目的:观察髂后上棘微调矫正法治疗骶髂关节后下错位的临床疗效.方法:将2020年5月—2021年4月于黑龙江中医药大学附属第三医院就诊的90例骶髂关节后下错位患者随机分为观察组、对照A组和对照B组,每组各30例.3组在关节整复前均采用传统推拿手法进行基础治疗以放松肌肉,随后观察组采用髂后上棘微调矫正法,对照A组采用传统复位手法,对照B组采用美式整脊矫正法.所有基础治疗均1次/d,手法矫正为1次/2 d,7 d为1个疗程,共治疗2个疗程.分别于治疗前、治疗后及治疗后1个月随访时观察三组患者VAS疼痛评分、ODI功能障碍评分、腰椎JOA评分和骨盆两侧髂嵴高度差的变化,比较3组的临床疗效差异.结果:治疗14 d后,观察组的总有效率为93.3％(24/30),明显高于对照A组的70％(21/30)和对照B组的60％(18/30).与治疗前相比,三组患者治疗后和治疗后1个月随访的VAS评分、ODI评分和两侧髂嵴高度差均明显下降,JOA评分明显升高(P<0.05).在治疗后和治疗后1个月随访时,观察组VAS评分、ODI评分和两侧髂嵴高度差均低于对照A组和对照B组,且JOA评分高于对照A组和对照B组.结论:对于骶髂关节后下错位患者,髂后上棘微调矫正法能明显缓解患者骶髂关节疼痛,改善机体日常功能,提高腰椎活动程度,其临床疗效和远期疗效均明显优于传统复位手法和美式整脊法,值得临床推广应用.

目的:观察短刺夹脊穴配合芒针治疗神经根型颈椎病的的临床疗效及对血清炎性因子的影响.方法:将60例患者随机分为对照组30例、试验组30例.对照组在基础治疗基础上,予以传统针刺干预;试验组在基础治疗的基础上,予以短刺夹脊穴配合芒针干预.两组均每日治疗1次,每周6d,疗程为2周,3个月后进行随访.分别于治疗前后观察两组视觉模拟疼痛量表(VAS)、上肢功能评分量表及血清白介素-1 β(IL-1β)、白介素-6(IL-6)和肿瘤坏死因子(TNF-α)的水平变化,对比临床疗效差异,并对3个月后复发率进行比较分析.结果:治疗后两组患者VAS评分均较治疗前明显降低,差异具有统计学意义(P＜0.01),且试验组优于对照组,差异具有统计学意义(P＜0.05).治疗后两组患者上肢功能评分较治疗前水平显著增高,差异具有统计学意义(P＜0.01),且试验组优于对照组,差异具有统计学意义(P＜0.05).治疗后两组血清炎性因子IL-1β、IL-6和TNF-α的含量均较治疗前下降,差异具有统计学意义(P＜0.05),且试验组低于对照组,差异具有统计学意义(P＜0.05).疗效评定方面,对照组总有效率为80.0％(24/30),试验组总有效率为96.7％(29/30),差异有统计学意义(P＜0.05).疾病复发方面,试验组症状复发率为10.3％ (3/29),明显低于对照组的41.7％(10/24),差异具有统计学意义(P＜0.01).结论:短刺夹脊穴配合芒针治疗神经根型颈椎病可有效缓解颈椎疼痛程度,改善上肢功能状态,其临床疗效明显优于传统针刺治疗,其机制可能与降低血清IL-1β、IL-6和TNF-α等炎性因子水平有关.

目的:观察揿针结合于氏丛刺治疗卒中后抑郁的临床疗效.方法:将90例患者随机分为对照组30例、传统针刺组30例和联合针刺组30例.对照组在基础治疗基础上,予以口服舍曲林,传统针刺组在对照组基础上予以传统针刺干预,联合针刺组在对照组的基础上,予以揿针结合额区丛刺干预,3组均每日1次,每周7次,连续治疗6周.3组患者分别于治疗前和治疗6周时运用24项汉密尔顿抑郁量表(HAMD)、改良爱丁堡-斯堪的那维亚神经功能缺损评分量表(MESSS)以及测定5-HT水平比较3组间的疗效差异.结果:治疗后,3组患者HAMD评分和MESSS评分均较治疗前显著下降,差异具有统计学意义(P＜0.01),传统针刺组和联合针刺组优于对照组,差异具有统计学意义(P＜0.05或P＜0.01).治疗后3组患者5-HT水平较治疗前水平显著增高,差异具有统计学意义(P＜0.01),传统针刺组和联合针刺组优于对照组,差异具有统计学意义(P＜0.01).疗效评定方面,对照组总有效率65.52％ (19/29),传统针刺组和联合针刺组总有效率分别为78.57％ (22/28)和89.66％(26/29).结论:在舍曲林基础上揿针结合于氏丛刺或传统针刺治疗卒中后抑郁比单独应用舍曲林更为有效、安全.揿针联合于氏丛刺较传统针刺疗效更优,值得临床推广应用.

