中医综合法治疗腰椎间盘突出症足底热成像变化临床观察

目的:通过观察伴单侧下肢放射痛的腰椎间盘突出症患者在经中医综合法治疗前后足底红外热成像温度变化,结合临床疗效分析其温度变化的规律性。方法:选取符合标准的30例腰椎间盘突出症患者,运用红外热成像技术对其治疗前后患侧与健侧足底进行探测。结果:(1)治疗前患侧足底平均温度均值标准差(25.37±3.7℃),低于健侧足底平均温度均值标准差(25.74±3.69℃),差异具有统计学意义(P<0.05);(2)治疗前VAS评分(7.0±0.91)、腰椎JOA评分(13.2±1.98);治疗后VAS评分(2.6±0.69)JOA评分(23.4±2.38),差异均具有统计学意义(P<0.05、P<0.05);(3)治疗后患健侧足底温度差绝对值低于治疗前患健侧足底温差绝对值(秩和检验Z=-4.397,P=0.000),差异具有统计学意义(P<0.01)。结论:医用红外热成像技术对腰椎间盘突出症患者的诊断与疗效评估有一定的临床参考意义,可以通过提供客观数据,在一定程度上弥补传统主观疗效评分的不足。

中风后肩-手综合征的针药结合治疗进展

针药结合的结合方式不仅仅指传统的针刺结合中药的内服、熏洗,还包括针刺与西药的结合、穴位注射等。采用针药结合为主治疗肩-手综合征,具有双管齐下、相得益彰的优势,且操作方便、安全,副作用小,疗效肯定,易于患者接受。以针药结合为主的多种干预手段的综合疗法成为当前的研究热点并将成为未来的研究趋势。及时了解当前针药结合治疗肩-手综合征的进展情况,对于寻求肩-手综合征的最佳治疗方案大有裨益。

Study of the relationship between acupuncture dose and effect

Acupuncture dose-effect relationship is the essential feature of acupuncture and the key factor of acupuncture’s therapeutic effect.It is a comprehensive category,including needle direction,needle strength,needle depth,selection of specific techniques,length of time between acupuncture treatment sessions,length of needle retention time,and frequency of treatment,all of which play a decisive role in the curative effect and prognosis of diseases[1].

How to conduct an acupuncture dose–effect relationship study? A discussion based on study methodology

Acupuncture therapy is widely used in the clinic,and its therapeutic effects have been proven by numerous studies.The dose–effect relationship of acupuncture is a fundamental aspect of the acupuncture research system.Recent studies found that different acupuncture dosages altered study results directly,indicating the importance of screening the optimal stimulation dosage.However,the system for studying the acupuncture dose–effect relationship is still in its infancy,and the methodology of the system needs to be improved.This review aimed to define the factors impacting acupuncture“dosage”and“effect,”and to improve the methodological system for research on the dose–effect relationship of acupuncture.By summarizing the current findings of acupuncture dose–effect studies,we discussed the vital acupuncture parameters and methodological problems that influence the relationship between acupuncture dosage and its effects.These factors consist of specific influencing factors(acupoint selection,acupuncture manipulation parameters,de qi response)and nonspecific influencing factors(comparison selection,blinding procedure,patient expectancy).Our perspectives offer suggestions for the design of acupuncture dosage–effect trials.Further studies need to be conducted to establish the methodological system and provide systematic evidence of the acupuncture dose–effect relationship.

医用红外热成像技术在骨伤科中的应用进展

医用红外热成像技术是一种利用红外探测器感应人体体表红外热辐射并将之转变为电信号,再经计算机处理转换成平面温度彩色图像,直观的显示出体表温度分布状态的一种技术[1]。1956年美国外科医师首次运用红外扫描技术证实了乳腺癌皮肤温度要高于正常的部位,1961年英国医师拍摄了世界第一张乳腺癌的红外热线图,自此经过50余年的发展,红外热成像技术在医学的临床诊断上得到了广泛的发展与应用,成为医学影像诊断技术中的重要组成部分[2]。

A network pharmacological study to investigate the combination of LHQW-XYS in the treatment of COVID-19 olfactory impairment-associated

