餐后不适综合征(postprandial distress syndrome,PDS)是功能性消化不良(functional dyspepsia,FD)的亚型之一,以早饱、餐后饱胀不适、食欲不振、嗳气等不适为主要症状,无法用器质性、系统性或代谢性疾病等解释其产生症状的原因[1].FD的全球患病率为10％～30％[2],PDS的发病率约占FD的58％[3].目前,PDS的现代医学发病机制尚未阐明,一般认为本病发生与精神心理因素、胃肠功能紊乱、幽门螺旋杆菌感染等多种因素相关.西医临床多以促胃肠动力药、质子泵抑制剂、抗感染、保护胃黏膜药物等治疗,但疗效不理想,容易复发.中医学认为FD属于"胃痞"范畴[4],因感受外邪、饮食不节、情志失调等导致.振腹疗法是在腹部施以振法为主的操作手法,对元气的生发、充养、输布起促进作用,用以治疗内、外、妇、儿等多种疾病[5].现举振腹疗法治疗PDS验案1则.

目的:观察推拿对运动性疲劳(EF)大鼠外周血炎症介质和外周血单个核细胞(PBMCs)凋亡与亚型平衡的影响,探索推拿改善运动性免疫炎性损伤的机制.方法:选取Wistar大鼠 30 只,随机将 6 只作为空白组,其余运用跑台运动法进行造模,将 16 只成模大鼠随机分为模型组及推拿组,每组 8 只.空白组不进行任何处理,模型组每日力竭运动后于笼中休息,推拿组每日力竭运动后予以推拿干预 1 次,共干预21 d.取材后,运用酶联免疫吸附试验(ELISA)法测定外周血白细胞介素-1 β(IL-1 β)与肿瘤坏死因子-α(TNF-α)含量,流式细胞术测定PBMCs凋亡情况及Th1/Th2,Th17/Treg亚型分布情况.结果:与空白组比较,模型组大鼠外周血中IL-1 β和TNF-α的含量显著升高(均P＜0.01);与模型组比较,推拿组外周血中IL-1 β和TNF-α含量显著下调(均P＜0.01).与空白组比较,模型组大鼠PBMCs凋亡率显著上升(P＜0.01);与模型组比较,推拿组大鼠PBMCs凋亡率显著下降(P＜0.05).与空白组比较,模型组大鼠PBMCs中Th1 和Th17 细胞增多,Th2 和调节性T(Treg)细胞减少,出现Th1 和Th17 漂移,Th1/Th2 及Th17/Treg细胞比例均显著上调(均P＜0.01);与模型组比较,推拿组大鼠PBMCs中Th1/Th2 及Th17/Treg细胞比例均显著下调(P＜0.01,P＜0.05).结论:推拿改善了EF大鼠外周血的免疫炎性状态,体现出抗炎、抗凋亡及免疫调节的手法效应.