目的 观察电项针对慢性睡眠剥夺(CSD)轻度认知障碍大鼠海马组织中突触素(SYN)、脑源性神经营养因子(BDNF)和酪氨酸激酶受体B(TrkB)蛋白表达的影响,探讨电项针改善CSD记忆损伤的作用机制.方法 将24只雄性Wistar大鼠随机分为大平台对照组、模型组和电项针组,每组8只.模型组和电项针组采用改良的多平台水环境法制备模型,大平台对照组除平台表面有细密铁丝网外,其他条件与造模环境一致.电项针组选取两侧的风池和供血穴电针治疗,模型组和大平台对照组给予相同时间的捆绑固定,共14 d.Morris水迷宫实验检测大鼠学习记忆能力,免疫组化技术检测各组海马CA1区SYN、BDNF和TrkB蛋白的定性表达,Western blot技术检测各组海马区SYN、BDNF和TrkB蛋白的定量表达.结果 造模后,模型组和电项针组大鼠逃避潜伏期较大平台对照组明显延长(P<0.05),经针刺治疗后,电项针组逃避潜伏期较模型组显著缩短(P<0.05).免疫组化和Western blot结果显示,与大平台对照组相比,模型组大鼠海马SYN、BDNF和TrkB蛋白表达均明显减少(P<0.05);与模型组相比,电项针组大鼠海马SYN、BDNF和TrkB蛋白表达升高(P<0.05).与大平台对照组大鼠相比,电项针组TrkB表达升高(P<0.05),SYN和BDNF表达差异无统计学意义(P>0.05).结论 电项针能显著上调CSD轻度认知障碍大鼠海马区SYN、BDNF和TrkB蛋白的表达,增强海马突触可塑性.

Objective To observe the intervention effect and influence of different frequencies electro-nape-acupuncture (ENA) on sleep phase of cortex EEG and the contents of serum hormone in insomnia rats induced by PCPA, to discuss the possible mechanism of promoting sleep quality of ENA. Methods Forty male rats were randomized into normal group, model group, ENA group Ⅰ (stimulus frequency of 2 Hz), ENA group Ⅱ (stimulus frequency of 50 Hz) and ENA group Ⅲ (stimulus frequency of 100 Hz), with 8 rats in each group. Acupoints of Fengchi and Gongxue on both sides were used for the each ENA group. 0.25 mm×25 mm disposable sterile acupuncture needles were inserted 7-10 mm. The same side acupoints were connected with wires of electroacupuncture therapeutic meter and corresponding stimulus frequencies were used for treatment. After intervention for seven consecutive days, sleep EEG of rats were recorded. The contents of serum adrenocorticotropic hormone (ACTH) and cortisol (CORT) were measured by enzyme-linked immunosorbent assay (ELISA) in each group. Results Compared with the normal group, total every stage of sleep time decreased (P < 0.01), and ACTH, CORT contents increased in model group (P <0.01). Compared with the model group, TST, FWS, SWS2 of sleep time in EEG of each ENA group significant increased (P < 0.05), (P < 0.01), SWS1 of sleep time significant increased in ENA Ⅰ and ENA Ⅱ groups (P < 0.01), ACTH and CORT contents in ENA Ⅰ and ENA Ⅱ groups decreased significantly (P < 0.05), (P < 0.01). Compared with other treatment group, total sleeping time increased significantly in ENA group Ⅰ (P < 0.01). Conclusion Different frequency electro-nape-acupuncture all can effectively short wake time of insomnia rats and extend the total time of sleep and the therapeutic effect of stimulus frequency of 2 Hz is superior to that of 50 Hz and 100 Hz. The mechanism of promoting sleep may be related to adjusting contents of serum ACTH and CORT.

