雷火神针产生、发展及适应证探讨

考察明清时期的中医古籍文献及近现代文献,结合当时寒冷的自然环境及灸法发展的社会背景,梳理古代雷火神针疾病谱的变化及其在近现代的传承发展,探讨其适应证的改变。回顾中医古籍,发现与当时的自然及社会环境相适应,雷火神针适应证主要是病因病机为风寒湿侵袭、临床症状为疼痛的疾病,如鹤膝风、鸡脚风、脚气病等痹病,附骨疽及流注等外科病,杨梅疮及麻风等传染病。通过近现代文献梳理发现,雷火神针在演变过程中逐渐由实按灸变化为悬灸,药物组成及操作手法等亦发生改变,应用局限于原发性痛经、慢性胃炎、骨关节及软组织损伤等疾病,对于附骨疽、流注、杨梅疮及麻风等疾病应用较少。建议应临床进一步推广应用该治疗方法,并研究其起效机制。

Observation on therapeutic efficacy of thunder-fire moxibustion for hypomenorrhea after induced abortion

Objective:To observe the clinical efficacy of thunder-fire moxibustion for hypomenorrhea after induced abortion.Methods:A total of 74 patients with hypomenorrhea after induced abortion were randomized into two groups,with 37 cases in each group.The control group was treated with conventional hormone sequential therapy,and the observation group was treated with thunder-fire moxibustion.The course of treatment was 3 menstrual cycles.The traditional Chinese medicine(TCM)symptom scores,menstrual volume,endometrial thickness and the sex hormone levels were observed before and after treatment.The clinical efficacy was compared after treatment.Results:The total effective rate in the observation group and the control group was 91.4%and 73.5%,respectively,and the difference between the two groups was statistically significant(P<0.05).After treatment,the TCM symptom scores in both groups decreased significantly(all P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).The menstrual volume,endometrial thickness and each sex hormone level of the patients in both groups were significantly improved after treatment(all P<0.05),and the improvements in the observation group were more significant than those in the control group(all P<0.05).Conclusion:Thunder-fire moxibustion can significantly improve the clinical symptoms of patients with hypomenorrhea after induced abortion;it can increase menstrual volume and endometrial thickness,and regulate the sex hormone levels,producing a better curative effect than the conventional hormone sequential therapy.

改良雷火针联合温阳活血汤对慢性萎缩性胃炎患者中医证候积分、临床疗效的影响

目的对慢性萎缩性胃炎患者采取改良雷火针联合温阳活血汤治疗后的中医证候积分以及临床疗效展开分析。方法选择2017年10月至2018年9月本院82例确诊慢性萎缩性胃炎的患者,采用随机数字表法分组,对照组41例采取单纯温阳活血汤,研究组41例采取温阳活血汤+改良雷火针,比较两组治疗后中医证候积分以及临床疗效。结果观察中医证候积分以及病理积分,研究组分数均低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后疗效比较,研究组总有效率(97.6%)高于对照组(73.2%),差异有统计学意义(P<0.05)。结论对慢性萎缩性胃炎患者采取改良雷火针联合温阳活血汤治疗后不仅能够提高临床疗效,还能降低证候积分,应用效果显著。