皮部与感受器可被用来从中、西医的不同角度阐释中医外治法的作用机制.文章收集、分析关联不同中医外治法(含针刺、推拿、砭法、罐法、灸法)与相关感受器(包括痛觉、机械、温度感受器)的文献后发现,针刺、推拿激活的感受器较多,砭法、罐法次之,灸法最少.此外,中医外治法的起效与感受器有关,不同疗法激活的感受器亦不同.上述结论可为初步揭示经络学说之皮部的部分科学内涵提供参考.

总结针灸在马耳他发展的现状及立法情况,为"一带一路"政策下,中医针灸在较高层面上进行规范化的推广,并进入良性发展的轨道提供政策参考.以作者在马耳他大学中医中心工作经历为背景,以实地调研为主要工作方法,结合检索PubMed、荷兰医学文摘数据库(Embase)、中国期刊全文数据库(CNKI)、维普(VIP)和万方数据库,搜集与马耳他针灸发展相关的文献资料进行综述.结果表明:针灸在马耳他应用已30余年,江苏省和上海市中医机构分别与当地政府、大学合作开展了针灸医疗与教学合作.马耳他在国家医疗保健法中包含有替代医学法章节,其中有针灸医师管理条例.中国与马耳他合作建成的两所医疗中心,为中医针灸在马耳他的发展打下了坚实的基础,有望在中医临床、教学、科研等方面开展更高层次的合作与交流.

目的 通过针刺眶周穴位组和眶内穴位组治疗干性黄斑变性来比较组间的临床疗效差别,并同时评估其针刺安全性.方法 将35例干性黄斑变性患者(70只眼)随机分为两组,眶周穴位组36只眼,眶内穴位组34只眼.眶周穴位组取穴为太阳透瞳子髎、攒竹透丝竹空、合谷、养老、光明以及太冲;眶内穴位组取穴为睛明、球后、合谷、养老、光明以及太冲.每周针刺2次,4周(8次)为1个疗程,共治疗2个疗程.比较两组治疗前后最佳矫正视力及眼底照相、眼底荧光血管造影.结果 对于干性黄斑变性患者临床症状的改善,针刺眶周穴位组或眶内穴位组疗效相近.结论 针刺治疗干性黄斑变性可以眶周穴位作为首选.

气血运行失调所致的经气不利,血脉失和,气血瘀滞病证在临床上具有相当的普遍性,尤其在针灸临床病例中所占比率甚高,以“激活经气、调和血脉、活血通络”为治疗大法作导向,采用针灸施术手段治疗此类病证每获立竿见影之效,但为提高疗效在针灸临床具体应用中还应注意以下四个要点:①代表性经穴的应用;②不同病机的审证论治;③补泻手法的施展;④不同施术手段的选用.四点合参,有的放矢,方能共奏“激活经气、调和血脉、活血通络、祛病健身”之效.

目的 观察电针对腺嘌呤诱导的精液异常大鼠卵泡刺激素(FSH)、黄体生成素(LH)的影响,探求电针治疗精液异常疾病的原理.方法 将SD雄性性成熟大鼠随机分为治疗组、模型组和对照组.治疗组造模成功后采用电针治疗7d.3组均在麻醉后腹主动脉取血,比较各组血清FSH、LH含量.结果 治疗组和对照组大鼠治疗后血清LH、FSH与模型组比较,差异均具有统计学意义(P＜0.01,P＜0.05).治疗组治疗后LH、FSH与对照组比较,差异均无统计学意义(P＞0.05).结论 电针可提高腺嘌呤诱导的精液异常大鼠血清FSH、LH的浓度.