Objective To observe the influence of different frequency electro-nape-acupuncture on the hypothalamic im-munogical cytokines interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)contents in rats with sleep deprivation, clear the function of electro-nape-acupuncture treatment for insomnia and discuss the possible mechanism of promoting sleep. Methods Fifty healthy male Wistar rats were randomly divided into normal group, model group, 2 Hz stimulation group, 50 Hz stimulation group, 100 Hz stimulation group, 10 rats in each group. The models of insomnia were established by using para-chlorophenylalanine (PCPA). After duplicating the models successfully, the rats of each different frequency treatment group were given electro-nape-acupuncture stimulation for one week, one time/day, 30 min/time. The normal and model groups were fixed in the corresponding time every day without any disposal. The rats in each group were sacrificed and the hypothalami were taken after treatment.The contents of IL-1β, IL-6 and TNF-α in hypothalamus were measured by enzyme-linked immunosorbent assay (ELISA) in each group. Results Hypothalamic IL-1β, IL-6 and TNF-α contents in the model group were significantly lower than those in the normal group (P<0.05). Compared with the model group, the IL-1β, IL-6 and TNF-α contents increased significantly in each different frequency treatment group (P<0.05). The hypothalamic IL-1β, IL-6 and TNF-α contents in 2 Hz stimulation group were higher than those in the 50 Hz and 100 Hz groups (P<0.05) and there were no statistically significant differences between the 50 Hz and 100 Hz groups (P>0.05). Conclusion Different frequency electro-nape-acupuncture all could effectively cure insomnia and the effect of 2 Hz group in promoting sleep is the best. The mechanism of promoting sleep may be related to regulating hypothalamic IL-1β, IL-6 and TNF-α contents.

Objective To observe the effect of different frequencies of electro-nape-acupuncture (ENA) on the contents of monoamine neurotransmitters 5-hydroxytryptamine (5-HT), dopamin (DA) and norepinephrine (NE) in brainstem of insomnia rats induced by PCPA, to discuss primarily the mechanism of promoting sleep and therapeutic efficacy of different frequencies of ENA. Methods Fifty Wistar rats were randomly divided into five groups, those are normal group, model group, ENA group Ⅰ (stimulus frequency of 2 Hz), ENA group Ⅱ (stimulus frequency of 50 Hz) and ENA group Ⅲ (stimulus frequency of 100 Hz). The animal models of insomnia were established by para-chlorophenylalanine (PCPA) intraperitoneal injection in each group except normal group. After duplicating the models successfully, each ENA group rats were treated by ENA therapy at different stimulus frequencies respectively for seven consecutive days, 1 time/day, 30min/time. After treatment the brainstems were taken and measured the contents of neurotransmitters 5-HT, DA and NE. Results The content of 5-HT were significantly lower and the contents of DA and NE were higher in the animal model of rats than that in the normal group, there were statistically significant differences (P<0.05); After the seven days of ENA treatment, the 5-HT content increased and the DA and NE contents decreased in brainstems of insomnia rats. Compared with the model group, there were significant differences (P<0.05). Among the ENA groups, ENA group Ⅰ was greatly superior to ENA group Ⅱ and ENA group Ⅲ at regulating the levels of monoamine neurotransmitters (P<0.05), however, there were no statistically significant difference between ENA group Ⅱ and ENA group Ⅲ (P >0.05). Conclusion The mechanism of ENA improve the structure of sleep may involve the regulation of monoamine neurotransmitters 5-HT, DA and NE contents in brainstem of insomnia rats.

目的:探讨推拿经筋结点[1]结合关节活动疗法对中风偏瘫上肢痉挛的治疗作用。方法:通过对肩、肘、腕、指各关节采用相应的推、扌衮、揉、按、外拿、内捏手法,对各关节经筋结点的点、按、揉、拨及对各关节采用相应的外展、内收、屈、伸、摇的关节活动方法,观察病人治疗前后上肢长期和即刻痉挛状态改善情况。结果:本法对肌张力长期改善,共治疗25例,其中显效12例,好转6例,有效5例,无效2例,总有效率72%。本法对各关节肌张力即刻改善:肩关节22例(88%),肘关节23例(92%),腕关节14例(56%),指关节5例(20%)。结论:经筋结点结合关节活动有效地改善了中风后上肢的痉挛状态,促进上肢运动功能恢复。

<正>腰痛又称“腰脊痛”,是以自觉腰部疼痛为主症的一类病症,临床上十分常见。西医学认为腰部的肌肉、韧带和关节发生损伤或病变均可导致腰痛。中医学则认为主要与感受外邪、跌仆损伤和劳欲太过等因素有关。除用药物、按摩等治疗外,笔者用针灸治疗本病取得了满意的疗效,现总结如下: