BACKGROUND:Visceral hypersensitivity (VH) is acknowledged as a critical pathogenic mechanism underlying functional gastrointestinal disorders (FGIDs), which is influenced by dysregulation of the gut-brain axis. Transauricular vagus nerve stimulation (taVNS) is a clinically used intervention for the relief of visceral pain; however, its underlying neural mechanisms remain poorly understood. Drawing on the pathogenesis of VH and our team's previous research, we hypothesized that taVNS mitigates VH through the nesfatin-1/corticotropin-releasing factor (CRF) pathway. This study aims to elucidate the potential central regulatory mechanisms that contribute to the analgesic effects of taVNS. METHODS:A validated VH model was established in Sprague-Dawley (SD) rats through maternal separation (MS) combined with acetic acid enema. The VH rats underwent taVNS at frequencies of 2 Hz, 10 Hz, and 15 Hz, whereas the sham group received 2 Hz electrical stimulation at the earlobe. The visceral pain threshold was evaluated using the abdominal withdrawal reflex (AWR) scoring and electromyographic activity of the external oblique muscle. Additionally, Western blot analysis was conducted to assess the expression levels of nesfatin-1, CRF, and its receptors 1 and 2 (CRF1/2R) in the hypothalamus. KEY RESULTS:The analyses of AWR and electromyogram (EMG) responses indicated that (a) the area under the curve (AUC) of the EMG response to colorectal distension (CRD) at four distension pressures (20, 40, 60, and 80 mmHg) was significantly elevated in the VH group. (b) The AUC was significantly reduced in the 2 Hz taVNS group across all four distension pressures. (c) The 10 Hz taVNS group exhibited a significant decrease in the AUC at 20 mmHg and 40 mmHg. Furthermore, the results of Western blot analysis demonstrated that (a) 2 Hz taVNS significantly lowered the expressions of nesfatin-1, CRF, and CRF1R, aligning with the findings in the sham group. (b) Both 10 Hz and 15 Hz taVNS significantly decreased CRF expression, whereas nesfatin-1 and CRF1R expression remained unchanged. (c) There was no significant downregulation of CRF2R expression among the intervention groups. CONCLUSION:This study demonstrated that taVNS alleviates VH, potentially via the nesfatin-1/CRF/CRF1R signaling pathway in the rat hypothalamus. Furthermore, the analgesic effect was frequency-dependent, with 2 Hz taVNS providing a more effective reduction in visceral pain.

Background/Aims Diabetes mellitus is a prevalent chronic condition globally. A frequent complication is gastric motility disorder, which substantially impacts patients' quality of life and overall well-being. The SMC-ICC-PDGFRα+ (SIP) syncytium plays an important role in the coordination of gastrointestinal (GI) motility. Auricular vagus nerve stimulation (aVNS) has demonstrated promising therapeutic efficacy against diabetic motility disorders, yet the underlying mechanism has not been well understood. The present study aims to evaluate whether low-frequency aVNS attenuates gastric dysmotility in diabetic rats through regulation of the SIP syncytium and its signaling pathways. Materials and Methods Male Sprague-Dawley rats were employed to induce the diabetic gastric motility disorder (DGMD) model using streptozotocin (STZ). The DGMD rats underwent treatment with aVNS, a combination of aVNS and body electroacupuncture (aVNS-EA), and sham aVNS. Gastric motility was evaluated by solid gastric emptying rate (SGER). Gastric antrum pathology was assessed via H&E staining, SIP syncytium function was evaluated by immunofluorescence, and serum nitric oxide (NO) levels with a Griess kit. Results Low-frequency aVNS significantly enhanced SGER and up-regulated the expression of ICCs and PDGFRα+ cells in the antrum, the smooth muscle marker α-SMA was increased at the immunofluorescence and mRNA levels but not significantly at the protein level. aVNS-EA exhibited similar effects, whereas sham aVNS showed no significant change. aVNS also up-regulated nNOS, increased NO release, and activated the sGC–cGMP–PKG1 pathway. Treatment with ODQ (1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one), the sGC inhibitor, reversed the aVNS-induced improvements in SGER and SIP syncytium integrity. Conclusion In contrast, aVNS-EA benefits were only partially inhibited by ODQ. These results suggest that low-frequency aVNS improves gastric motility and SIP syncytium function in diabetic rats by activating the NO/sGC/cGMP/PKG1 pathway, and the combination of aVNS and body electroacupuncture yields additional beneficial effects. Clinical trial registration Not applicable.

