Objective:To explore the clinical effect of filiform needle acupuncture combined with Epley otolith reduction method on benign paroxysmal positional vertigo（BPPV）. Methods:Totally 107 BPPV patients admitted to the hospital from May 2021 to May 2022 were included. They were randomly divided into control group（56 cases） and observation group（51 cases）. The control group was treated with Epley otolith reduction method. The observation group was treated with filiform acupuncture on the basis of control group. The clinical effect was observed at the second week, and the balance function and quality of life was compared between the two groups before treatment, at the first day, the first week and the second week of treatment. Results:After 2weeks of treatment, the observation group showed better clinical efficacy than control group（P ＜0.05）. The observation group showed shorter average treatment time than control group（P＜0.05）. There was an upward trend in BBS scores in the two groups at the first day, the first week and the second week of treatment（P＜0.05）.There was no statistical significant difference in BBS scores in the two groups before and after treatment（P＞0.05）. The observation group showed higher BBS score than control group at the first and second week of treatment（P＜0.05）. There was a downward trend in scores of emotion, function and body in DHI of the two groups at the first day, the first week and the second week of treatment（P ＜0.05）. There was no statistical significant difference in DHI scores of the two groups before treatment and at the first day of treatment（P＞0.05）.The observation group showed lower scores of emotion, function and body in DHI than control group（P＜0.05）.Conclusion:Filiform needle acupuncture combined with Epley otolith reduction method is effective in the treatment of BPPV, which can effectively shorten treatment time, improve the patients’ balance ability and improve their quality of life.

清代医家陈士铎对耳鸣病症见解独到,他认为耳鸣的病因有心肾不交、胆气不舒致风火侵袭、肝胆气郁、肝血虚损及阳虚.根据阴阳、气血相互转化、脏腑相关关系,结合耳鸣的病因病机,提出交通心肾、舒发肝胆、疏肝健脾、补益气血、补阳滋阴等治疗方法,自拟两归汤、润胆汤、开郁至神汤、缓中汤、发阳通阴汤等方药,组方用药层层深入,方药精湛.根据相关医案可知,陈士铎诊治耳鸣病症的思维依然运用在当代临床实践中.

整理《针灸大成》中关于风池穴的相关记载,总结其定位、刺灸法及临床应用规律.风池穴操作手法以针刺为主,施以不同的补泻手法,部分病证应用灸法.治疗的病症主要包括头面五官病症、颈项腰背部病症、精神神志病症、外感病、中风等.将《针灸大成》中风池穴的应用进行总结,能够为现代临床应用提供文献支持,拓宽现代临床的治疗思路.

目的 观察芎芷地龙汤联合局部电针刺激疗法治疗偏头痛的临床疗效.方法 选择74例偏头痛患者按照随机数表法分为观察组与对照组,各37例.对照组进行常规药物西比灵预防性治疗,观察组以芎芷地龙汤联合局部电针刺激疗法为主.比较2组临床疗效、疼痛情况及中医证候评分.结果 与对照组相比,观察组临床疗效优于对照组(P<0.05);治疗后观察组VAS评分低于对照组,疼痛持续时间短于对照组,疼痛发作频率低于对照组,观察组的各证候评分均低于对照组(P<0.05).结论 采用芎芷地龙汤联合局部电针刺激疗法治疗偏头痛疗效确切.

目的:探讨超声引导下肩胛上神经阻滞结合针刀治疗肩袖钙化性肌腱炎的临床疗效.方法:对我院收治有症状的42例肩袖钙化性肌腱炎患者行肌骨超声、MRI及三维CT检查,明确病灶部位及钙化病灶范围,在超声引导下行肩胛上神经阻滞并对钙化病灶进行针刀治疗.采用视觉模拟评分(VAS)、Constant-Murley肩关节功能评分(CMS)、美国肩肘外科协会评分系统(ASES)肩关节评分评价治疗后1个月、3个月、末次随访时患者疼痛缓解情况、肩关节功能恢复情况及X线片影像学变化.结果:所有患者均获得随访,平均随访时间(13.65±2.07)个月,患者临床症状均得到明显缓解,肩关节疼痛及活动功能均明显改善,随访效果良好.治疗后1个月、3个月及末次随访时的VAS评分均低于治疗前,ASES评分均高于治疗前,且末次随访时的VAS评分＜治疗后3个月＜治疗后1个月,末次随访时的ASES评分＞治疗后3个月＞治疗后1个月,差异均有统计学意义(P＜0.05).治疗后1个月、3个月及末次随访时的CMS评分均高于治疗前,且随访时间越长,患者疼痛、日常活动功能、肩关节活动度、肌力及CMS总分越高,差异均有统计学意义(P＜0.05).结论:肌骨超声对肌腱组织钙化病灶分辨率较高,声像图特征明显,在超声引导下行肩胛上神经阻滞结合针刀治疗肩袖钙化性肌腱炎的效果确切,可缓解患者临床症状,促进患者肩关节活动功能恢复.