Background: Major depressive disorder (MDD) is a highly prevalent and complex psychiatric disease concomitant with severe impairment in social functioning. Abdominal massage therapy (AMT), also known as Zhenfu (ZF), is an ancient and effective form of complementary and alternative medicine in China. Applied to the patient's abdomen, the fundamental technique of AMT uses rapid vibrations created by the hand which can be used to treat multiple diseases. This study aims to evaluate the antidepressant effects of AMT.Methods: In this study, 30 rats were randomly divided into three groups: the control group, the model group, and the abdominal massage therapy group. We first established a rat model of chronic unpredictable mild stress (CUMS) and observed the changes in depression-like behaviors. Then, Tandem Mass Tags (TMT)-based quantitative proteomics analysis was conducted to investigate the differentially expressed proteins in the hippocampus between CUMS and AMT rats to excavate potential antidepressant protein targets. Finally, we validated molecules of interest and detected proteins using parallel reaction monitoring (PRM) to further determine the related mechanisms. The expression of p11/Anxa2/Ahnak in the hippocampus was also measured by western blot and immunohistochemistry analysis.Results: Our study revealed the presence of depression-like behaviors in rats subjected to CUMS. In the TMT proteomic analysis, 78 differentially expressed proteins were identified: 55 were upregulated and 23 were downregulated. Functional analysis revealed that these proteins participate in Acute myeloid leukemia, the Toll-like receptor signaling pathway, Glycolysis/Gluconeogenesis, interleukin 17 (IL-17) signaling pathway and Metabolism of xenobiotics by cytochrome P450. Further independent analysis using PRM revealed that identified changes in Acss1, Tagln2, Serpina6, Cmbl, Serpinh1, Ampd3, Gstm7, Anxa2, AABR07034632.1, Apoa1, Ahnak that were distinctly correlated to CUMS and AMT groups. The expression of p11/Anxa2/Ahnak in the hippocampus was significantly downregulated in the CUMS rats (p < 0.01, p < 0.01, p < 0.01). AMT could significantly normalize these alternations with evident curative effects (p < 0.01, p < 0.01, p < 0.01). Conclusions: In summary, the current study explored the antidepressant-like effects of AMT in rats subjected to 21 consecutive days of CUMS. The results of TMT proteomic analysis demonstrated that AMT could ameliorate the symptoms of depression by modulating multiple molecular targets. Our results also provide new insights to further explore alternative therapeutic approaches for the treatment of depression.

目的:探讨振腹手法对抑郁症大鼠模型骨骼肌组织炎症损伤的干预作用.方法:将32 只大鼠随机抽取 8 只作为正常组,其余大鼠进行3 周的慢性不可预见性温和应激方法(CUMS)造模并随机分为模型组、振腹组和氟西汀组,干预4 周,在第7 周末完成行为学检测,取大鼠骨骼肌组织样本分别检测白细胞介素-1β(IL-1 β)、IL-4、IL-6、IL-8、IL-10、肿瘤坏死因子-α(TNF-α)的含量,沉默信息调节因子 1(SIRT1)、过氧化物酶体增殖物激活受体γ辅激活物-1α(PCG-1 α)、核因子κB(NF-κB)的蛋白及信使核糖核酸(mRNA)含量.结果:第 7 周末,与模型组大鼠比较,振腹组大鼠的糖水偏好率、绝望时间、总移动距离、穿格次数均显著改善(P＜0.01).第7 周末,与模型组大鼠比较,振腹组大鼠的IL-4、IL-10 显著升高(P＜0.01),IL-1β、IL-6、IL-8、TNF-α含量显著降低(P＜0.01);核因子κB蛋白含量下降(P＜0.05),mRNA含量显著下降(P＜0.01);SIRT1 蛋白含量、mRNA含量显著升高(P＜0.01);PGC-1α蛋白含量升高(P＜0.05),mRNA含量显著升高(P＜0.01).结论:振腹推拿手法可以改善抑郁症模型大鼠的抑郁症状,其作用机制可能是抑制骨骼肌组织核因子κB蛋白的表达,促进SIRT1、PGC-1 α蛋白的表达,从而增加抑炎因子的含量,减少炎症介质的含量.

Objective To investigate the effects of finger vibration on ST36 and BL57 on energy metabolism in rats with exercise fatigue.Methods A total of 45 10-week old healthy male Wistar rats, which were good at exercise, were divided into blank group, model group and finger vibration group according to random number table method, and each group was 15. For the model group and finger vibration group, a treadmill was used to establish the exercise fatigue model rat, the finger vibration group was treated by the middle finger vibrating on ST36 and BL57 with the vibration frequency of 250 times/min, each point was 5 min, and the intervention lasted for 28 days. Then, the content changes of rat blood lactate（Lac）, malondialdehyde（MDA）, urea nitrogen（BUN）, creatine kinase（CK）, adenosine triphosphate（ATP） were detected.Results The level of blood urea nitrogen（BUN）, lactic acid（Lac）, and creatine kinase（CK） in the model group were significantly higher than those in the blank group, and the level of ATP in gastrocnemius was lower and the level of MDA was higher（P＜0. 05）. The contents of BUN, Lac and CK in the finger vibration group were significantly lower than those in the model group, the level of ATP in gastrocnemius increased significantly and the MDA content decreased significantly（P＜0. 05）.Conclusion Finger vibration on ST36 and BL57 can effectively accelerate the removal of metabolites and improve energy supply in exercise fatigue rats.

