Background To investigate the effec of the herb-partitioned moxibustion on T-lymphocyte activity in immunosuppressed rats through differential modulation of the immune checkpoint molecules CD28 and CTLA-4. Methods Forty-eight Sprague‒Dawley rats were randomly divided into the normal group (NG), the cyclophosphamide model group (CTX), the herb-partitioned moxibustion group (HPM), the CD28 inhibitor + herb-partitioned moxibustion group (aCD28 + HPM), the CTLA-4 inhibitor + herb-partitioned moxibustion group (aCTLA-4 + HPM), and the levamisole group (LEV) (8 rats per group). The immunosuppression model was prepared using cyclophosphamide. HPM treatments was performed via herb-partitioned moxibustion at 4 acupoints, Zhongwan (CV12), Shenque (CV8), Guanyuan (CV4), and Zusanli (ST36). Subsequently, the moxa floss was made into a conical moxa cone, which was then placed on the herbal cake and ignited. Five consecutive moxibustion strokes were performed daily for 10 consecutive days. In addition to the same moxibustion, each rat in the aCD28 + HPM group was injected intraperitoneally with 0.5 mg/kg of CD28 inhibitor per rat on the first day of treatment, and 100 μL of CTLA-4 inhibitor was injected into the aCTLA-4 + HPM group on Days 1, 4, and 7. For the positive control, levamisole (LEV) was administered by gavage at a dose of 2 mg/kg once daily for 10 days. Results Compared with those in CTX model rats, the WBC counts in the HPM and other groups were significantly higher. The immobility time of EPM in the HPM group was significantly lower than that of the CTX group. The HE stainin results also showed that after treatment, the the marginal zone area of the spleen tissue in the HPM increased, the number of lymphatic sheath lymphocytes around the small central artery of the spleen increased, and the amount of red pulp containing a small amount of pigmentation was partially reduced. Compared with those in the CTX group, the serum levels of CD28, CTLA-4, B7-1, and B7-2 were significantly lower, and the levels of α-MSH, TrkB, and BDNF were significantly greater in the HPM group. The results of the flow cytometry assay showed a significant increase in the number of CD8 + T lymphocytes after treatment with HPM or other agents compared to that in the CTX group. The immunofluorescence results showed that the levels of CD28 and CTLA-4 lower in spleen tissues than in control tissues, and the binding ability of CD28 to B7-1 and B7-2 was weakened after treatment with HPM and other treatments compared with CTX rats, PCR for CD28, CTLA-4 and B7-1 showed similar results. Conclusion In the immunosuppressive rat model induced by cyclophosphamide, HPM upregulated the expression of α-MSH, TrkB, and BDNF, and downregulated the expression of CD28 and CTLA-4, thereby enhancing the activity of CD 8 + T lymphocytes, restoring spleen function, improving the immunosuppressive state, restoring immune function, and effectively alleviating depressive symptoms.

小柴胡汤出自《伤寒论》,是和解少阳法之代表方,以寒热往来、胸胁苦满、默默不欲饮食、心烦喜呕为辨证要点.本文以中国期刊全文数据库、万方数据库、维普数据库中收录的与小柴胡汤相关的近十年文献为支撑,着重整理并分析了近三年小柴胡汤及其加减方,以及联合普通针刺、透刺、火针等治疗方法,对呼吸系统等多个系统疾病的临床治疗效应,旨在更好地探讨基于小柴胡汤的针药结合临床效应,以便为临床治疗提供参考.