目的:观察长期针刺治疗对慢性神经痛大鼠海马EphrinBs/EphBs mRNA和EphrinB3蛋白表达的影响,探讨针刺镇痛可能的机制.方法:SD雄性大鼠共35只,随机分为假手术组(n=9)、模型组(n=8)、电针组(n=9)、手针组(n=9).采用慢性坐骨神经结扎性损伤(CCI)模型,电针组和手针组大鼠从造模后第8天开始至第34天分别给予电针、手针干预大鼠“足三里”和“三阴交”穴,隔日1次.所有大鼠均在造模前、造模后第7、14、21、28和35天进行机械性痛阈(MWT)测定;各组大鼠于术后第35天处死取材,采用定量Q-PCR的方法检测海马EphrinBs/EphBs各型mRNA的表达,并采用Western blot方法检测EphrinB3蛋白的表达.结果:与假手术组比较,模型组造模后第7天起各时间点MWT值显著降低(P＜0.01).与模型组比较,电针组、手针组大鼠造模后第14至35天大鼠MWT值均显著上调(P＜0.05,P＜0.01),与假手术组相比,模型组大鼠海马中EphB1、EphB2、EphB3和EphrinB2的mRNA表达水平均显著增加(P＜0.05,P＜0.01);与模型组比较,手针组及电针组大鼠EphB1、EphB2、EphB4和EphrinB3 mRNA表达水平显著下降(P＜0.05,P＜0.01),电针组EphB6 mRNA的表达显著下调(P＜0.01);电针组和手针组海马EphrinB3蛋白表达水平明显降低(P＜0.05).结论:针刺广泛调节海马EphrinBs/EphBs系统的表达可能是针刺治疗神经病理性疼痛的机制之一.

帕金森病（Parkinson's disease，PD）是常见于中老年人的神经变推行性疾病，临床上以静止性震颤、肌强直、运动迟缓和姿势步态障碍为主要特征。其主要病理改变是黑质纹状体多巴胺能神经元变性及黑质残存的神经细胞质内出现嗜酸性包涵体，即 Lewy小体。我国65岁人群的 PD患病率为1.67%，且发病率随年龄增加而升高，男性稍高于女性［1］。PD高发病率及高致残率严重影响患者生活质量，一些药物只能改善其症状，不能阻止病情的发展。本病属中医“颤证”范畴，为本虚标实之证，肝肾阴虚、气血不足为病之虚，风、火、痰为病之实。近年来，针刺治疗PD有一定的疗效，现将有关此方面的临床和实验研究文献综述如下。

With the development of acupuncture teaching method in undergraduate students and 7 years learners,new requirements on acupuncture training teaching method was proposed.Nowadays,LBL was used for acupuncture training,CBL and EMB were applied at sometimes.These methods have its superiority and weaknesses.Based on the current state of acupuncture training methods,we view that PBL training method is feasible on acupuncture training teaching and will become the trend in the future.

Objective To observe the effect of electro-acupuncture on expression of TNF-α,IL-1β,IL-6 in peripheral blood in rats with chronic constriction injury(CCI) of the sciatic nerve,and discusses its mechanism of acupuncture analgesia.Methods Thirty-seven male rats were randomized into CCI sham-operation group(n = 9);CCI control group(n = 9);CCI hand acupuncture group(n = 10) and CCI electro-acupuncture group(n = 9).The mechanical pain threshold was detected before operation,at 7d,17d,27d and 37d after operation;the expression of TNF-α,IL-1β and IL-6 was detected by ELISA at the 37d after operation.Results The mechanical pain threshold in control group,hand acupuncture group and electro-acupuncture group were decreased after operation,and different from that of the sham-operation group at the same period(P 0.05).From 7d to 37d after operation,the mechanical pain threshold in hand acupuncture group and electro-acupuncture group were improved(P 0.05).The levels of TNF-α(P 0.01) and IL-6(P 0.05) in control group were higher than that of the sham-operation group.The TNF-α level in hand acupuncture group and electro-acupuncture group were lower than that of the control group(P 0.05),and no significant difference was found between acupuncture groups and sham-operation group(P 0.05).No significant difference was found in IL-1β among each group.Conclusion Acupuncture treatment can inhibit the expression of proinflammatory cytokines.It may be association with neuropathic pain.