摩揉法作为宫廷推拿流派的创新手法之一,操作于振腹法之前,结合了摩法与揉法的特点,手法轻而不浮,重而不滞,操作时采用逆推顺走的方法,可起到通补兼施的作用.摩揉法是在中医基础理论的指导下,通过调节脏腑功能,激发经络之气,促进元气的充养与气机的升降,进而养心神、调脾胃、贯三焦以调和阴阳、通畅血脉,达到治疗疾病的作用,目前临床应用广泛,善治内、外、妇、儿等多类疾病,疗效显著.本文通过对摩揉法这一创新手法的梳理,阐述其治疗疾病的核心思想,探析摩揉法的作用机制,分析摩揉手法作用特点,总结临床经验,以促进摩揉法的推广与应用.

目的 探讨振腹法治疗对多囊卵巢综合征(polycystic ovarian syndrome,PCOS)大鼠空腹血糖(Fasting plasma glucose,FPG)、血清胰岛素(fasting serum lisulin,FINS)、胰岛素抵抗指数(Homeostatic model assessment for insulin resistance,HOMA-IR)及卵巢p38 丝裂原活化蛋白激酶(p38 mitogen-activated protein kinase,p38 MAPK)、磷酸化 p38 丝裂原活化蛋白激酶(p-p38 mitogen-activated protein kinase,p-p38 MAPK)蛋白表达与卵巢组织结构的影响,为振腹法的临床应用推广提供科学依据.方法 采用芳香酶抑制剂(来曲唑)造模法建立PCOS大鼠模型,将40 只雌性SD大鼠随机分为空白组、模型组、二甲双胍组、振腹组,每组10 只,各组大鼠给予相应药物连续灌胃 21 天.用葡萄糖氧化酶法测定FPG水平、酶联免疫吸附测定法测定空腹FINS水平,并计算HOMA-IR,比较各组的大鼠卵巢形态结构的差异;用蛋白免疫印迹法测定各组大鼠卵巢组织 p38 MAPK、p-p38 MAPK蛋白表达量.结果 与空白组相比,模型组大鼠卵巢出现囊性卵泡,卵巢皮质间质细胞明显增生,颗粒细胞层数减少;FPG、FINS、HOMA-IR水平升高(P<0.05),p38 MAPK、p-p38 MAPK表达量升高(P<0.05).与模型组相比,二甲双胍组、振腹组大鼠卵巢囊性卵泡减少,颗粒细胞层增厚,可见卵母细胞,可见少量黄体;FPG、FINS、HOMA-IR水平降低(P<0.05),p38 MAPK、p-p38 MAPK表达量降低(P<0.05).与二甲双胍组相比,振腹组大鼠 FPG、p38 MAPK、p-p38 MAPK 水平均相近(P>0.05).结论 振腹法可以改善 PCOS 模型大鼠卵巢结构,降低 PCOS 卵巢组织 p38 MAPK、p-p38 MAPK蛋白表达水平,对PCOS血糖、胰岛素有一定调节作用,对PCOS伴胰岛素抵抗能有一定治疗作用,且振腹法在降低FPG水平上作用与二甲双胍作用相近.

燕京地区具有深厚的文化底蕴,推拿扎根于首善之都,在学术碰撞中传承推拿学的精华,博采众长,形成诸多别具特色的流派,在历史的发展中不断形成自身独特的理论体系和代表手法,为近现代中医推拿学发展做出了卓越贡献.本文旨在梳理燕京地区推拿流派,探讨燕京地区各推拿流派的源流、传承谱系及学术特色,总结传承中遇到的问题,为今后燕京地区推拿流派的学术思想的传承发展提供建议.

目的：通过文献研究擦法的发展与演变，对比擦法在古籍、历版教材、现代临床文献中的异同并分析，为手法的规范化和临床应用提供参考。方法：通过搜集古籍、推拿教材及临床文献，对手法的各个要素进行梳理并分析研究。结果：擦法定义及分类演变由抽象逐渐精准，最终趋于一致；归属类别标准不一；操作的力度、频率、热效应等细节表述模糊；临床应用中多与其他手法配合，施术部位表述有差异。结论：在中医推拿手法规范化、标准化的大背景下，擦法在古代文献、教材及现代临床文献中的内容逐渐丰满，规范化不断提高，但客观量化指标还存在局限性，意见不统一，有待完善和规范化。

付国兵教授为推拿界知名专家,在推拿教学及临床工作中有自己深切的体会,并在养生保健科普宣传方面作出了巨大贡献.付教授在教学工作和科普宣讲过程中也善于思考和总结,经过多年的教学及科普宣讲,积累了丰富的讲课经验,总结出"四个层次"讲课法,即"念、背、讲、演",并提出讲课方法所需要达到的最高层次——"演".此外,付教授认为一名优秀的教师除了需要掌握正确的讲课方法外,还应具备端正的讲课态度、丰厚的知识体系、卓越的讲课能力和良好的心理素质等四个方面的能力.付教授还归纳出教师可以通过打造语言魅力、设置讲课情境和强化模拟实践三个方面来逐步提高讲课层次,最终达到"演"的讲课层次,从而达到讲课的真正目的,提高课堂的质量和效果.

目的 探讨慢性不可预见性温和应激方法(chronic unpredictable mild stress,CUMS)建立的抑郁症大鼠模型骨骼肌线粒体能量代谢水平变化情况以及振腹推拿手法的干预作用.方法 将40只大鼠随机抽取10只作为正常组,其余大鼠进行3周的CUMS造模,第3周末将造模的30只大鼠随机分为模型组、振腹组和氟西汀组,进行糖水偏好试验和悬尾试验,之后继续4周的造模刺激,并给予相应的干预.在第7周末完成糖水偏好试验、悬尾试验和旷场试验,处死大鼠,取各组大鼠的骨骼肌样本检测腺嘌呤核苷三磷酸(adenosine triphosphate,ATP)、活性氧(reactive oxygen species,ROS)、呼吸链Ⅰ～Ⅴ的含量,辅酶Q10、线粒体内转录因子A(mitochondrial transcription factor A,TFAM)的蛋白含量以及SQSTM1(sequestosome-1)的蛋白、mRNA含量.结果 第3周末,模型组、振腹组和氟西汀组3组大鼠的糖水偏好率和悬尾试验绝望时间无统计学差异(P>0.05);与正常组相比均有显著的差异(P<0.01).第7周末,模型组大鼠的糖水偏好率、绝望时间与正常组相比有显著差异(P<0.01);与模型组大鼠比较,振腹组、氟西汀组大鼠的糖水偏好率、绝望时间显著改善(P<0.01).第7周末,模型组大鼠的总移动距离、中央进入次数和穿格次数与正常组相比均显著降低(P<0.01);与模型组大鼠比较,振腹组、氟西汀组大鼠的总移动距离、穿格次数显著升高(P<0.01),氟西汀组的中央进入次数与模型组相比有统计学意义(P<0.05),振腹组的中央进入次数与模型组相比有上升趋势.第7周末,模型组大鼠的ATP含量、呼吸链复合体Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ含量与正常组相比显著降低(P<0.01),ROS含量与正常组相比显著升高(P<0.01);与模型组大鼠比较,振腹组大鼠的ATP含量显著升高(P<0.01),ROS含量显著降低(P<0.01),氟西汀组大鼠的ATP含量升高(P<0.05),ROS含量显著降低(P<0.01).经过4周的干预,与模型组大鼠相比,振腹组大鼠的呼吸链复合体Ⅰ、Ⅱ、Ⅲ、Ⅴ含量显著升高(P<0.01),呼吸链复合体Ⅳ含量升高(P<0.05),氟西汀组大鼠的呼吸链复合体Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ含量显著升高(P<0.01).第7周末,模型组大鼠的辅酶Q10、TFAM蛋白含量及SQSTM1蛋白含量、mRNA含量与正常组相比显著降低(P<0.01);与模型组大鼠相比,振腹组大鼠的辅酶Q10、SQSTM1蛋白含量升高(P<0.05),TFAM蛋白含量、SQSTM1的mRNA含量显著升高(P<0.01);氟西汀组大鼠的辅酶Q10、TFAM蛋白含量及SQSTM1蛋白、mRNA含量显著升高(P<0.01).结论 振腹推拿手法可以改善抑郁症模型大鼠的症状,增强其自主探索能力,减少其绝望时间,而这一手法效应可能是通过增加骨骼肌SQSTM1蛋白的转录和表达,从而增加TFAM的含量,改善线粒体的功能,增加呼吸链Ⅰ～Ⅴ的含量、减少ROS的含量,从而增强线粒体能量代谢的能力,缓解线粒体损伤,增加ATP含量实现的.