Objective: Functional dyspepsia (FD), which has a complicated pathophysiologic process, is a common functional gastrointestinal disease. Gastric hypersensitivity is the key pathophysiological factor in patients with FD with chronic visceral pain. Auricular vagal nerve stimulation (AVNS) has the therapeutic effect of reducing gastric hypersensitivity by regulating the activity of the vagus nerve. However, the potential molecular mechanism is still unclear. Therefore, we investigated the effects of AVNS on the brain-gut axis through the central nerve growth factor (NGF)/ tropomyosin receptor kinase A (TrkA)/phospholipase C-gamma (PLC-gamma) signaling pathway in FD model rats with gastric hypersensitivity. Materials and Methods: We established the FD model rats with gastric hypersensitivity by means of colon administration of trinitrobenzenesulfonic acid on ten-day-old rat pups, whereas the control rats were given normal saline. AVNS, sham AVNS, K252a (an inhibitor of TrkA, intraperitoneally), and K252a + AVNS were performed on eight-week-old model rats for five consecutive days. The therapeutic effect of AVNS on gastric hypersensitivity was determined by the measurement of abdominal withdrawal reflex response to gastric distention. NGF in gastric fundus and NGF, TrkA, PLC-gamma, and transient receptor potential vanilloid 1 (TRPV1) in the nucleus tractus solitaries (NTS) were detected separately by polymerase chain reaction, Western blot, and immunofluorescence tests. Results: It was found that a high level of NGF in gastric fundus and an upregulation of the NGF/TrkA/PLC-gamma signaling pathway in NTS were manifested in model rats. Meanwhile, both AVNS treatment and the administration of K252a not only decreased NGF messenger ribonucleic acid (mRNA) and protein expressions in gastric fundus but also reduced the mRNA expressions of NGF, TrkA, PLC-gamma, and TRPV1 and inhibited the protein levels and hyperactive phosphorylation of TrkA/PLC-gamma in NTS. In addition, the expressions of NGF and TrkA proteins in NTS were decreased significantly after the immunofluorescence assay. The K252a + AVNS treatment exerted a more sensitive effect on regulating the molecular expressions of the signal pathway than did the K252a treatment. Conclusion: AVNS can regulate the brain-gut axis effectively through the central NGF/TrkA/PLC-gamma signaling pathway in the NTS, which suggests a potential molecular mechanism of AVNS in ameliorating visceral hypersensitivity in FD model rats.

Background and objectives:Gastrointestinal dysmotility commonly follows thermal injuries, such as burns. This study aimed to investigate the effects and mechanisms of electroacupuncture (EA) on burn-induced gastric dysmotility in rats. Methods:Sprague-Dawley rats were divided into sham and thermal injury groups subjected to a 60% scald burn. Antagonists, including β-blockade (propranolol), α-blockade (phentolamine), or a selective cyclooxygenase (COX)-2 inhibitor (nimsulide), were administered to verify the pathways involved. Six hours after the burn, the animals were evaluated for gastric emptying and heart rate variability. Blood and gastric tissues were collected for assays of cytokines, hormones, and COX-2 levels. EA was performed at bilateral ST36 (Zusanli) acupoints for 45 m. Results:Burn injury delayed gastric emptying by 61% (P < 0.01), which was normalized by nimsulide or propranolol but not by phentolamine. EA improved gastric emptying by 87% (P = 0.03) in burned rats. Heart rate variability and plasma hormone (noradrenaline and pancreatic polypeptide) analyses indicated sympathetic hyperactivity in burned rats; EA improved burn-induced sympathovagal imbalance by enhancing vagal activity. Protein and mRNA expressions of COX-2 in the gastric fundus and antrum increased with burn but were normalized by propranolol. EA reduced the burn-induced increase in COX-2 expression in the gastric fundus but not in the antrum. EA also decreased burn-induced elevations in plasma interleukin (IL)-6 and IL-10. Negative correlations were found between gastric emptying and plasma IL-6 levels, as well as between gastric emptying and COX-2 mRNA levels. Conclusions:These findings suggest that burn-induced gastric dysmotility is mediated via autonomic-COX-2 pathways. EA at acupoint ST36 improves burn-induced delays in gastric emptying by down-regulating COX-2 and pro-inflammatory cytokines through the autonomic nervous pathway.