OBJECTIVE To explore the effects on thyroid function in patients of Hashimoto's thyroiditis treated with aconite cake-separated moxibustion and option the better therapeutic program. METHODS Eighty-five cases were randomly divided into a moxibustion group (42 cases) and a western medication group (43 cases). The moxibustion group was treated by aconite cake-separated moxibustion therapy with acupoints of two groups [(1) Danzhong (CV 17), Zhongwan (CV 12), Guanyuan (CV 4); (2) Dazhui (GV 14), Shenshu (BL 23), Mingmen (GV 4)] alternatively and oral administration of 25 microg Euthyrox everyday. The western medication group was oral administration of 25 microg Euthyrox everyday. Indices of thyroid function before and after treatment and clinical effect were compared between two groups. RESULTS The clinical total effective rate and effective rate of thyroid function were 25.0% (10/40), 87.5% (35/40) in moxibustion group respectively, 7.53% (3/40) and 57.5% (23/40) in western medication group, with significant differences between two groups (both P < 0.05). Content of serum free thyroxine index (FT4) increased significantly in the moxibustion group after treatment (P < 0.01); content of serum supersensitive thyrotropin (S-TSH) in the moxibustion group was lower than that of western medication group, and contents of serum FT4 and free triiodothyronine (FT3) were higher than those of western medication group, but with no significant differences (all P > 0.05). CONCLUSION Aconite cake-separated moxibustion at Guanyuan (CV 4) and Mingmen (GV 4) combined with oral administration of Euthyrox can improve clinical symptoms and thyroid function in patients of Hashimoto's thyroiditis, which is better than simple oral administration of Euthyrox.

男性不育症不是一种独立的疾病,而是由一种或很多疾病与因素造成的结果。目前对于男性不育的发病病因研究主要集中于遗传、免疫、内分泌以及相关分子因素。针灸治疗男性不育症确有较好的临床疗效,对于针灸作用机制,目前主要集中于免疫、内分泌及其他疾病方面的病因研究,在未来的科研中对于遗传因素将是一个重要的研究方向。

To observe the clinical effect of combined moxibustion and medication for Hashimoto’s thyroiditis.

目的:观察经皮穴位电刺激(TEAS)对大运动量耐力训练大鼠骨骼肌B细胞白血病-淋巴瘤-2(Bc1-2)和B细胞白血病-淋巴瘤-2相关蛋白基因(Bax)含量的影响.方法:将30只雄性SD大鼠随机分为正常组、模型组、正常刺激组、治疗1组、治疗2组,每组6只.模型组和治疗组的大鼠进行8周大运动量跑台训练,治疗1组、治疗2组的大鼠分别于跑台训练前1h和跑台训练后1h采用TEAS干预手段,刺激大鼠“后足三里”和“环跳”穴位,正常刺激组不进行跑台训练,刺激方法同治疗组.8周跑台训练结束后,检测大鼠骨骼肌Bc1-2和Bax的含量.结果:与正常组比较,模型组大鼠骨骼肌中Bax表达显著增加,Bc1-2表达有较多的下降；与模型组比较,正常刺激组、治疗1组、治疗2组大鼠骨骼肌中Bax表达均有降低,Bc1-2表达均有增加.结论:TEAS可以防止因过度训练导致骨骼肌细胞的细胞凋亡,能提高大鼠骨骼肌中Bc1-2的水平和降低骨骼肌中Bax的水平,起到防治运动性疲劳的作用.

Objective To observe the effects of electro-acupuncture on serum estrogen(E2) and testosterone(T) in rats of hydrocortisone-induced sperm abnorma-lities,in an attempt to study its mechanisms.Methods SD sexually mature male rats were randomly divided into three groups: normal group,model group and acupuncture group.After successful modeling,the acupuncture group was treated by the electro-acupuncture for seven days.After treatment,the rats were sacrificed and the E2 and T levels were detected.Results Compared with the normal group,the level of E2 in model group was higher and the level of T in model group was lower,with significant differences between the two groups(P0.01);compared with the model group,the level of E2 in acupuncture group was lower and the level of T in acupuncture group was higher,with significant differences between the two groups(P0.05).Conclusions Electro-acupuncture can treat dysspermia by regulating the levels of serum E2 and T.