目的 探讨振腹法对多囊卵巢综合征(polycystic ovary syndrome,PCOS)大鼠血清性激素水平与炎症因子的影响,为振腹法的临床应用推广提供科学依据.方法 24只SD雌性大鼠随机分为空白组、模型组、二甲双胍组、振腹组,采用来曲唑溶液灌胃制备PCOS大鼠模型.模型制备成功后,二甲双胍组给予二甲双胍溶于1％羧甲基纤维素钠溶液灌服43 mg/(kg·d),连续给药15天;振腹组给予振腹法干预,15分钟/只,连续治疗15天.比较各组的大鼠卵巢形态结构的差异,酶联免疫吸附法检测性激素促黄体生成素、卵泡刺激素、雌二醇、睾酮及炎症因子肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin 6,IL-6)水平.结果 与空白组相比,模型组卵巢形态呈多囊样改变,性激素促黄体生成素、卵泡刺激素、雌二醇、睾酮水平变化显著(P<0.05),炎症因子TNF-α、IL-6水平表达均高于空白组(P<0.05);与模型组相比,二甲双胍组、振腹组大鼠卵巢形态结构改变具有明显差异,血清促黄体生成素、卵泡刺激素、雌二醇、睾酮水平显著改变(P<0.05),炎症因子TNF-α、IL-6水平均降低(P<0.05);与二甲双胍组比较,振腹组大鼠卵巢形态结构、血清促黄体生成素、卵泡刺激素、雌二醇、睾酮水平存在显著差异(P<0.05).结论 振腹法可改善PCOS大鼠卵巢形态,良性调节PCOS大鼠血清性激素水平,降低PCOS大鼠外周炎症因子TNF-α、IL-6水平,这可能是振腹法治疗PCOS的机制之一.

目的 观察宫廷推拿法治疗松弛性跖痛症的临床疗效.方法 将72例松弛性跖痛症患者随机分为对照组和观察组,每组36例.观察组采用宫廷推拿法治疗,即在点按穴位、摩擦足底手法的基础上,采用摇拔戳踝关节治疗手法结合跖趾关节拔伸法;对照组采用理疗治疗.2周治疗、4周及8周随访后,对比2组疗效及治疗前后视觉模拟量表(VAS)评分、美国足踝外科协会前足(ACFAS)评分.结果 治疗前2组VAS评分、ACFAS评分比较差异均无统计学意义(P＞0.05);与治疗前比较,治疗后2组VAS评分降低,ACFAS评分升高(P＜0.01),治疗后及随访4周、8周观察组VAS评分低于对照组,ACFAS评分高于对照组(P＜0.01).结论 宫廷推拿法相比于理疗能够显著提高松弛性跖痛症的临床疗效,缓解临床症状,且后期随访疗效稳定.

目的 观察腹部推拿对运动性疲劳(exercise-induced fatigue,EF)大鼠外周血单个核细胞(peripheral blood mononuclear cell,PBMC)能量代谢及炎性反应相关因子的影响,探讨腹部推拿改善运动性免疫炎性抑制的分子机制.方法 Wistar大鼠30只,适应性跑台训练后随机取出8只作为空白组,剩余大鼠运用改进的递增跑台有氧力竭运动法进行造模.最终造模成功16只大鼠,将其随机分为模型组及推拿组,每组8只.空白对照组常规喂养,不做任何处理;模型组常规喂养,每日力竭运动后于笼中休息;推拿组常规喂养,每日力竭运动后予推拿干预1次,连续21天.末次干预后,取大鼠外周血检测EF相关指标:血乳酸(lactate acid,Lac)、尿素氮(blood urea nitrogen,BUN)及肌酸激酶(creatine kinase,CK).同时运用蛋白免疫印迹法测定大鼠腺苷酸活化蛋白激酶(AMP-activited protein kinase,AMPK)、磷酸化腺苷酸活化蛋白激酶(pAMPK)、过氧化物酶体增殖物激活受体 γ共激活因子1α(peroxisome proliferator-activated receptorγcoactivator-1α,PGC-1α)、半胱氨酸蛋白酶(caspase-3)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及白细胞介素-1β(interleukin-1β,IL-1β)的表达水平.结果(1)与空白组比较,模型组EF相关代谢产物Lac、BUN及CK水平均显著升高(P<0.01);与模型组比较,推拿组Lac、BUN及CK水平均显著下降(P<0.05,P<0.01).(2)与空白组比较,模型组pAMPK/AMPK比值及PGC-1α蛋白表达水平显著降低(P<0.01),caspase-3蛋白表达水平显著升高(P<0.01),炎性因子TNF-α及IL-1β蛋白表达水平显著上调(P<0.05,P<0.01).与模型组比较,推拿组pAMPK/AMPK比值及PGC-1α蛋白表达水平显著升高(P<0.05,P<0.01),caspase-3蛋白表达水平出现下降趋势,TNF-α及IL-1β蛋白表达水平显著下调(P<0.05,P<0.01).结论 腹部推拿可显著降低EF大鼠外周血疲劳相关代谢产物Lac、BUN、CK水平,并通过调节能量代谢及线粒体功能关键信号链AMPK/PGC-1α,同时降低PBMCs内炎性因子TNF-α及IL-1β水平,部分揭示了推拿可减轻EF大鼠PBMCs凋亡,恢复运动性免疫抑制,改善EF的分子机制.

Background Autism spectrum disorder is a neurodevelopmental disorder with increasing incidence. At present, the global incidence of the disease is on the rise, and the cause is unknown. There is no specific treatment for this disease at present, mainly education and training. Traditional Chinese medicine treatment has a certain effect on the improvement of the symptoms of the disease. The treatment methods are mainly oral Chinese medicine and acupuncture, but children are often not easy to cooperate. As a safe and effective green therapy, massage is easy to be accepted by children. Methods We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage therapy in treating autism spectrum disorders: Wanfang and PubMed Database, China National Knowledge Infrastructure Database, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, and Excerpta Medica database. Each database will be searched from inception to March 2021. The entire process will include study selection, data extraction, risk of bias assessment, and meta-analyses. Results This proposed study will evaluate the effectiveness and safety of massage therapy for patients with autism spectrum disorders. The outcomes will include changes in autism spectrum disorder relief and adverse effect. Conclusion This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for patients with autism spectrum disorders. Dissemination and ethics The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process.

