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.

目的 观察针刺联合中药熏蒸治疗干眼症的临床疗效.方法 选取北京黄寺整形外科医院及河南省鹤壁市中医院2017年7月至2019年7月干眼症患者80例,按照随机数字表法分为观察组和对照组,各40例.观察组采用针刺、中药熏蒸治疗,对照组给予玻璃酸钠滴眼液治疗.治疗3个疗程后,观察两组治疗前后泪液分泌试验、泪膜破裂时间评分变化情况.结果 观察组有效率为92.5％,对照组有效率为72.5％,观察组优于对照组(P<0.05);治疗后两组泪液分泌试验、泪膜破裂时间比较,差异有显著性(P<0.05).结论 针刺联合中药熏蒸治疗干眼症的疗效优于人工泪液.

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.

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.

Objective:To assess the possible effects of acupuncture at GB 20 ( Fengchi) on the CGRP and 5-HT signal of hemicrania based on the influence of inserting GB 20 ( Fengchi) on RAMP1 and 5-HT1B recep-tors.Methods:We used immunohistochemical staining to observe the influence of inserting GB 20 (Fengchi) on RAMP1 and 5-HT1B receptors.Results:Electrical stimulation of rats’ dura could cause the increase of RAMP1 and the decrease of 5-TH1B receptors of middle meningeal arteries.The expression of RAMP1 was significantly <br> reduced when acupuncture at GB 20 ( Fengchi) both before and after the modeling, while there was no signifi-cant changes of the expression of 5-TH1B .Conclusion:On acute attack of hemicrania, there is activation of CGRP and inhabitation of 5-TH.Acupuncture at GB 20 (Fengchi) can influence the blood response during the attack of hemicrania, and probably act mainly through CGRP path.

Objective: To study the effect of acupture of Fengchi point on the expression of myosin light chain kinase( MLCK) in middle meningeal artery of migraine model rats. Methods: Evoked by electrical stimulation induced migraine animal models,detect the expression of the MLCK in middle meningeal artery. Results: The models of migraine rats were established successfully. Through statistical analysis of the blank control group being compared with the control group,MLCK expression decreased obviously( P 0. 01); Fengchi acupuncture group compared with Fengchi prevention group,there was no significant difference( P 0. 05),but Fengchi acupuncture group compared with the blank control group,Fengchi prevention group compared with the blank control group,there were all significant differences( P 0. 05). Conclusion: Possibly there is a relationship between acute attack of migraine and the decrease of MLCK of calcitonin gene related pepitde( CGRP) signal system,and the expression of MLCK by acupuncturing Fengchi point in the middle meningeal artery is increased,and it has the preventive and curative effect acute attack of migraine.

Objective: To study the effect of acupuncture at Fengchi Point (GB20) on neurogenic inflammatory reaction in the middle meningeal artery of rats by immunofluorescence. Methods: 44 healthy female Sprague–Dawley (SD) rats were randomly divided into four groups: normal control group, model control group, acupuncture at Fengchi group and prevention group. Normal control group without any treatment, model control group was arranged to modle only, acupuncture at Fengchi group were treatment with acupuncture at Fengchi point 20 minutes and Fengchi prevention group were processed with manipulation 2 minutes and needle retention 20 minutes and then to model by electrical stimulation. Results: Immunofluorescence microscopy showed that a large number of green fluorescent colored CRLR immunoreactive particles at the middle meningeal artery of the model control group, with higher brightness deeper color and higher fluorescence intensity of CRLR immunoreactive particles compared with other groups; the acupuncture at Fengchi group and prevention group was difficult to distinguish by fluorescence intensity and color distribution with naked eyes. The acupuncture group and the wind pool to prevent the wind pool acupuncture group and the fluorescence intensity distribution of eye color was difficult to distinguish differences between the two stain intensity compared with the control group, fluorescence intensity was weak. But both stain intensity of the two groups were lighter, compared with the model control groups. Conclusion: The CRLR expression of the middle meningeal artery was significantly increased at neurogenic inflammatory reaction model rats, compared with normal rats. And treatment with acupuncturing at Fengchi point can inhibit the expression of CRLR.

本文参考近年来关于针灸治疗偏头痛的18篇文章,根据针灸治疗的不同方法分别从毫针治疗、透刺治疗、刺血治疗、电针治疗、刺压耳穴治疗和其他疗法等6方面对偏头痛的治疗进行总结,以便为治疗本病和临床研究提供有效的方法。

风池穴的传统刺法包括刺向对侧内眦、对侧鼻尖、对侧眼球及双侧风池对刺,危险结构为脊髓上端、延髓、椎动脉,安全深度一般控制在35mm之内,安全性依次为双侧风池对刺、对侧鼻尖、对侧内眦.风池穴刺向对侧眼球最为危险;风池穴的神经径路与颈3神经后支、枕小神经干或枕大神经分支的外侧支、枕下三角外侧、颈后神经丛、椎动、静脉丛等关系密切,针刺效应可能与其神经径路有关;目前对风池穴作用机理的研究多倾向于风池穴对颈内动脉、椎-基底动脉系统的影响.

原发性痛经属中医月经不调之经行腹痛范畴,古今医家多从气滞、血瘀、风寒入手,以调理冲任为总纲。笔者从脾胃立论,以调理太阴阳明,培补脾胃生化之源为总纲,选取双侧脾俞、胃俞、上髎,采用艾条治疗、大艾炷治疗、小艾炷治疗三种不同的灸量灸法进行调治,对比不同的灸量灸法对原发性痛经的治疗疗效的差异,同时对比三种治疗方法对穴位皮温、穴位皮阻的影响。研究证实,三种治疗方法均能有效缓解疼痛,提高痛经的疗效;艾炷治疗方法可显著提高患者的皮温耐受性,降低患者穴位皮阻,提高患者对疼痛的耐受性,至于灸疗法如何降低穴位皮阻,以及降低穴位皮阻对疗效有何影响,还需要进一步研究。

Fengchi point(GB30)is regarded as an important point which be used to cure migraine for a long time.Usually deep insertion to get better effect when using single fengchi point to cure migraine,and methods as point injection,massage etc were adopted too.Recently sting fengchi point as common method is used at practical migraine treatment,and usually combined with point injection or ear point bean-press in order to get notable curative effect.The extensive application of using fengchi point at clinic treatment should be paid great attention by physicians and researchers.

从脾胃立论,阐述原发性痛经病机基础所重在冲脉,所重在胃气,所重在心脾生化之源,冲任之血由阳明水谷所化,而阳明胃气为冲脉之本,认为脾胃损伤→气血失和→冲任劳损是月经不调之经行腹痛的重要病机,强调以调理太阴阳明为总纲,调养脾胃治疗本病的重要性。

Objective To study the changes of brain auditory working memory of Chinese character phrases in patients with liver-qi stagnation syndrome by applying functional magnetic resonance imaging(fMRI),find the brain functional region of the liver-qi stagnation syndrome and the changes of cognitive function,and to reveal the cerebral mechanism of the syndrome.Methods The patients with liver-qi stagnation syndrome(n=16,male 5 and female 11)from 25 to 50 year-old and healthy postulants(n=16)according to the age and sex matching were chosen and scanned by magnetic resonance imaging.The task of brain auditory working memory function of Chinese character phrases was carried out in 1-bck of block-design.The scan was started from resting and the sequence was resting-baseline-resting-stimulating circularly by using magnetic resonance machine of Plilips1.5T.The data was processed with SPM software based on MATLAB platform.Results The number and area of activated brain regions of working memory in the healthy group were much more than those in the patient group.Besides the left inferior frontal gyrus(BA44/47,Broca motor speech region)of activated brain regions in the healthy group other brain regions and the right parietal lobe were inhibited in the patient group when the working memory reduced.Conclusion The brain regions were positioned related to the changes of working memory in the patients with liver-qi stagnation syndrome.The liver-qi stagnation syndrome can induce cognitive function changing,which provides the visual objectified evidence for TCM syndrome types.