OBJECTIVE To observe the effects of herbal cake separated moxibustion on macrophage effector molecule T-cell immunoglobulin and mucin-domain containing-4 (Tim-4) and ubiquitination of programmed cell death protein 1 (PD-1) in rabbits with immunosuppression, and to explore the possible mechanism on herbal cake separated moxibustion in improving immunosuppression. METHODS Thirty-two big-ear white rabbits were randomly divided into a normal group, a model group, a moxa stick moxibustion group and a herbal cake separated moxibustion group, 8 rabbits in each group. Except the normal group, the immunosuppression model was established by intraperitoneal injection of cyclophosphamide of60 mg/kg in the other 3 groups. "Shenque" (CV 8), "Shenshu" (BL 23), "Zusanli" (ST 36), etc. were selected in both the moxa stick moxibustion group and the herbal cake separated moxibustion group. Moxa stick moxibustion was applied in the moxa stick moxibustion group, one cone at each acupoint; herbal cake separated moxibustion was applied in the herbal cake separated moxibustion group, 5 cones at each acupoint. The intervention was given once every other day for 10 times in both groups. Leukocyte content in peripheral blood was detected by blood cell analyzer; the positive expression of PD-1 in CD+4 T lymphocytes, CD+8T lymphocytes and CD+68 macrophages in peripheral blood was measured by flow cytometry, the serum levels of interleukin 2 (IL-2), CD8, CD68 and Tim-4 were detected by ELISA, and the expression of Tim-4 and F-box only protein 38 (FBXO38) in the liver and spleen tissues was measured by immunohistochemistry. RESULTS Compared with the normal group, in the model group, white blood cell count (WBC) and percentage of neutrophils (NEU%) were decreased while percentage of lymphocyte (LYM%) was increased (P<0.01) in peripheral blood; the positive expression rates of PD-1 in CD+4 T lymphocytes, CD+8T lymphocytes and CD+68 macrophages in peripheral blood were increased (P<0.01); the serum levels of IL-2, CD68 and Tim-4 were increased (P<0.01), the serum level of CD8 was decreased (P<0.01); the average optical density (AOD) of Tim-4 in the liver tissue and FBXO38 in the liver and spleen tissues was increased (P<0.01). Compared with the model group, in the moxa stick moxibustion group and the herbal cake separated moxibustion group, WBC and NEU% were increased (P<0.01); the positive expression rates of PD-1 in CD+4 T lymphocytes, CD+8T lymphocytes and CD+68 macrophages in peripheral blood were decreased (P<0.01); the serum levels of IL-2, CD68 and Tim-4 were decreased (P<0.01), the serum levels of CD8 were increased (P<0.01); the AOD of Tim-4 and FBXO38 in the liver tissue and FBXO38 in the spleen tissue was decreased (P<0.01, P<0.05). Compared with the moxa stick moxibustion group, in the herbal cake separated moxibustion group, the positive expression rate of PD-1 in CD+68 macrophages in peripheral blood was increased (P<0.05); serum level of Tim-4 was increased (P<0.01); AOD of Tim-4 in the liver tissue was decreased (P<0.05). CONCLUSION Herbal cake separated moxibustion can improve immunosuppression by regulating the expression of macrophage effector molecule Tim-4 and the FBXO38 mediated ubiquitination of PD-1, Tim-4 may be one of the specific indexes of immunomodulation involving with herbal cake separated moxibustion.

目的 探讨隔药饼灸治疗慢性疲劳综合征(chronic fatigue syndrome,CFS)的作用机制.方法 50 只SD大鼠随机分为空白组、模型组、隔药饼灸组、假药饼灸组、中药灌胃组,每组各10 只.采用复合应激方法造模21 d,行为学检测CFS模型,隔药饼灸组与假药饼灸组大鼠取"神阙""关元""足三里""期门"穴进行相应干预,中药灌胃组大鼠给予逍遥散悬浊液灌胃,10 d 后ELISA法检测各组大鼠血清中免疫球蛋白(Ig)A、IgG及补体C3 含量;苏木精-伊红染色观察肝脏、脾脏组织形态学变化;实时荧光定量PCR法检测股四头肌Tim-3、LAG-3 mRNA表达水平.结果 与空白组比较,模型组大鼠肝脏、脾脏病理改变明显,血清中IgA、IgG、C3 含量显著降低,股四头肌Tim-3、LAG-3 mRNA水平显著升高(P＜0.05).与模型组比较,隔药饼灸组与中药灌胃组大鼠上述指标均有明显改善(P＜0.05),假药饼灸组大鼠仅出现Tim-3 mRNA水平下降(P＜0.05).结论 隔药饼灸可能通过提高CFS模型大鼠IgA、IgG及补体C3 水平,降低免疫负调节因子Tim-3、LAG-3 mRNA水平,从而恢复机体免疫功能,增强免疫力,起到治疗CFS的作用.