"证"是疾病阶段性的病理全貌;"症"是症状,是辨证的依据.基于"证"与"症"的特点,将其二者关系用哲学范畴中整体与部分的关系来阐述,整体之"证"和部分之"症"既相互关联,又存在相对独立性.文中通过引用《伤寒论》中关于吴茱萸汤的四段论述,中医内科学常见外感病感冒的辨证分析,以及针灸治疗失眠的随证选穴和随症选穴来加以论述.

五脏辨证理论在癃闭的发生与发展过程中起着重要的作用.肾阳不足、肝失疏泄、脾运失司、心火炽盛、肺失肃降均可导致水道不行,小便点滴,发为癃闭.分析五脏辨证与癃闭的关系,从五脏辨治癃闭.膀肾表里,气化失司,水液不能下输,发为癃闭;治以温肾化气、通利膀胱,方选金匮肾气丸加减.肺失肃降,津液不布,水道不利,癃闭乃生;治以宣降肺气、布散津液,方选补肺汤加减.肝失疏泄,气机不畅,水液代谢失常,从而发为癃闭;治以调达肝气、疏通水道,方选一贯煎加减.脾运失司,水液失常,导致癃闭;治以健脾益胃、化湿利水,方选补中益气汤加减.心火炽盛,熏灼水液,水液不能趋下,从而发生癃闭;治以清心利水、泻小肠热,方选导赤散加减.临证结合症状,辨病与辨证相结合,配伍相应的专病专药,以提高中医药治疗癃闭的临床疗效.

本文探讨了高频彩色多普勒超声在膝关节滑膜炎早期诊断及针刺疗效评估中的应用价值.86例膝关节滑膜炎患者均给予高频彩色多普勒超声检查,观察患者膝关节滑膜、关节腔积液及关节软骨的超声表现.针刺治疗2周、4周后复查高频超声,比较患者治疗前后膝关节滑膜厚度、关节腔积液改善情况、视觉模拟疼痛(VAS)、Lysholm膝关节康复量表(LKSS)评分.结果 显示,膝关节滑膜炎患者均存在不同程度的滑膜增厚、关节腔积液及软骨病变.治疗2周后,患者膝关节滑膜厚度、关节腔积液及VAS评分均低于治疗前,LKSS评分高于治疗前,且治疗4周后上述指标均优于治疗2周后,差异均有统计学意义(P＜0.05).结果 表明,高频彩色多普勒超声可清晰显示膝关节滑膜增厚、关节腔积液及关节间软骨病变等病变类型,对膝关节滑膜炎的早期诊断及针刺疗效评估均具有重要临床价值.

From the foramen ovale, maxillary fissure anatomy, and acupuncture methods, precautions, etc., this article introduced the acupuncture treatment of trigeminal neuralgia according to the mandibular nerve and maxillary nerve cranial anatomy structure, i.e. oramen ovale sting method and maxillary fissure sting method. Its clinical application involves nerve positioning accuracy, requires consistent acupuncture and nerve distribution affected areas.

灸法用于“治未病”历史由来已久,其发展经历了萌芽-发展-批判-总结的过程.春秋战国时期开始萌发灸法保健,到唐代明确提出,宋元时期是其主要发展时期,其发展既包括理论的深入也包括治法的完善.可以说宋元时期是灸法“治未病”发展的鼎盛时期,随后到了明代,由于灸法“治未病”的滥用开始出现质疑,并在质疑中总结.在演变过程中,积累了大量的经验,但资料分散不易研究.本文按历史发展顺序为脉络对灸法“治未病”的几部重要文献进行了梳理分析.

自20世纪50年代日本首次发现穴位表面皮肤具有低电阻特异性以来,穴位电阻特性研究就引起了国内外学者的广泛关注.穴位电阻特异性作为电学特性的一部分,是经穴反应特异性研究常用的客观指标.但笔者查阅文献发现,目前对于穴位电阻特异性的认识并不一致,涉及的疾病、穴位及临床治疗方法也较多,而且临床试验中采用的仪器也没有统一标准.因此笔者以“穴位电阻”为关键词,通过对中国期刊网全文数据库(CNKI)、万方数据库、维普数据库及英文数据库PubMed自2012-2017年关于穴位电阻特异性研究的相关期刊文献进行检索,获得文献40篇,剔除重复、非临床试验研究后,得出密切相关文献21篇.笔者对以上文献从经穴电阻特异性表现、应用疾病、涉及的穴位及测试仪器、结合的临床治疗方法等方面进行归纳总结,以便为今后相关研究提供理论支持.

便秘的困扰成为很多人的"难言之隐".为了去解决这个"难言之隐",不少人放弃美食,不敢多吃东西.但吃得越少,则粪便越少,大肠内压力越小,便秘就会越发严重.

目的:观察足太阳膀胱经、足少阳胆经特定穴、非特定穴、非经非穴皮肤电阻在腰椎间盘突出症患者中的表现,探寻哪些穴位可以特异性地反应腰椎间盘突出症.方法:本研究在北京中医药大学第三附属医院针灸科门诊进行,招募腰椎间盘突出症患者78例(膀胱经组38例和胆经组40例)、正常受试者36例.选取膀胱经的特定穴包括原穴京骨、郄穴金门、络穴飞扬、下合穴及合穴委中,胆经的特定穴包括原穴丘墟、络穴光明、郄穴外丘、下合穴及合穴阳陵泉,非特定穴包括膀胱经的秩边、胆经的风市,以及非经非穴,连续动态探测3组受试者的皮肤电阻30 min,以同名穴位电阻差值作为结局指标.结果:膀胱经组委中穴的左右两侧同名穴位电阻差值有显著性差异(P＜0.01),其他穴位无明显差异(P＞0.05).结论:初步推测膀胱经的下合穴及合穴委中可能是腰椎间盘突出症的1个反应点.

Objective:To explore the clinical application rules of special acupoints by studying the related literature in the past five years using randomized controlled trial(RCT).Methods:" The specific points" was regarded as the theme or keywords to retrieval the related literature published from January 2010 to December 2015 from China Journal Full-text Database (CNKI),Wan Fang and the VIP database.Results:Through computer retrieval of commonly used Chinese databases,1072 documents were obtained.After reading articles and manually excluding documents that did not meet the inclusion criteria,a total of 39 documents which met the requirements were included in the data mining scope,among them,21 kinds of diseases were involved,and the total frequency of occurrence of all diseases was 39 times,and the frequency of migraine was the highest.A total of 53 acupuncture acupoints were retrieved;According to the frequency of appearance,there were 241,of which 204 were specific points;The following appeared more than 10 times:Yanglingquan (SP 9),Zusanli (ST 36),,Waiguan (TE 5),Qiuxu (GB 40),Fengchi (GB 20) for 14 times.Among the 39 articles,if not counting the frequency of occurrence,there were 53 acupoints which once appeared,all the specific acupoints of other categories appeared except the meridian points of the five Shu points with the highest proportion of acupints.From the retrieved literature summary,application method of specific points from high to low in order were as follows:25 articles on acupuncture,6 articles on moxibustion,and 2 articles on electro-acupuncture,2 articles acupoint injection,,2 articles on catgut embedding,1 article on massage,and 1 on infrared radiation.According to the site distribution,among53 specific points,11 were in lower limbs;21 were in upper limbs;8 were in back and waist;7 were in head and neck,5 were in chest and abdomen,and 1 was in sacrococcygeal.Conclusion:Specific acupoints are mainly used to treat meridian disease and visceral disease;The clinical application of specific points are mainly distributed in the limbs,using specific acupoints in five Shu acupoints is of the highest rate;Acupuncture and moxibustion are mostly used in clinical practice.