To explore the target of action of LHQW-XYS on the main components of COVID-19 olfactory impairment by using network pharmacological methods and try to reveal its mechanism of action in the treatment related to COVID-19 induced olfactory impairment,we used the TCMSP platform to obtain potential active ingredients through oral utilization and drug-like properties screening;the Swiss TargetPrediction platform to predict the targets of the active ingredients and construct a drug-ingredient-target network,and then obtained the gene targets of COVID-19 olfactory injury through GeneCards,OMIM,and TTD platforms to intersect the drug targets and disease genes to obtain common targets.The drug targets and disease genes were intersected to obtain common targets.STRING and Cytoscape 3.8.2 software were used to construct the target-disease gene PPI network,screen the key targets and core gene clusters,and analyze the key targets by GO and KEGG enrichment analyses with the help of the Metascape platform,and then map the screened core active ingredients and their targets into the pathway to construct the core active ingredients-targets-pathway network.The core active ingredient-target-pathway network was constructed,and finally,molecular docking was carried out.The results showed that there were 4669 potential targets,5609 disease targets,and 17 drug-disease cross-targets for the active ingredients of LHQW-XYS.The GO and KEGG enrichment analyses indicated that the mechanism of LHQW-XYS in the treatment of olfactory impairment in COVID-19 may be due to the regulation of related signaling pathways,such as Serotonergic synapse and Regulation of lipolysis in adipocytes.Molecular docking showed that six active components(quercetin,luteolin,kaempferol,7-methoxy-2-methylisoflavone,wogonin,medicarpin)and two key genes(PTGS2,PPARG)had good binding properties.In the end,we conclude that LHQW-XYS may act on Serotonergic synapse and Regulation of lipolysis in adipocyte pathways to achieve anti-COVID-19 olfactory impairment-associated effects.

Study on timing and dosage of acupuncture in stroke treatment

Objective： To summarize the timing-efficacy relationship and the dosage–efficacy relationship of acupuncture in stroke treatment. Method： Literature research was conducted for quantitative clinical studies of acupuncture in stroke treatment, with the entry point on the timing factor and dosage factor. A hierarchical analysis was performed on observing the time–efficacy relationship and the dosage–efficacy relationship before, during and after acupuncture. Results： Though the retrieved studies differ especially in such timing factors as needle retaining time, acupuncture interval and course, they share an agreement in the acupuncture intervention time point, acupuncture timing, specificity of acupoints and acupuncture manipulation. Conclusion： The optimal stimulation is the core of the research on the timing-efficacy relationship and the dosage–efficacy relationship of acupuncture and also the key to the clinical efficacy.

Effect of holistic stratification acupotomy on lower limb function,MMP1 and MMP13 in bursal fluid of patients with knee osteoarthritis:A randomized clinical trail

Objective:To observe the differences in clinical effect on knee osteoarthritis(KOA)between the holistic stratification acupotomy and the joint injection with sodium hyaluronate so as to provide a safe and effective treatment for KOA.Methods:A total of 100 KOA patients were randomly divided into an acupotomy group and a sodium hyaluronate group,50 patients in each one.In the acupotomy group,the holistic stratification acupotomy was adopted.In the sodium hyaluronate group,sodium hyaluronate injection was applied in the joints.The index of Western Ontario and McMaster University(WOMAC)and the expressions of MMP1 and MMP13 in bursal fluid of the patients were compared before and after treatment in the patients between two groups before and after treatment,and the clinical therapeutic effect was observed.Results:After treatment,WOMAC score of each dimension and the concentrations of MMP1 and MMP13 in bursal fluid of the patients of either group were all lower than those before treatment(all P<0.05).After treatment,WOMAC score of each dimension and the concentrations of MMP1 and MMP13 in bursal fluid in the acupotomy group were lower than the sodium hyaluronate group(all P<0.05).The total effective rate in the acupotomy group was higher than that of the sodium hyaluronate group(P<0.05).Conclusion:Both the holistic stratification acupotomy and the joint injection with sodium hyaluronate are effective on KOA in this trial.However,the therapeutic effect of holistic stratification acupotomy is remarkable,which is probably related to the improvements in inflammatory response.

The analgesic effect of electroacupuncture in complete Freund's adjuvant rats:a meta analysis

Pain is a global problem and has been found sensitive to acupuncture. A large number of existing and newly published studies have demonstrated the analgesic effect of electroacupuncture(EA) in complete Freund's adjuvant(CFA) rat model, necessitating a new and comprehensive review. To evaluate the curative effect of EA on thermal hyperalgesia in CFA rats, and to explore parameters that influence treatment effects, studies of EA treatment on thermal hyperalgesia of CFA rat model were identified from nine databases up to June 17, 2017. Outcome measure was heat pain threshold. All the data were analyzed using Stata 14.0/MP software. 26 studies identified included 801 rats. The quality score of the studies ranged from 3 to 6, with a mean of 4.08. The effect of EA group was improvement in outcome compared with CFA group. In subgroup analyses, frequency 2, 100, 2/100 or 20-100 Hz. acupoint Huántiào(环跳GB30),Kūnlún(昆仑 BL60) +Xuánzhōng(悬钟 GB39), Zúsānlī(足三里 ST36) +BL60 or ST36+Sānyīnjiāo(三阴交SP6), retention time 20 or 30 min, treatment time for post-CFA injection immediately, the same day as CFA injection, post-CFA injection 24 or 48 h and interval 24 or 48 h all can improve the effect on CFA rat heat pain threshold. These results show that there is positive effective of EA in CFA-induced pain,different parameters have different effects on EA treatment of CFA heat hyperalgesia, however, because of the number of eligible researches and the high risk of bias, the evidence supporting this conclusion is limited.