本文从"小肠气化"理论角度认识自闭症共患胃肠功能障碍的病机.小肠的"气化"功能在吸收水谷精微以生成宗气的过程中具有不可替代的作用,是"脏腑气化"功能的重要组成部分,也是小肠"受盛化物"和"泌别清浊"功能的综合体现.临床所见自闭症患者的脏腑形气不足、发育迟缓等症状,常具有小肠失化的表现.振腹推拿以手法直接施术于腹部,通过振法的节律性操作,可以振奋肠腑、升降气机以调整小肠气化功能,最终达到对自闭症患者形神同调的目的.振腹推拿不仅能有效地改善患者便秘、腹痛、腹泻等胃肠道症状,同时也能一定程度地提升其睡眠质量、交往以及自我照顾等能力.

目的 比较振腹推拿手法与传统推拿手法治疗肩关节周围炎(简称"肩周炎")的疗效差异.方法 采用前瞻性队列研究设计,设振腹推拿(观察)组和传统推拿(对照)组,采用倾向性评分中的匹配法(propensity score matching,PSM)将2组287例患者运用SPSS 23.0软件PSM功能进行匹配,得到组间协变量均衡(P＞0.05)样本27对.2组均治疗1个月,共15次,观察统计2组VAS评分、Melle评分、肩外展角度、肩前屈角度、指脊间距、指耳间距等.结果 2组间年龄、其他疾病情况、焦虑、肩关节周围组织疼痛等基本资料不均衡的协变量经匹配后均达到均衡.治疗1个月后和3个月后随访时,2组间VAS评分、Melle评分、肩外展角度、肩前屈角度、指脊间距、指耳间距比较,差异均有统计学意义(P＜0.05).结论 在肩周炎的治疗中,振腹推拿在缓解疼痛、增强肩关节活动度方面效果优于传统推拿手法,且疗效稳定持久.

热敷是将热的物体置于患处以消除或缓解疼痛的疗法.其历史悠久、操作简便易行且收效迅速,从古沿用至今,是人们日常生活中防病治病的常用疗法之一.热敷一般可分为药物热敷、黄土热敷、水热敷、盐热敷、沙热敷、砖热敷、蒸饼热敷等.

胃气不降、肝肺升降失司、三焦失调均可引起脏腑气机升降功能失司,从而导致便秘.振腹推拿主要通过调脾胃、通任脉、畅三焦、补肾气以及调心神来治疗内科疾病.因此,振腹推拿可通过调脾胃以助运化、调气机以畅情志、调三焦以升清降浊而恢复脏腑气机升降,从而治疗慢性功能性便秘.治疗时以振腹为基本手法,振深势柔,操作过程中腹背并重,俞募并用,上下并举,根据患者病情对具体手法及相关穴位随症加减,以使五脏安和,便秘自除.

Abstract Background Autism spectrum disorder is a neurodevelopmental disorder with increasing incidence. At present, the global incidence of the disease is on the rise, and the cause is unknown. There is no specific treatment for this disease at present, mainly education and training. Traditional Chinese medicine treatment has a certain effect on the improvement of the symptoms of the disease. The treatment methods are mainly oral Chinese medicine and acupuncture, but children are often not easy to cooperate. As a safe and effective green therapy, massage is easy to be accepted by children. Methods We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage therapy in treating autism spectrum disorders: Wanfang and PubMed Database, China National Knowledge Infrastructure Database, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, and Excerpta Medica database. Each database will be searched from inception to March 2021. The entire process will include study selection, data extraction, risk of bias assessment, and meta-analyses. Results This proposed study will evaluate the effectiveness and safety of massage therapy for patients with autism spectrum disorders. The outcomes will include changes in autism spectrum disorder relief and adverse effect. Conclusion This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for patients with autism spectrum disorders. Dissemination and ethics The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process.