腰椎间盘突出症在我国成年人中有8%~25%的患病率 [1] ,青年人患病率有快速增长趋势,多因运动量小、长期坐姿不良,或长期不运动、不接受紫外线照射而产生骨质疏松所致。病情严重时,腰痛剧烈甚至不能活动,并可伴有下肢麻痹、发凉、无力、间歇性跛行,甚至肌肉萎缩及神经功能障碍等,具有发病率高和反复发作、

针刺治疗下肢动脉硬化闭塞症从脏腑辨证归肾、脾两脏,本在肾,肾阳虚衰,标在脾,脾阳虚弱,运化水湿无力,久致痰湿瘀阻治病.为探讨针刺治疗下肢动脉硬化闭塞症取穴规律,笔者利用CNKI数据库,以针刺和下肢动脉硬化闭塞症为关键词,检索文献里有穴位记录的有效文献共18篇.将文献中的穴位按照辨证分型归纳总结,将本病的治疗方法大致分为温阳通络法、活血化瘀法、健脾利湿法三大类.温阳通络法取穴以任脉、足少阴肾经、足阳明胃经穴位为主;活血化瘀法以行气活血为原则,取穴以多气多血的足阳明胃经、主藏血之肝经,化生气血之脾经为主;健脾利湿法取穴方法多以足阳明胃经、足太阴脾经之健脾利湿的穴位为主.

目的:观察通腑理气方保留灌肠治疗恶性肠梗阻的临床疗效.方法:将确诊入选的恶性肠梗阻患者随机分为两组,在常规治疗的基.础上,对照组予等体积甘油灌肠剂保留灌肠,治疗组加通腑理气方保留灌肠,两组均连续治疗6d.观察两组患者临床疗效.结果:观察组临床疗效优于对照组;治疗组治疗后4d生存质量即有改善,7d后效果更为明显,差异有统计学意义(P＜0.01).与对照组相比,7d后的效果有显著统计学差异(P＜0.05).结论:通腑理气中药保留灌肠能提高恶性肠梗阻患者疗效和生存质量.

Objective To investigate clinical effects of Deanxit in non-erosive gastroesophageal re-flux disease ( NERD) with anxiety and depression.Methods A total of 76 patients diagnosed NERD with anxiety and depression by endoscopy and hospital anxiety and depression scale ( HAD) were randomly divid-ed into regular treatment group and Deanxit treatment group.Clinical efficacy, symptom score, and anxiety and depression score were observed after one week, four weeks, and eight weeks.Results Deanxit signifi-cantly increased the clinical efficacy after one week ( P <0.01) and remission rate after one week ( P <0.05), four and eight weeks ( P <0.01).It improved symptoms, depression, and anxiety, which showed significant differences ( P <0.01) compared to control group after one week, four and eight weeks adminis-tration.Conclusions Deanxit can be applied in NERD with anxiety and depression treatment, which has quick effect and high remission rate, and improve patient's reflux symptoms and anxiety depression.

辛开苦降法调理脾胃不和证,首先,助脾胃所宜,通其气机为要,使脾升胃降,互相交通.辛味之药助脾气升以润胃,苦味之品助胃气降而燥湿醒脾.辛开苦降,脾胃沟通,互惠互利.其次,采用抑其强、扶其弱的原则,使脾胃之体,强弱均衡.虚则补之,实则泻之,动者制其旺,静者助其动.胃阳热有余,热者寒之,予寒清以制热.脾气虚弱,甘入中土,予甘以补脾之体,健脾之气.温以助阳,助脾以动,运化水谷.最后,顺其所喜,甘寒养阴以润胃体防燥,苦温燥化以助脾防湿困.

目的：观察针刺风池穴对RAMP1和5－HT1B受体的作用，探讨风池穴对偏头痛CGRP和5－HT信号的可能影响。方法：采用免疫组化的方法，观察了针刺风池穴对偏头痛模型大鼠脑膜中动脉RAMP1和5－HT1B受体的影响。结果：电刺激大鼠硬脑膜可引起脑膜中动脉RAMP1增多、5－TH1B受体减少，无论是在造模前针刺风池穴还是在造模后针刺风池穴，RAMP1表达显著减少，而对5－TH1B受体并没有显著影响。结论：在偏头痛发作期，存在着CGRP作用的激活和5－TH作用的抑制，针刺风池穴显然能影响偏头痛发作过程中的血管反应，而其主要作用可能是通过CGRP途径实现的。