桥本甲减中医的研究进展

祖国医学认为桥本氏甲状腺炎合并甲减归属瘿病、虚劳,其引起因素包括情志内伤、饮食水土失衡以及先天体质,病机为本虚标实。以脾肾阳虚、肝失疏泄为本,血瘀、气滞、痰凝蕴结于颈部为标。治以标本兼治,扶正祛邪,活血化瘀,温肾健脾,疏肝理气,化痰散结以及清热解毒。

基于数据挖掘方法分析程为平教授治疗癫痫的用药经验

目的:通过应用中医传承辅助系统(V1.1)软件,分析程为平教授治疗癫痫病的用药经验。方法:收集程为平教授门诊接诊的癫痫患者病案,录入"中医传承辅助系统",采用该软件集成的规则分析、复杂系统熵聚类等数据挖掘方法,分析治疗癫痫的药物使用频次、对药的配伍、组方特点等,分析程为平教授治疗癫痫的用药经验。结果:程为平教授治疗癫痫时强调治病求本、标本兼顾,治疗以补脑益髓为主,辅以熄风、化痰、开郁、散结。程为平教授确认药物组合及处方补脑止痫散为其治疗癫痫的核心方剂。结论:程为平教授以补脑益髓法为基本治疗原则,选用首乌、石斛、天麻、僵蚕、全蝎、远志、甘松并辨病辨证相结合,治疗癫痫特点突出、用药准确。中医传承辅助系统分析结果结合专家本人校审与其临床辨证论治心得基本吻合,中医传承辅助系统对于挖掘名老中医临床经验具有重要实用价值。

佩连麻黄方治疗单纯性肥胖的临床研究

目的:观察佩连麻黄方治疗单纯性肥胖的临床疗效。方法:将90例诊断为单纯性肥胖的患者随机分为奥利司他组、中药治疗组、空白对照组各30例,空白对照组采用基础治疗,奥利司他组在对照组基础上给予奥利司他片口服,中药治疗组在对照组基础上给予佩连麻黄方,疗程12周。将三组患者治疗前后的体重、腰臀比值、BMI值、血脂进行统计学处理和分析。结果:治疗后三组体重、腰臀比、BMI均有下降,能有效减轻体重、腰臀比和体重指数(P<0.05);治疗后中药治疗组、奥利司他组降低体重、腰臀比、BMI的效果均优于空白对照组(P<0.05);治疗后中药治疗组与奥利司他组降低体重、腰臀比、BMI疗效相当(P>0.05)。与同组治疗前相比,中药治疗组治疗后TC、TG、LDL-C明显下降(P<0.01),奥利司他组与空白对照组TC、TG均下降(P<0.05),LDL-C下降不明显(P>0.05);治疗后,中药治疗组改善血脂的疗效优于其他两组(P<0.05)。结论:佩连麻黄方组治疗单纯性肥胖有较好的临床疗效,可明显改善患者体重、BMI、腰臀围比值、血脂。

佩连麻黄方对单纯性肥胖大鼠减肥作用的实验研究

目的:观察中药佩连麻黄方对单纯性肥胖大鼠的减肥作用,探讨其作用机制。方法:将60只雄性SD大鼠随机分为5组,正常对照组,模型对照组,高、中、低剂量佩连麻黄方组,采用喂饲高脂饲料复制单纯性肥胖模型,分组给药8周。分别测定大鼠体重、体长,计算Lee’s值,采用酶法测定血清总胆固醇(TC)、甘油三酯(TG),采用双抗体夹心酶联免疫法(ELISA)测定大鼠炎性细胞因子(TNF-α、IL-6、CRP)、脂多糖(LPS)水平,采用细菌培养法测定大鼠优势肠道菌群水平。结果:与模型对照组比较,中药高、中剂量组大鼠TG、TC、Lee’s指数明显降低(P<0.01);LPS、TNF-α、IL-6、CRP明显降低(P<0.01);乳酸杆菌属、拟杆菌属、双歧杆菌属、肠球菌属均显著增加,肠杆菌属显著减少(P<0.01)。结论:佩连麻黄方可能是通过调节大鼠肠道菌群分布,减少机体慢性炎症的发生,改善机体代谢紊乱而对单纯性肥胖大鼠起到有效的减肥作用。

