手阳明大肠经;特定穴以交会穴、五腧穴与八脉交会穴使用最多;聚类分析获得7个有效聚类群;核心关联规则分3类:“曲池-环跳-肩髃-外关-风市”、醒脑开窍针刺法主穴和百会-曲鬓,置信度均≥90%、支持度均≥35%。结论:针灸治疗卒中后丘脑痛以水沟-内关-极泉-委中-三阴交为主穴,重视阳经、夹脊穴和郄穴的应用,同时结合头针及肢体腧穴,可取得更加满意的疗效。

基于Neo4j探究程红亮教授针灸治疗中风后吞咽障碍临床规律

目的基于Neo4j知识图谱技术探究程红亮教授针灸治疗中风后吞咽障碍临床规律。方法收集568份安徽中医药大学第二附属医院脑病五科2019年6月至2023年6月门诊的中风后吞咽障碍患者针灸诊疗记录,运用Neo4j 3.5.25图数据库生成证型总体关系图谱,基于Python 3.8.6进行频数统计分析,利用PHP 5.4程序代码进行腧穴关联规则分析,并在Neo4j中绘制腧穴关联规则知识图谱,运用Cypher语句查询目标证型关联度较高的关系并输出得到证型聚类知识图谱。结果共涉及中医证型7种,分布频率百分比≥20%的症状有18个,频率≥20%的腧穴有19个,腧穴归经分布次数较多的有任脉、足少阳胆经、经外奇穴、督脉、足阳明胃经、足太阴脾经。提升度较高的关联组合由以下腧穴组成:手三里、外关、曲池、阳陵泉、大钟、气海、血海等,得到证型聚类知识图谱。结论程红亮教授提出“咽为经脉之所聚”理论,认为针灸治疗中风后吞咽障碍当以“辨经论治”为核心,确立了以任、督二脉为主,结合不同经脉组穴的取穴思路。

温针灸联合低频电刺激治疗急性卒中后尿失禁的疗效观察及对尿动力学的影响

目的观察温针灸联合穴位低频电刺激治疗急性卒中后尿失禁的临床疗效及对患者尿动力学的影响。方法将收治的108例急性卒中后尿失禁患者按随机数字表法分为对照组和观察组,每组54例。对照组采用常规留置、间歇清洁、导尿、膀胱训练、药物及穴位低频电刺激治疗,观察组在对照组治疗基础上联合温针灸治疗。比较两组临床疗效和72 h排尿情况,观察治疗前和治疗后两组国际尿失禁咨询委员会问卷简表(International Consultation on Incontinence questionnaire-short form,ICIQ-SF)、生存质量(quality of life,QOL)和国际下尿路综合征症状(lower urinary tract symptoms,LUTS)的评分变化以及尿动力学指标水平的变化。结果观察组总有效率为98.1%,高于对照组的85.2%(P<0.05)。治疗后,两组72 h排尿情况、尿动力学指标、ICIQ-SF评分、QOL评分和LUTS评分均优于同组治疗前(P<0.05),且观察组上述观察指标结果均优于对照组(P<0.05)。结论在常规治疗基础上,温针灸联合穴位低频电刺激治疗急性卒中后尿失禁可提高临床疗效,改善患者尿动力学指标和尿失禁的情况。

贾红玲针灸治疗缺血性脑卒中经验探讨

对贾红玲教授针灸治疗缺血性脑卒中的经验进行总结。从针灸疗法、放血拔罐疗法、脐疗法、自我按摩四个方面进行分析。贾红玲教授善于从整体观念出发,将针灸疗法与放血拔罐疗法、脐疗法、自我按摩相结合,强调辨证论治,补泻兼施,标本兼治,治则为疏经活血,调神导气,温补脾肾。该方案可有效改善肢体运动、感觉功能,并能提高患者生活质量。