目的 观察隔药饼灸对免疫抑制兔TIGIT/CD155和JAK2/STAT3通路表达的影响及相关性,探讨隔药饼灸介导免疫应答的机制.方法 将32只日本大耳白兔随机分为空白组、模型组、艾条灸组和隔药饼灸组,每组8只.除空白组外,其余3组连续7 d腹腔注射环磷酰胺60 mg/kg建立免疫抑制模型.造模成功后次日开始干预,选取"神阙""关元""足三里""脾俞""肾俞"隔日灸,共10次.ELISA检测血清白细胞介素(IL)-10、TIGIT、CD155含量,Western blot检测肝组织JAK2、STAT3蛋白表达,免疫组化检测脾组织和肝组织TIGIT表达.采用Pearson相关性分析评价上述指标间相关性.结果 与空白组比较,模型组兔血清IL-10含量显著减少,TIGIT、CD155含量明显增加(P＜0.01),肝组织JAK2、STAT3蛋白表达显著降低(P＜0.05),肝组织和脾组织TIGIT表达升高(P＜0.01);与模型组比较,艾条灸组和隔药饼灸组兔血清IL-10含量显著增加,TIGIT、CD155含量显著减少(P＜0.01),隔药饼灸组肝组织JAK2、STAT3蛋白表达显著降低(P＜0.05),艾条灸组和隔药饼灸组兔肝组织、脾组织TIGIT表达显著降低(P＜0.01).Pearson相关性分析结果显示,血清IL-10 与CD155(r=-0.68)、TIGIT(r=-0.72)含量呈负相关,与肝组织JAK2(r=0.73)、STAT3(r=0.75)表达呈正相关;肝组织JAK2与血清CD155(r=-0.84)、TIGIT(r=-0.88)含量呈负相关,与肝组织STAT3(r=0.98)呈正相关;肝组织STAT3与血清CD155(r=-0.86)、TIGIT(r=-0.89)呈负相关.结论 隔药饼灸对免疫抑制兔免疫功能有明显改善作用,该作用与IL-10介导的JAK2/STAT3通路及TIGIT变化有密切关系.

小柴胡汤出自《伤寒论》,是和解少阳之代表方剂,临证应用极为广泛.以小柴胡汤为基础方结合针刺治疗临床多系统疾病疗效显著.该方善治半表半里病症,具有和解少阳、疏利三焦、清降肝胆之火、行气活血、调和阴阳等作用,所治疾病范围较广,包括咳喘、胃炎、头痛、眩晕、郁证以及带状疱疹等.针刺疗法可以调和脏腑、疏通经络、调理气血、缓解急慢性疼痛等,对于病在少阳者,在小柴胡汤基础上配合循经针刺局部穴、远端穴及阿是穴以缓解患者不适症状,疗效显著.针刺时还可针对疾病的类型选取毫针、火针、浮针、揿针、腹针、针刀等不同的针具及针刺手法,更快、更好地取得治疗效果.小柴胡汤与针刺疗法配合运用,内外兼调,协同增效,较单一疗法效果更佳,临证可广泛运用.

Immunotherapy targeting immune checkpoint molecules has emerged as a key approach in cancer treatment, representing the forefront of antitumor research. However, studies on immune checkpoint molecules have mainly focused on targeted therapies. Chinese medicine (CM) research as a complementary medicine has revealed that immune checkpoint molecules also undergo disease-specific changes in the context of autoimmune diseases. This review article presents a comprehensive analysis of CM studies on immune checkpoint molecules in the last 5 years, with a focus on their role in different diseases and treatment modalities. CM research predominantly utilizes oral administration of herbal plant extracts or acupuncture techniques, which stimulate the immune system by activating specific acupoints through temperature and needling. In this study, we analyzed the modulation and mechanisms of immune checkpoint molecules associated with different coinhibitory and costimulatory molecules, and reviewed the immune functions of related molecules and CM studies in treating autoimmune diseases and tumors. By summarizing the characteristics and research value of CM in regulating immune checkpoint molecules, this review aims to provide a useful reference for future studies in this field.