活骨注射液对SANFH家兔BMP-2及VEGF表达的影响

目的:通过建立SANFH家兔模型,探讨活骨注射液髋关节注射治疗激素型股骨头坏死(steroidinduced avascular necrosis of femoral head,SANFH)中股骨头局部血管内皮生长因子(vascular endothelial growth factor,VEGF)及骨形态发生蛋白2(bone morphogenetic protein 2,BMP-2)表达的变化及意义。方法:选择健康成年雄性新西兰大白兔72只,空白组18只无特殊处置,其余家兔采用马血清加激素法造模。将造模成功家兔随机分为模型组、对照组与治疗组3组,每组18只。模型组家兔双侧髋关节每日给予生理盐水关节腔注射,对照组给予等量冠心宁关节腔注射治疗,治疗组给予等量活骨注射液双髋关节注射治疗。2、5、8周各处死6只新西兰大白兔,取双侧股骨头,免疫组化法检测BMP-2及VEGF的蛋白表达,RT-PCT法检测VEGF mRNA表达变化。结果:活骨注射液在SANFH治疗的过程中对BMP-2及VEGF的表达有影响(P<0.05),具有统计学意义。结论:活骨注射液在SANFH治疗2周后可使BMP-2及VEGF的表达上调,其中8周达到最佳疗效。

心通胶囊治疗不稳定型心绞痛的临床观察

目的观察心通胶囊治疗冠心病不稳定型心绞痛的临床疗效。方法将确诊为冠心病不稳定型心绞痛的患者60例随机分为治疗组和对照组各30例,治疗组口服心通胶囊治疗,对照组口服复方丹参片治疗。结果治疗组心绞痛疗效总有效率为90.00%,心电图疗效总有效率为86.67%,对照组心绞痛疗效总有效率为73.33%,心电图疗效总有效率为60.00%,两组比较有统计学意义(P<0.05)。结论心通胶囊治疗冠心病不稳定型心绞痛疗效优于复方丹参片。

Effects of pricking blood therapy at meridian sinews on upper limb spasm of post-stroke patients

Objective:To observe effects of pricking blood therapy at meridian sinews on upper limb spasm of poststroke patients.Methods:A total of 72 patients with post-stroke upper limb spasm were randomly divided into a comprehensive group of pricking blood therapy at meridian sinews with rehabilitation training(comprehensive group)and the simple rehabilitation training group(rehabilitation group),and there were 36 patients in each group.On the basis of routine therapy,the patients of the two groups received rehabilitation therapy for 6 consecutive days and 1-day rest,for 4 weeks in total.On the above basis,the patients in the comprehensive group received pricking blood therapy at meridian sinews,once every other day,3 times per week,for 4 weeks in total.Before treatment,after the first treatment,and after 4-week treatment,the patients were observed for changes of upper limb spasticity(Modified Ashworth Scale,MAS),upper limb movement function(Fugl-Meyer Assessment,FMA),activity of daily living(Modified Barthel Index,MBI),and biceps and triceps integrated electromyogram(IEMG)values were observed as well as the therapeutic effects.Results:(1)After the first treatment,there were statistically significant differences of the MAS scale grades in patients of the two groups(P<0.05).The FMA scores in the comprehensive group were increased than that before treatment(P<0.05),and the MBI scores of the two groups were increased than those before treatment(both P<0.05).The FMA and MBI scores in the comprehensive group were higher than those of the rehabilitation group(both P<0.05).The biceps and triceps IEMG values were not improved than those before treatment(all P>0.05).(2)After 4-week treatment,there were statistically significant differences of MAS grades in patients of the two groups(P<0.05).The FMA and MBI scores in the two groups were increased than those before treatment(all P<0.05),and the FMA and MBI scores in the comprehensive group were higher than those in the rehabilitation group(both P<0.05).Through comparison of the differences of FMA and MBI scores of the two groups,the difference values in the comprehensive group were higher than those of the rehabilitation group(both P<0.05).The biceps and triceps IEMG values in the two groups were decreased than those before treatment(all P<0.05),and those in the comprehensive group were lower than those in the rehabilitation group(both P<0.05).The biceps and triceps IEMG values in patients of the comprehensive group were higher than those before treatment(both P<0.05).(3)After 4-week treatment,the total effective rate in the comprehensive group was 83.3%(30/36),and that was 58.3%(21/36)in the rehabilitation group.The total effective rate in the comprehensive group was higher than that in the rehabilitation group(P<0.05).Conclusions:The pricking blood therapy at meridian sinews can release affected upper limb flexor muscle spasticity and movement function of the patients with post-stroke upper limb spasm,decrease biceps IEMG values of the affected side,and improve activities of daily living.

Clinical effect on knee osteoarthritis treated with Fu’s subcutaneous needling therapy

Objective:To observe and compare the clinical effect on knee osteoarthritis(KOA)between Fu’s subcutaneous needling therapy(FSN)and convention acupuncture.Methods:A total of 80 outpatients with KOA were divided into a FSN group(40 cases)and a conventional acupuncture group(40 cases)according to random number table.Within 1 week of treatment,FSN was used once every two days in the FSN group.The needle tip of Fu’s subcutaneous needle was inserted toward the affected muscle,about 5 mm in depth,at the angle of 15 to 25°.After the needle body lifted slightly,the needle went forward subcutaneously for 25 to 35 mm in depth and was swiped side to side horizontally with even exertion for about 1 min.According to the distribution of affected muscle,the reperfusion approach was repeated for 3 times consecutively.In the conventional acupuncture group conventional acupuncture was given,once a day,for 6 times totally.The scores of Western Ontario and McMaster universities osteoarthritis index(WOMAC)and Lysholm knee scoring scale(Lysholm)were compared between the two groups before and after 1-week treatment.The clinical effect of the two groups was analyzed statistically and evaluated.Results:After 1-week treatment with FSN,in the FSN group,the score of WOMACpain was reduced to be7.7±1.9 from 18.5±3.2,the score of WOMACstiffnessto be 1.5±0.7 from 4.5±1.8,WOMACfunction to be22.7±3.9 from 45.7±2.7 and the score of WOMACoverall to be 31.9±5.3 from 69.7±6.5.The differences were significant in comparison before and after treatment(all P<0.05).In the conventional acupuncture group,after 1-week treatment with conventional acupuncture,the score of WOMACpain was reduced to be11.3±2.8 from 18.2±3.0,the score of WOMACstiffness to be 3.0±1.6 from 5.6±1.7,WOMACfunction to be29.8±5.1 from 44.3±2.9 and the score of WOMACoverall to be 44.1±7.8 from 69.1±7.3.The differences were significant in comparison before and after treatment(all P<0.05).WOMAC score of every item in the FSN group was lower obviously than that in the conventional acupuncture group(P<0.01).After 1-week treatment,Lysholm score was increased to be 78.52±18.4 from 59.64±18.3 in the FSN group and it was to be 69.27±11.9 from 58.17±12.5 in the conventional acupuncture group.The differences were significant in comparison before and after treatment in either group(both P<0.05).Lysholm score in the FSN group was higher than that in the conventional acupuncture group(P<0.05).The total effective rate was 92.5%in the FSN group,higher than 77.5%in the conventional acupuncture group(P<0.05).Conclusion:Fu’s subcutaneous needling therapy effectively relieves the clinical symptoms of KOA and improves knee joint function.The therapeutic effect is better than that of the regular acupuncture.

Efficacy of catgut-embedding therapy at"five neck points"on cervical spondylotic arteriopathy and effects on hemodynamics:A randomized clinical trial

Objective:To observe the effect of catgut-embedding therapy at five neck points in the treatment of cervical spondylotic arteriopathy(CSA)and analyze its effects on the hemodynamics of patients with CSA.Methods:Using the computer randomization method,72 patients with CSA were divided into a catgutembedding therapy group(n=36,none dropped out)and a western medication group(n=36,none dropped out).In the catgut-embedding therapy group,the therapy was applied to five neck points,i.e.bilateral Jǐngjiājǐ(颈夹脊)at C5,bilateral Jǐngjiājǐ(颈夹脊)at C6,and Dàzhuī(大椎GV14)once a week.One3-week treatment session was required.In the western medication group,flunarizine hydrochloride 5 mg capsules were administered orally once daily for 3 weeks.Efficacy was assessed before and after 3 weeks treatment using a functional evaluation scale for cervical spondylotic arteriopathy(FS-CSA).Changes in vertebral-basilar arterial hemodynamics,serum nitric oxide(NO)level,and plasma endothelin(ET)level were detected.Results:Efficacy was assessed when the treatment session was completed.The total efficacy rate was significantly higher in the catgut-embedding therapy group(86.1%)than in the western medication group(61.1%;P<0.01).The after treatment FS-CSA score was reduced compared with baseline score in both groups(P<0.05),and the reduction in the catgut-embedding therapy group was superior to that in the Western medication group(P<0.05).Compared with baseline,the flow velocity and pulsatility index of the bilateral vertebral and basilar arteries increased at each period in both groups(P<0.05)except for the left systolic velocity of the vertebral artery after treatment.The increase in the catgut-embedding therapy group was greater than that in the western medication group(P<0.05).After treatment,the serum NO concentration was increased and the plasma ET concentration was reduced compared to baseline in both groups(P<0.05),while the improvements in the catgut-embedding therapy group were superior to those in the western medication group(P<0.05).Conclusion:The clinical efficacy in the catgut-embedding therapy group was superior to that in the western medication group.Catgut-embedding therapy at five neck points may effectively improve psychological and functional conditions,promote vertebral basilar arterial supply,and relieve clinical symptoms in patients with CSA.

Combination of acupuncture with rehabilitation training for pseudobulbar paralysis after stroke:A randomized controlled trial

Objective:To compare the clinical effects of needling at "five acupoints for swallow function" combined with rehabilitation training and only rehabilitation training in the treatment of dysphagia due to pseudobulbar paralysis after stroke.Methods:Seventy-six patients were randomized into rehabilitation group and combination group,with 38 cases in each.Both groups were treated with basic treatment of western medicine.The rehabilitation group was treated with routine rehabilitation training,and the combination group was treated with acupuncture at "five acupoints for swallow function" based on treatment in the rehabilitation group.Patients in the two groups were treated once a day,6 days a week,1 day for rest,for 3 weeks in succession.The changes in the grades and scores of water swallow test(WST),video fluoroscopic swallowing study(VFSS),and swallowing quality of life questionnaire(SWAL-QOL) in the two groups were observed before and after treatment,and the clinical effects of the two groups were compared.Results:After treatment,the WST grades of the two groups were statistically different from that of before treatment(both P<0.05),and the WST grade of the combination group was statistically different from that of the rehabilitation group(P<0.05).After treatment,the VFSS and SWAL-QOL scores of the two groups were increased in comparing with those of before treatment(all P <0.05),and the VFSS and SWAL-QOL scores of the combination group were higher than those of the rehabilitation group(both P <0.05).The total effective rate of the combination group was 92.1%(35/38),higher than 60.1%(23/38) of the rehabilitation group.Conclusion:The acupuncture combined with rehabilitation training for pseudobulbar paralysis after stroke is more effective than rehabilitation training only.The combination of the two can significantly relieve the dysphagia and improve the patients' quality of life.

Clinical observation on the effect of electroacupuncture treatment for chloasma in young and middle-aged women

Objective:To evaluate the clinical effect of electroacupuncture treatment for chloasma in young and middle-aged women.Methods:Sixty young and middle-aged female patients with chloasma were divided into treatment group(n=30)and control group(n=30)according to random number table.In the treatment group,the electroacupuncture was applied to the facial acupoints and"Vagus"in the cavity of concha in the ear.The selection of facial acupoints was relating to the running course of facial nerve trunk:Yifeng(翳风TE17),Shangguan(上关GB3)-Sizhukong(丝竹空TE 23)(Temporal branch),Xiaguan(下关ST7)-Sibai(四白ST2)(Zygomatic branch),Qianzheng(牵正Extra)-Quanliao(颧髎SI18)(Zygomatic branch),Jiache(颊车ST6)-Jiachengjiang(夹承浆Extra)(Buccal branch),Hegu(合谷LI 4).Electro-stimulation was adopted at"Vagus"in the cavity of concha in the ear(two distribution points of the vagus in the cavity of concha of each ear).The control group received conventional acupuncture(surrounding method of needling at the Ashi points in the facial lesion area and 15 acupoints which were selected in the highest frequency in the conventional acupuncture treatment).After 8 weeks of treatment,the clinical effects were compared.The total score of facial skin lesion,score of skin lesion color,score of lesion area,and effective rate of treatment for chloasma were used to evaluate the clinical effect of the two groups before and after treatment.Results:After treatment,the effective rate of the treatment group was 95.00%,that of the control group was 67.50%.The effect of the treatment group was better than that of the control group,and the difference was statistically signifiicant(x2=9.928,P=0.002).Before treatment,there was no difference in the area score,color score,and total score of skin lesions between the two groups(P>0.05).After treatment,the area score,color score,and total score of skin lesions in the treatment group were(1.05±0.64),(1.05±0.64),and(2.10±0.98)points respectively,while those in the control group were(1.38±0.63),(1.28±0.75),and(2.65±1.19)points respectively.The area score,color score,and total score of skin lesions in the treatment group were lower than those in the control group,with statistically significant differences(all P<0.05).Conclusion:electroacupuncture is more effective than conventional acupuncture in treating chloasma in young and middle-aged women.

Electroacupuncture for postpartum urinary retention:A randomized controlled study

Objective:To observe the clinical effect of electroacupuncture on postpartum urinary retention(PPUR)through a randomized controlled study.Methods:Seventy-two PPUR puerperae who met the inclusion criteria were divided into the observation group(electroacupuncture at Ciliao(次髎BL 32) and Zhongliao(中髎 BL 33) group) and the control group(sham acupuncture group) according to the random number table method,with 36 cases in each.Urine catheters were retained.After 3 days of treatment,the therapeutic effect of PPUR was compared between the two groups.Results:In the observation group,the first urination time was significantly earlier than that in the control group,the first urination volume was significantly more than that in the control group,the bladder residual urine volume was significantly less than that in the control group,and the urinary infection was significantly less than that in the control group,the differences were statistically significant(all P <0.001).Compared with the control group,there were statistically significant differences in catheter removal,independent urination,cured cases,effective cases,ineffective cases,and total effective cases in the observation group(all P <0.05).Conclusion:The therapeutic value of electroacupuncture at BL32 and BL33 for primiparae with PPUR is significantly obvious.This therapy is worthy of clinical promotion.