To observe the clinical effect of electroacupuncture in treating perimenopause syndrome (PMS) and explore its possible action mechanism.

Objective To investigate the effect of transcutaneous electrical acupoint stimulation(TEAS) on skeletal muscle energy metabolism in strenuous endurance training rats.Methods Forty male SD rats were randomly allocated to normal,model,normal stimulation,treatment 1 and treatment 2 groups,8 rats each.TEAS was used as an intervention.Rat points Zusanli and Huantiao were stimulated.Rat gastrocnemius hepatin,lactic acid(LA),lactic acid dehydrogenase(LDH),Na+-K+-ATPase and Ca2+-ATPase contents were measured after 8 weeks of platform exercises.Results TEAS could significantly decrease gastrocnemius hepatin consumption,reduce lactic acid accumulation and increase Na+-K+-ATPase and Ca2+-ATPase contents.There were statistically significant differences between the model group and each of the other 4 groups(P0.05).Conclusion Transcutaneous electrical stimulation of points Zusanli and Huantiao can stabilize skeletal muscle cell energy metabolism,prolong muscular work and delay skeletal muscle fatigue.

Objective To observe the effect of the transcutanclus electrical acupiont stimulation(TEAS) on the nitrogen monoxidum(NO),nitric oxide synthase(NOS),total nitric oxide synthase(TNOS) and inducible nitric oxide synthase enzyme(iNOS) levels of skeletal muscle in rats during extensive endurance training,and to explore its possible role in eliminating skeletal muscle fatigue.Methods 40 male SD rats were equally and randomly divided into normal group,model group,normal stimulation group,treatment group 1,and treatment group 2.Each group contained 8 rats.Model group and treatment groups started training with the intensity of 15 m·min-1,for 15 min,and increased the speed and duration 2 m·min-1 and 5 min respectively every other day until 38 m·min-1 × 60 min for a total of 8 weeks.TEAS("Zusanli" and "Huantiao")(15 min) were performed for rats in treatment group 1 and treatment group 2 1h before and 1h after treadmill training.After 8-week experiment,all rats were weighted,and skeletal muscle NO,TNOS and iNOS levels were tested.Results The body weight of model group,treatment group 1,treatment group 2 was significantly lower than that of model group and normal stimulation group,and the weight of treatment group 1 and treatment 2 was significantly higher than that of model group.The NO,TNOS and iNOS levels of groups receiving TEAS significantly lower than that of model group(P < 0.05).Conclusion TEAS prevents the rapid decline of rat's body weight,inhibits the formation of NO,TNOS and iNOS of skeletal muscle in rats during extensive endurance training,and thus eliminating muscle fatigue.

Experience is accumulated through PBL teaching practice about Acumox Therapeutics for 7 terms.In the coming teaching practice,we will advance the proportion of PBL step by step,until to 100%.

To introduce the advances of clinical research on acupuncture and moxibustion for treatment of women's climacteric syndrome(CS).The following reports are classified by different methods of acu-mox therapy.Some advice might be helpful for further clinical research of treatment of women's CS.

Objective: To observe the effects of electro-acupuncture at acupoints Tianzhu(GB 10) and Dazhu(GB 11) on expressions of IL-1α and IL-6 of the degenerated cervical intervertebral discs in rats.Methods: The model of degenerated cervical intervertebral discs was made by imbalance of cervical disc dynamic-static forces imbalance.The rats in acupuncture group were treated by electro-acupuncture at Tianzhu(BL10) and Dazhu(BL11) and the IL-1α and IL-6 expressions were assayed by ELISA technique,meanwhile sham group,Fenbid group and model group were also made and respectively treated.Results: The expressions of IL-1α and IL-6 were higher in model group than in the other three groups(P < 0.01,P < 0.05);electro-acupuncture and Fenbid both could reduce the expressions of IL-1α and IL-6,but electro-acupuncture had better effect than Fenbid in reducing the expression of IL-1α(P < 0.01).Conclusion: Electro-acupuncture can reduce the expressions of IL-1α and IL-6 of the degenerated cervical interverte-bral discs in rats to attain its purpose of treatment.