功能性消化不良(functional dyspepsia, FD)是临床常见的功能性胃肠病,表现为上腹痛、上腹胀满、早饱、嗳气、食欲不振、恶心、呕吐等不适症状的一组临床综合征,检查排除引起上述症状的器质性、系统性或代谢性疾病.本病已经成为全球日益关注的功能性胃肠道疾病,患病率在10％～30％[1],在我国约为15.57％[2].同时,该类患者常伴有焦虑、抑郁、失眠等精神行为.本病可持续或反复发作,但缺乏有效的治疗手段,西药作用尚不肯定,且存在胃肠道反应.

目的:观察耳电针对糖尿病胃轻瘫大鼠行为学、胃排空率和胃窦组织中酪氨酸激酶受体(c-Kit)和促肾上腺皮质释放激素因子(corticotropin releasing factor,CRF)表达的影响,探讨耳电针改善糖尿病胃轻瘫大鼠胃排空和抑郁样行为的作用机制.方法:将36只SPF级SD大鼠随机分为空白对照组、模型组、耳电针组和假耳针组,每组9只.空白对照组腹腔注射柠檬酸钠缓冲液,其余3组腹腔注射链脲佐菌素(streptozotocin,STZ)溶液,随后继续饲养6周后开始治疗,耳电针组电针双侧耳穴"胃",每日1次,每周5日,连续2周;假耳针组针刺耳垂,不加电.治疗结束后,进行行为学以及胃排空率检测,qRT-PCR检测胃窦组织CRF、c-Kit mRNA表达,ELISA检测胃窦组织CRF、c-Kit蛋白表达.结果:旷场实验中模型组大鼠进入中央区域次数(CE)、进入中央区域时间百分比(CT%)和进入中央区域距离百分比(CD%)均较空白对照组明显降低(均P<0.05),耳电针组CE、CT%和CD%值均较模型组明显升高(均P<0.05);强迫游泳实验中模型组大鼠漂浮时间百分比(FT%)较空白对照组明显升高(P<0.05),耳电针组FT%值较模型组明显降低(P<0.05);与空白对照组相比,模型组大鼠胃排空率显著降低,胃窦中CRF的mRNA和蛋白表达水平明显升高(P＜0.05),c-Kit的mRNA和蛋白表达水平明显降低(P＜0.05);与模型组和假耳针组比较,耳针组大鼠胃排空率显著升高,胃窦中CRF的mRNA和蛋白表达水平明显降低(P＜0.05),c-Kit的mRNA和蛋白表达水平明显升高(P＜0.05).结论:低频耳电针可以改善糖尿病胃轻瘫大鼠的胃动力与抑郁样行为,其机制可能与调节胃窦组织中相关因子的表达有关.

仲远明教授"穴、针、灸"并重治疗枕大神经痛的临床经验.仲远明教授认为,枕大神经痛多因患者感受风寒之邪侵袭,提出从"选穴""针刺手法"和"艾灸"三部分出发,采用"疏风散寒,温通经络"的治疗方法,在传统取穴的基础上,联合其独创的"透风穴",改良齐刺法,重用灸法在风池穴,"穴、针、灸"并重,杂合以治,注重循经感传,临床效果显著.

自主神经系统在胃肠道组织中分布广泛,自主神经功能紊乱可引起胃肠道动力障碍、内脏高敏和消化液的分泌异常等.耳穴疗法已经广泛用于治疗消化系统疾病,其作用机制与耳穴疗法具有调节自主神经的功能相关.该文从自主神经在耳廓和胃肠道的分布、胃肠道自主神经功能紊乱、耳穴疗法通过调节自主神经对胃肠道的效应及机制研究3个方面作论述,旨在初步明确耳穴疗法的作用机制,促进耳穴疗法在胃肠道疾病中的运用.

风池穴是临床常用穴,治疗疾病范围广,一般不受体位的限制.仲远明教授认为,针刺风池穴可通过松解枕下相关肌群以及颈部周围的肌肉、韧带、神经,改善和缓解局部组织的粘连、挛缩,消除血管、肌肉、神经的卡压,治疗头面诸疾.以风池为主穴,上清头目、通调头面诸窍气血,用于脑卒中、失眠、耳鸣、头痛、动眼神经麻痹、贝尔面瘫等的治疗中,可获得较好的临床疗效.附验案2则以佐证.

在分析恩格尔生物心理社会医学模型与认知心理学模型、心身医学模型之间关系的基础上,结合《黄帝内经》对心身疾病的论述,构建了中医学心身医学和心身疾病模型,以及包括先天失衡、生活不节、外邪入脏、天地运气、社会因素、情志不节六大病因在内的中医学心身疾病病因模型,并对每一种病因从中医学以及传统文化角度进行了针对性分析,同时比较了中、西医心身疾病病因的异同,为后期临床使用中药、针灸等传统方法破解心身疾病病因以治疗心身疾病提供了初步思路.

目的 观察电针疗法预防胰十二指肠切除术后胃瘫综合征的临床疗效.方法 选取2016年5月—10月期间在南京医科大学第一附属医院胰腺中心需接受胰十二指肠切除手术的住院患者80例,所有病例初筛合格后,按照随机数字表法随机分为两组,每组40例.对照组在术后第1天开始采取补液、抗感染、静脉营养等常规治疗.治疗组在对照组治疗的基础上采用电针治疗.比较两组术后胃瘫综合征的发生率,术后首次排气、排便时间及术后腹部疼痛视觉模拟评分法(Visual Analogue Scale,VAS)评分等.结果 治疗组术后胃瘫综合征发生率为5％(2/40),对照组术后胃瘫综合征发生率为25％(10/40),治疗组术后胃瘫综合征的发生率明显低于对照组,两组比较差异有统计学意义(P<0.05).治疗组术后首次排气时间和术后首次排便时间均明显短于对照组,两组比较差异有统计学意义(P<0.05,P<0.01).两组患者治疗后VAS评分与治疗前比较均下降(P<0.05,P<0.01);且治疗组治疗第2～6天后腹部疼痛VAS评分明显低于对照组,两组比较差异有统计学意义(P<0.01),治疗组治疗效果优于对照组.结论 电针疗法对胰十二指肠切除术后胃瘫综合征有良好的预防作用,并且可以缩短患者术后首次排气、排便时间,促进术后胃肠道功能的恢复,还可以减轻患者术后腹部疼痛,提高生活质量,从而促进患者术后快速康复.

目的:观察低频耳电针在降低内脏高敏感模型大鼠内脏敏感性中的作用.方法:SD大鼠随机分为空白组、模型组、耳针1组、耳针2组,每组10只.除空白组外,其余大鼠通过母婴分离加醋酸灌肠建立内脏高敏感大鼠模型.耳针1组与耳针2组接受2 Hz电针刺激30 min/d,10 d.通过腹外斜肌肌电(EMG)测定直肠扩张下大鼠内脏疼痛阈值,远端结肠HE染色观察病理改变,实时荧光定量PCR检测大鼠下丘脑nesfatin-1,促皮质素释放因子(CRF)及其受体1,2(CRF1/2R)及结肠5-羟色胺受体4(serotonin receptor4,5-HT4R)的mRNA表达情况.结果:模型组腹外斜肌放电曲线下面积(AUC)较空白组显著增加(P＜0.05);与模型组相比,耳针1组AUC显著减少(P＜ 0.05).与空白组比较,模型组下丘脑CRF、nesfatin-1、CRF1R、CRF2R的mRNA表达均显著升高(P＜0.05),远端结肠5-HT4R的mRNA表达有下降的趋势(P=0.067).耳针1组下丘脑CRF、nesfatin-1、CRF1R、CRF2R的mRNA较模型组显著下降(均P＜0.05),且远端结肠5-HT4R的mRNA表达显著提高(P＜0.05).耳针2组下丘脑CRF、CRF2R的mRNA较模型组显著下降(均P＜0.05),但较模型组nesfatin-1、CRF1R无显著差异,远端结肠5-HT4R的mRNA表达上调不显著(P＞0.05).结论:低频耳电针可缓解内脏高敏感大鼠的内脏敏感性,可能与调节下丘脑CRF、CRF1R、CRF2R、nesfatin-1,以及远端结肠5-HT4R的mRNA表达有关.

目的 观察电针治疗在结肠癌术后康复中的作用和临床疗效.方法 按照纳入标准将86例结肠癌术后患者随机分为观察组和对照组,每组43例.对照组在围手术期采用加速康复外科方案的常规治疗,观察组在对照组治疗基础上在术后第1至第5天采用电针治疗.比较两组术后首次排气、排便时间,观察术后腹部疼痛视觉模拟量表(VAS)评分的变化.结果 观察组术后首次排气、排便的时间均短于对照组,两组比较差异均有统计学意义(P<0.05).术后第2天开始,观察组腹痛VAS评分均低于对照组(P<0.05).结论 在加速康复外科治疗基础上,电针治疗可缩短术后排气、排便时间,并减轻患者术后腹部疼痛,从而促进术后的快速康复.

目的 了解问题式教学法(problem-based learning,PBL)与讲授式教学法(lecture-based learning,LBL)结合在留学生《针灸学》教学中的应用效果.方法 将2014级和2015级南京医科大学临床医学专业本科留学生分为两组进行研究,试验组96人,在完成LBL课程教学的基础上,叠加使用PBL教学法;对照组65人,采用单纯LBL教学法,在学期结束后采用闭卷考核的方式对教学效果进行评估.结果 考核结果显示,试验组学生的期末成绩优于对照组(P=0.000),试验组40分及以上的学生人数多于对照组(P=0.008).结论 PBL+LBL混合教学法的教学效果优于单纯LBL教学法.

OBJECTIVE:To observe the effect of electroacupuncture (EA) at "Ashi" acupoint and "Kunlun" (BL60) on elastic modulus, histopathological changes and expression of myogenic regulatory factors in gastrocnemius(GM) contusion rats, so as to explore the therapeutic effect of local acupoint selection and acupoint selection along channel. METHODS:Male SD rats were randomly divided into blank control (n＝5), model (n＝15), Ashi-point (n＝15) and BL60 (n＝15) groups. The acute GM contusion model was established by striking (free falling) the GM with a homemade hitter. EA (0.5 to 1.0 mA, 2 Hz/10 Hz) was applied to Ashi-point (local focus) and BL60 for 30 min 24 h after muscle injury. The elasticity maximum (Emax) of gastrocnemius muscle was measured by using an ultrasonic device. Histopathological changes were observed after H．E. stain, and the number of Myogenic differentiation(MyoD)- and Myogenin (MyoG)-positive cells was detected by using immunohistochemistry. RESULTS:After mdeling, the Emax value of GM was significantly increased from the 3rd h to 7th day in comparison with pre- injury of muscle (P<0.05), and was markedly increased on the 3rd day and obviously lower on day 7 in the Ashi-point group than in the model group (P<0.05). The numbers of MyoD- and MyoG-positive cells of GM were significantly increased on day 7 in the model group than in the blank control group (P<0.05), and both further increased in Ashi-point on day 3 and 5, and MyoG-positive cells further increased in BL60 group on day 5 and in Ashi-point group on day 7 relevant to the model group(P<0.05). The therapeutic effect of EA-Ashi-point was apparently superior to that of BL60 in up-regulating Emax on day 3 and in up-regulating the number of MyoD-positive cells on day 3 and 5 (P<0.05). H．E. stain showed disordered arrangement of muscle fibers, infiltration of inflammatory cells, increase of intercellular space, and edema on day 3 after modeling (which was milder in the Ashi-point group); and gradual fusion and thickening of new born muscle fibers with obvious connective tissue hyperplasia converged to the lesioned region on day 7 in the model group (convergence of new born muscle cells to the lesion region in both EA groups, and more complete tissues in the Ashi-point group). CONCLUSION:EA of Ashi-point and BL60 can up-regulate the expression of myogenic regulatory factors MyoD and MyoG of GM tissue in GM contusion rats, which may contribute to its function in promoting recovery of muscle elasticity. The role of EA-Ashi-point is superior to that of EA-BL60.

目的:观察电针对胰十二指肠切除术后胃肠道功能恢复的干预作用.方法:将行胰十二指肠切除术的74例胰腺及壶腹部肿瘤患者随机分为治疗组与对照组,每组37例.对照组于围手术期至出院予补液、镇痛、抗感染、营养支持等加速康复外科方案治疗;治疗组在对照组干预的基础上于术后第1～6天加用电针治疗,1次/d.观察并比较2组患者术后首次排气、排便时间,术后胃瘫综合征发生率,治疗前与术后各时期腹部疼痛视觉模拟评分法(VAS)评分及术后住院时间.结果:治疗组术后首次排气、排便时间均明显短于对照组(P<0.05,P<0.01).治疗组术后胃瘫综合征发生率为5.4％,明显低于对照组的37.0％(P<0.05).治疗组术后第3～6天腹痛VAS评分较治疗前明显降低(P<0.01),且第2～6天腹痛VAS评分明显低于对照组(P<0.01).治疗组术后住院时间明显短于对照组(P<0.01).结论:在加速康复外科方案治疗的基础上加用电针疗法能明显促进胰十二指肠切除术后患者胃排空和胃肠道蠕动,减少术后胃瘫综合征的发生率,缓解术后腹部疼痛,促进患者胃肠道功能的恢复.

To assess the effects of electro-acupuncture (EA) on glycemic control, myocardial inflammation, and the progression of diabetic cardiomyopathy in mice with type 2 diabetes. Db/Db mice received EA at PC6+ST36 (DM-Acu), non-acupoint simulation (DM-Sham), or no treatment (DM). EA was applied for 30 min per day, 5 days a week for 4 weeks. Heart function was assessed by echocardiography. Myocardium was assessed by RT-PCR, immunoblotting, and histology. Serum TNF-α, IL-1α, IL-1β, IL-6, and IL-8 were measured. DM-Acu, but not DM-Sham, reduced fasting blood glucose without affecting body weight. DM decreased systolic function. DM-Acu, but not DM-Sham, attenuated the decrease in systolic function. Heart weight was significantly smaller in the DM-Acu than in the DM and DM-Sham groups. Percent fibrosis and apoptosis were reduced in the DM-Acu, but not the DM-Sham, group. Serum levels of IL-1α, IL-1β, IL-6, IL-8, ICAM-1, MCP-1, and TNF-α were significantly lower in the DM-Acu than in the DM or DM-Sham groups. Protein levels of P-Akt and P-AMPK and mRNA levels of phosphoinositide-3-kinase regulatory subunit 6 (PIK3r6) were significantly higher in the DM-Acu group. Myocardial mRNA and protein levels of insulin-like growth factor 1 receptor (IGF1R) were significantly lower in the DM and DM-Sham groups compared with the DM-Acu group. EA reduced serum glucose; prevented DM-induced hypertrophy and deterioration of systolic function, inflammation, and fibrosis; and restored IGF1R, P-Akt, and P-AMPK levels in mice with type 2 diabetes mellitus.