Electroacupuncture at facial acupoints combined with electrical stimulation on the auricular vagus nerve points for 60 cases of chloasma

Objective： To observe the clinical efficacy of electroacupuncture at facial acupoints combined with electrical stimulation on the auricular vagus nerve points for treatment of chloasma.Methods： Sixty patients with chloasma were selected. According to acupoint selection along facial nerve trunk initially created by professor Gao Wei-bin, Yifeng（翳风TE 17）, Shangguan（上关GB 3） Sizhukong（丝竹空 TE 23）,temporal branches, Xiaguan（下关 ST 7） Sibai（四白 ST 2）,zygomatic branches, Qianzheng（牵正）Quanliao（颧髎 SI 18）,zygomatic branches, Jiache（颊车 ST 6） Chengjiang（承浆 CV 24）,buccal branches, and Hegu（合谷 LI 4）. The auricular vagus nerve acupoints was added additionally（two distribution points in each cavity of auricular concha were selected）. Electroacupuncture was conducted for30 min/time, once a day, and 6 times/week. One day was free from treatment between 2 weeks. Treatment for 4 weeks was 1 course of treatment, and the effect was observed after 1 course.Results： Cured： 39 cases, markedly effective： 13 cases, effective： 6 cases, ineffective： 3 cases. The cure rate was 65%, and the total effective rate was up to 95.0%.Conclusion： The curative effect of electroacupuncture at facial acupoints combined with electrical stimulation on the auricular vagus nerve points for treatment of chloasma was satisfactory.

Electroacupuncture for postpartum sexual dysfunction with urinary incontinence:A prospective case series study

Objective:To observe the clinical therapeutic effect of electroacupuncture on postpartum sexual dysfunction associated with urinary incontinence.Methods:The prospective case-series study was adopted.A total of 36 patients with postpartum sexual dysfunction associated with urinary incontinence were included consecutively.Electroacupuncture was applied to Shènshū(肾俞BL23),Huìyáng(会阳BL35),Pángguāngshū(膀胱俞BL28),Shíqīzhuī(十七椎EX-B8),Cìliáo(次髎BL32),Zhōngliáo(中髎BL33),Qìhǎi(气海CV6),Guānyuán(关元CV4),Zhōngjí(中极CV3),Qūgǔ(曲骨CV2),Shuǐdào(水道ST28),Zǐgōng(子宫EX-CA1),ZXsānlǐ(足三里ST36) and Sānyīnjiāo(三阴交SP6),once daily,6 times a week.The treatment for 2 weeks was as one phase and it should be completed in one menstrual cycle.For the cases without menstrual cycle recovery,the treatment should be given for any two weeks in one menstrual cycle and for those with menstrual cycle recovery,the treatment should avoid the menstrual period.Totally,the treatment lasted for 3 menstrual cycles.Before and after treatment,the scores of postpartum female sexual dysfunction diagnostic scale(PFSDDS),sexual intercourse pain assessment scale(SIPAS) and pelvic floor muscle strength test(PFMST),as well as the results of urodynamic examination(UE) were observed before and after treatment in the patients.Results:After treatment,the scores of PFSDDS,SIPAS and PFMST were all increased as compared with those before treatment separately,presenting the statistical significance(all P <0.05).Regarding UE,after treatment,the maximum bladder capacity,detrusor pressure at maximum flow,maximum flow rate and maximal urethral closure pressure were increased and postvoiding residual urine volume was reduced obviously as compared with the values before treatment,respectively,indicating the statistical differences(all P <0.05).Conclusion:Electroacupuncture has the significant effect on postpartum sexual dysfunction associated with urinary incontinence.

Case for vaginal pain induced by multiple sclerosis

A female patient with vaginal pain induced by multiple sclerosis was treated by acupuncture.Her chief complaint:pricking vaginal pain during intercourse for 1 year.Electroacupuncture was applied to Shènshū(肾俞BL23),Huìyáng(会阳BL35),Cìliáo(次髎BL32)and Zhōngliáo(中髎BL33)on lumbosacral region.The disperse wave was adopted firstly,followed by the dense wave in stimulation.The stimulation intensity was determined by the patient’s tolerance.The needles were retained for 50 min totally.After 2-month treatment,the sexual function of the patient was recovered to be normal.The sexual activity was normal in 1-year follow-up and vaginal pain was not recurred.