Chronic fatigue syndrome is characterized by long-term sustained fatigue and difficulty to recover after rest.In addition to fatigue,patients also commonly experience changes in mental state(such as depression,anxiety and other symptoms),decreased sleep quality,and even a series of accompanying symptoms that seriously affect the quality of life,such as muscle soreness,headache,sore throat and joint pain.In recent years,the incidence of the disease has increased year by year,but most of the clinical examinations have no organic lesions,so the scale is used as the main method of diagnosis and detection of treatment effect.There are some problems such as unclear selection criteria in the process of using the scale.In order to make the direction of using the scale clearer and the selection more standardized in the future,this study analyzes the evaluation effect of different categories of scales for evaluating chronic fatigue syndrome.

桂枝汤临床应用广泛,并有"群方之魁"的美誉.本文探讨桂枝汤的立方之基,从阴阳的角度去认识疾病的本质,辨病求本,本在阴阳,并提出桂枝汤的立方依据为基于阴阳.张仲景以桂枝汤为基础,衍生出一系列加减方.通过对桂枝汤系列方在调节人体表里、上下、左右、脏腑之阴阳进行简要分析,并基于中医学"治未病"理念,对桂枝汤在疾病防治中的作用进行阐述.桂枝汤药少方精,在现代临床仍然能够发挥重要作用,被后世医家称为"群方之魁"乃实至名归.

目的:通过Meta分析对亚健康偏颇体质人群体表皮肤温度变化进行探讨.方法:计算机检索中国期刊全文数据库、万方数据知识服务平台、维普期刊中文服务平台、中国生物医学文献数据库、PubMed、the Cochrance Librany、Embase、Web of Science数据库,收集关于亚健康偏颇体质人群特定穴位处皮肤温度变化的相关文献,检索时限为2012年1月—2022年5月.由研究者严格按照纳入和排除标准筛选文献,提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.4软件进行Meta分析.结果:最终筛选出19篇文献,共纳入1329例病例.Meta分析结果示偏颇体质人群头面部异常区域平均温度具有明显改变,差异有统计学意义[SMD=0.36,95％CI(0.19,0.53),P<0.0001].偏颇体质人群中焦部异常区域平均温度具有明显改变,差异有统计学意义[SMD=-0.75,95％CI(-0.79,-0.71),P<0.00001].偏颇体质人群督脉部异常区域平均温度具有明显改变,差异有统计学意义[SMD=0.68,95％CI(0.59,0.77),P<0.00001].结论:现有证据表明红外热成像技术被逐步应用于体质研究中,其在偏颇质者的体表温度特点、疗效评价等方面已取得一定的进展,可以作为偏颇体质评价的工具,它的评价方式、评价效果与体质量表相比同样突出.但是要进一步应用于临床、指导医疗实践还有待进一步扩大样本的试验研究.

在生命活动过程中,细胞的分裂周期会随着分裂次数的增多而减少,伴随生理功能和增殖分化能力的衰退,这种现象称为细胞衰老.随着近期对细胞衰老的深入研究,人们掌握了关于细胞衰老的众多生理机制,其中就包括端粒学说和线粒体功能障碍学说.端粒是真核细胞线性染色体末端的DNA-蛋白质复合体,包括富含G的核酸重复序列和蛋白质组成,是细胞有丝分裂的生物钟,端粒长度与细胞衰老关系密切,端粒损伤是诱导细胞衰老的重要因素;线粒体是细胞进行氧化磷酸化并产生ATP的重要场所,是细胞"能量工厂",其质量、活性改变与细胞衰老密切相关,衰老细胞中线粒体自噬水平的提高有利于清除损伤的线粒体,从而达到延缓细胞衰老的作用.本文将通过分析端粒、线粒体自噬的生理机制,阐明二者在细胞衰老中的作用.

目的 观察兔胸腺的发育退化过程及取材时的注意事项.方法 取8只大耳白兔,随机分为空白组和免疫抑制模型组,每组4只.模型组以环磷酰胺制备免疫抑制模型,以60 mg/kg腹腔注射,连续7 d.造模结束后20 d,取胸腺组织进行HE染色.结果 一般形态显示,胸腺多呈左、右双叶状,质地偏硬,与脂肪组织比更有韧性.其中空白组胸腺多呈淡粉色,环磷酰胺模型组胸腺多呈白色.HE结果显示,胸腺结构完整,皮髓界限清楚,皮质淋巴细胞密集;免疫抑制模型组胸腺失去正常结构,皮髓界限不清,皮质淋巴细胞减少,周围脂肪组织增多.结论 环磷酰胺致免疫抑制模型会对机体胸腺组织形态结构产生不可逆破坏.

目的 评价慢性疲劳综合征(CFS)大鼠模型的行为学特征.方法 选取力竭游泳与慢性束缚两种方法进行长期复合刺激建立CFS大鼠模型,造模持续21 d.观察大鼠的一般状态、饮水量与摄食量、体质量变化等,进行定时检测旷场悬尾指标变化,并在实验过程中对这两种行为学检测方法进行改进.造模结束后,采用酶联免疫吸附试验(ELISA)法检测免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、补体C3以及血乳酸(BLA)水平,并取大鼠双侧股四头肌组织,进行常规苏木精-伊红(HE)染色观察形态学.结果 与空白组比较,模型组大鼠体型明显减小,毛发稀疏暗淡,部分大鼠出现烦躁好斗的现象,饮水量与摄食量均存在下降趋势.旷场实验结果显示,造模21 d,模型组水平跨格数与站立次数较空白组均明显减少(P<0.05),运动距离较空白组缩短,但差异无统计学意义(P>0.05).悬尾实验结果显示,与空白组相比,模型组大鼠造模21 d挣扎次数明显减少(P<0.05),不动时间明显变长(P<0.05).与空白组比较,模型组大鼠血清中IgA、IgG及补体C3含量明显降低(P<0.05),血乳酸含量明显升高(P<0.05).与空白组比较,模型组大鼠股四头肌部分纤维结构破坏,胞核固缩、凝聚.结论 力竭游泳与慢性束缚方法可以成功构建CFS大鼠模型,体质量、旷场实验和悬尾实验、血清学指标以及组织形态学指标可作为检测模型成功的标准,同时对旷场悬尾实验方法进一步完善,得到可被重复验证与实践的较成熟方案.

OBJECTIVE:To evaluate the clinical efficacy and safety of acupuncture combined with moxibustion on allergic rhinitis. METHODS:Using the random number table, 80 patients with allergic rhinitis were divided into a medication group and an acupuncture combined with moxibustion (acu-mox) group, 40 cases in each one. In the medication group, ioratadine tables were prescribed for oral administration, one tablet daily for 10 days as 1 session , 3 sessions of treatment were required. In the acupuncture combined with moxibustion group, bilateral Yingxiang (LI20), Yintang (EX-HN3), bilateral Hegu (LI4) and bilateral Shenshu (BL23) were selected as the main points and stimulated with acupuncture and moxibustion; and the acupoint prescription was modified according to symptoms. This combined treatment was given once every day, stimulating for 30 min each time, and 10 treatments made 1 course, for 3 courses of treatment totally. Before and after treatment, the scores for symptoms and physical signs, as well as the score of rhino-conjunctivitis related quality of life scale (R-QOL) were evaluated separately. The sample of the inferior turbinate mucosa tissue was collected and the distribution of eosinophil (EOS) was scored using HE staining and Sheldeny evaluation. Using enzyme-linked immunosorbent assay (ELISA), the contents of serum immunoglobulin E (IgE), retinoic-acid-receptor-related orphan nuclear receptor γt (RORγt), forkhead box protein P3 (Foxp3), interleukin-17 (IL-17), IL-27 and IL-33 were determined. The clinical efficacy was evaluated in the patients with allergic rhinitis of two groups and all the adverse reactions were recorded during treatment. RESULTS:The scores of symptoms and physical signs as well as the score of R-QOL, and EOS distribution score and the contents of serum IgE, RORγt, IL-17 and IL-33 were all reduced as compared with those before treatment in each group (P<0.05), and the contents of serum Foxp3 and IL-27 were increased as compared with those before treatment in each group (P<0.05). After treatment, the scores of symptoms and physical signs as well as the score of R-QOL, and the contents of serum IgE, RORγt and IL-33 in the acu-mox group were lower than those in the medication group (P<0.05), and the contents of serum Foxp3 and IL-27 were higher than those of the medication group (P<0.05). The total effective rate of the acu-mox group was 100.0% (40/40), significantly higher than 82.5% (33/40) in the medication group (P<0.05). No ob-vious adverse reaction was found in either group during and after treatment. CONCLUSION:Acupuncture combined with moxibustion is significantly effective and safe in treatment of allergic rhinitis. Its effect mechanism may be related to the balance modulation of Th1/Th2 and Th17/Treg cells mediated by naive CD4+T cells.

围绝经期综合征在临床较为常见,是广泛影响中老年妇女身心健康的主要疾病之一.对近5年针灸及其他非药物疗法治疗围绝经期综合征的相关文献进行整理总结,研究提示围绝经期综合征采用针(毫针、电针、腹针、耳针)、灸(包括督灸、热敏灸等)、穴位埋线、推拿、刮痧、足浴等方法,选用关元、子宫、足三里、三阴交、涌泉等穴位可有效改善围绝经期综合征心烦失眠、潮热盗汗等症状.针灸具有起效快、安全、适应范围广等优势,远期疗效显著,且可避免激素替代疗法带来的副作用.

目的 观察分析针刺在缺血-再灌注损伤过程后对大鼠离体心肌细胞凋亡的变化.方法 随机将24只清洁级Wistar大鼠分为假手术组、模型组、针刺Ⅰ组(内关组)、针刺Ⅱ组(郄门组)、针刺Ⅲ组(合谷组),针刺Ⅳ组(抑制剂组),每组各4只.假手术组单纯打开大鼠胸腔,冠状动脉左前降支不行结扎术,只做穿线.模型组按照动物模型建立方法进行造模,不进行干预,全程监测心电图.内关组、郄门组和合谷组在结扎冠状动脉前分别电针大鼠内关、郄门和合谷穴各20 min,然后结扎40 min,并记录心电图变化,40 min后各组再次电针上述穴位20 min,恢复冠状动脉血流,灌流60 min.抑制剂组麻醉成功后,尾静脉注射磷脂酰肌醇3-激酶抑制剂LY294002(0.3 mg/kg),余法同内关组.假手术组在试验开始100 min、模型组与内关组、郄门组、合谷组、抑制剂组于恢复灌流后60 min,在体实验结束,保存处理心脏标本,分离培养心肌细胞,采用流式细胞术分析心肌细胞凋亡率.结果 内关组和郄门组同模型组、合谷组相比较,离体心肌细胞凋亡率明显降低,差异有统计学意义(P<0.01);抑制剂组心肌细胞凋亡率高于内关组和郄门组(P<0.01),相比模型组和合谷组有所降低,差异无统计学意义(P>0.05).结论 针刺对在体心肌细胞的保护效应在针刺后离体心肌细胞凋亡中依然持续.

JAK2/STAT3信号转导通路由细胞因子、受体、JAK2、STAT3蛋白和下游基因组成.现代分子免疫学通过对JAK2/STAT3信号转导通路的调节机制进行研究,证明了JAK2/STAT3信号转导通路的免疫调控应用在脂质代谢、血管生成、肿瘤微环境等方面,其机制是在主要通过调控免疫细胞或其他细胞激活相应靶基因、分泌细胞因子来完成的.相关研究表明,针灸能干预JAK2/STAT3信号转导通路的激活,来对脂质代谢异常、脑血管疾病等有治疗作用.但目前研究尚有不足,明确针灸治疗对相关通路调控下游基因的作用机制以及针灸干预效应将有助于更好地认识临床作用.