目的:观察低频电针耳穴“胃”对链脲佐菌素(streptozotocin,STZ)致糖尿病大鼠胃窦病理形态、Cajal间质细胞(interstitial cells of Cajal,ICC)、血清胃促生长素(Ghrelin)和血管活性肠肽(vasoactive intestinal peptide,VIP)浓度的影响.方法:24只雄性SD大鼠随机分为模型组、假耳针组、耳针组,每组各8只,腹腔注射STZ(55 mg/kg)诱导糖尿病大鼠模型,造模后第8周假耳针组取耳垂,耳针组取耳穴“胃”进行电针治疗(2 Hz,20 min/次,每天1次,1周5d,连续2周),模型组无治疗.比较治疗前、后各组大鼠空腹血清Ghrelin、VIP浓度的改变,治疗结束后取胃窦组织行HE染色、c-Kit免疫组化染色,以及Western blot检测胃窦组织c-Kit蛋白表达水平.结果:治疗后,耳针组血清Ghrelin浓度较治疗前显著上升(P＜0.05),且高于模型组(P＜0.05);免疫组化及Western blot结果均显示耳针组胃窦c-Kit蛋白的表达均显著高于模型组与假耳针组(P均＜0.01).结论:电针耳穴“胃”能够促进糖尿病大鼠胃窦ICC的修复,可能与上调血清Ghrelin有关.

背景 阿是穴是针灸治疗骨骼肌损伤的常用穴位.然而,其在急性骨骼肌损伤后的干预时机尚未有相关报道.目的 观察不同时机电针阿是穴对腓肠肌钝挫伤大鼠腓肠肌高频超声成像评分、血清肌酸激酶(CK)水平的影响.方法 2017年9月,将清洁级健康成年雄性SD大鼠60只随机分为空白组(n=6)、模型组(n=18)、24 h电针组(n=18)、72 h电针组(n=18).除空白组外,模型组、24 h电针组、72 h电针组均参照本课题组前期研究的方法 建立腓肠肌急性钝挫伤模型,并采用超声成像技术进行评定.由于动物无言语表达能力,研究中阿是穴的选取以局部病灶(即腓肠肌肌腹的中点,辅以超声进行病灶定位)作为针刺部位.除空白组外,各组造模后3、5、7 d分别抓取不同的6只大鼠进行以下操作:24 h电针组在钝挫伤后24 h进行1次针刺治疗,72 h电针组在钝挫伤后72 h进行1次针刺治疗.模型组与2个电针组同步抓取与固定,但不做电针干预.空白组不做任何处理.记录各组大鼠造模后3、5、7 d超声分级评分表评分.评分后处死,记录各组大鼠造模后3、5、7 d血清CK水平.结果 模型组、24 h电针组、72 h电针组大鼠造模后即刻、3、5、7 d超声分级评分表评分比较,差异均无统计学意义(P>0.05).造模后3 d、24 h电针组大鼠不同时间点造模后即刻超声分级评分表评分与干预后超声分级评分表评分差值大于模型组、72 h电针组(P<0.05).模型组大鼠造模后3、5、7 d血清CK水平均高于空白组(P<0.05);24 h电针组大鼠造模后5、7 d血清CK水平均高于空白组(P<0.05);72 h电针组大鼠造模后3 d血清CK水平低于模型组,5、7 d血清CK水平均高于空白组(P<0.05).结论 电针阿是穴能有效促进大鼠腓肠肌钝挫伤后的组织修复,损伤后24 h电针阿是穴治疗能较早地促进组织修复.

目的:运用循证医学的方法,对针刺疗法治疗乳腺癌术后潮热短期和中期有效性进行Meta分析.方法:收集2017年6月30日以前CNKI、CBM、维普、万方、PubMed数据库针刺疗法治疗乳腺癌术后潮热的临床试验资料,用Cochrane系统评价方法对文章进行质量评分,利用Revman5.3软件对多个研究结果的总体效应进行Meta分析,并进行异质性评价.结果:共纳入6篇文献,Meta分析结果示治疗3个月(SMD:-0.36,95％CI:-0.61～-0.10)和6个月(SMD:-0.41,95％CI:-0.64～-0.18)的随访结果都表明针刺组患者的潮热症状改善优于对照组,两组比较差异有统计学意义(P=0.006,P=0.000 5).结论:在研究设计较完善的临床研究中,针刺对于乳腺癌术后潮热症状改善的短期和中期效果优于对照组.