OBJECTIVE:To observe the effect of herbal cake-separated moxibustion (HCSM) on serum lactic acid (BLA) level and AMPK/PGC-1α signaling pathway in the quadriceps femoris in chronic fatigue syndrome (CFS) rats, so as to explore its mechanisms underlying improvement of CFS. METHODS:According to the random number table, 50 SD rats were divided into blank control, model, HCSM, sham HCSM and medication (herbal medicine gavage) groups, with 10 rats in each group. The CFS model was established by using chronic restraint and exhaustive swimming, alternately, once daily for 21 days. The herbal cake was made of Xiaoyao Powder (Mental Ease Powder, composed of [Danggui (Radix Angelicae Sinensis), Baishao (Radix Paeoniae Alba), Chaihu (Radix Bupleuri), Fuling (Poria), Baizhu (Rhizoma Atractylodis, Macrocephalae), etc.]. The HCSM was applied to "Shenque" (CV8), "Guanyuan "(CV4), bilateral "Zusanli" (ST36) and "Qimen" (LR14), 5 moxa-cones for each acupoint, once daily for 10 days. For sham HCSM, the excipient was instead of herbal cake, and the same 5 moxa-cones was given as the HCSM group. Rats of the medication group received gavage of Xiaoyao Powder suspension (60 mg·kg-1), once daily for 10 days. The open field test and tail suspension test were conducted for determining the animals' locomotor activity. The blood sample was taken from the abdominal aorta under anesthesia for assaying the levels of serum BLA, chemokine ligand CXCL9 and β-endorphin (EP) by ELISA. Bilateral quadriceps femoris were sampled for observing histopathological changes after staining with conventional H.E. technique, and for detecting the expression levels of phosphorylated AMP-activated protein kinase (p-AMPK) and peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) by using immunohistochemistry. RESULTS:Compared with the blank control group, the number of rearing and horizontal grid-crossing times, struggling times of tail suspension test were significantly decreased (P<0.05), and the immobility time was obviously prolonged (P<0.05) in the model group. Compared with the model group, both HCSM and medication groups had a significant increase of rearing, horizontal grid-crossing times and struggling times (P<0.05), and the immobility time had a significant decrease (P<0.05). But there were no significant differences in the total movement distance among the 5 groups (P>0.05), and in the 5 indexes of behavioral measurements between the HCSM and medication groups (P>0.05). The sham HCSM could also evidently increase the struggling times and reduce the immobility time (P<0.05). The contents of serum BLA, CXCL9 and β-EP were obviously higher in the model group than in the blank control group (P<0.05), as well as remarkably lower in the HCSM and medication groups than in the model group (P<0.05). Whereas the expression levels of muscular p-AMPK and PGC-1α were considerably lower in the model group than in the blank control group (P<0.05), and significantly increased in both HCSM and medication groups relevant to the model group (P<0.05). Compared with the sham HCSM group, the contents of BLA, CXCL9 and β-EP in serum of the HCSM group and contents of CXCL9, β-EP in medication group were significantly decreased (P<0.05), and the protein expressions of p-AMPK and PGC-1α in quadriceps femoris in both HCSM and medication groups were significantly increased (P<0.05). H.E. staining showed smaller intercellular space, uneven cytoplasmic staining in some muscle fibers, nucleus pyknosis and condensation, and inflammatory cell infiltration in the model group, which was milder in both HCSM and medication groups. CONCLUSION:HCSM can mitigate the stress behavioral state in CFS rats, which may be related with its functions in lowering the levels of serum BLA, CXCL9 and β-EP, and activating AMPK/PGC-1α signaling pathway (balancing energy metabolism) in the quadriceps femoris.

针药结合是指在中医理论指导下将针灸与中药相结合以治疗疾病的方法.针药结合记载首见于《黄帝内经》,在中医发展的长河中经过历代医家的继承和发展,为后世提供了宝贵的经验.针灸和中药的结合需要辨证施治,将针药结合灵活应用于临床,对于医者治疗疾病有显著的优势,也是中医治疗的一大特色.

该文分析单纯艾灸涌泉及联合其他疗法(毫针刺法、腕踝针、穴位贴敷等)治疗不同证型失眠产生效应的临床文献,阐述其应用的现状及优势,为临床治疗失眠提供更多的思路和方法.