Objective:To investigate the efficacy of Tongyu Decoction in treating acute attack of stable angina pectoris（SAP） cases with syndrome of stagnant blockade of heart blood. Methods:102 acute attack of SAP patients with syndrome of stagnant blockade of heart blood were selected and divided into two groups by random number table method. The control group received conventional western medicine intervention according to the guidelines,and the treatment group orally took Tongyu Decoction on the basis of the control group. Both groups were treated for 2 weeks. Angina pectoris attack,nitroglycerin dosage,symptom scores of the syndrome of stagnant blockade of heart blood,cardiac function index,and the clinical efficacy were compared between the two groups.Results:After treatment,the angina pectoris attack frequency,duration,and nitroglycerin dosage in the two groups were significantly decreased,and the above three indexes in the treatment group were significantly lower than those in the control group（P ＜ 0.01）. After treatment,the symptom scores of the syndrome of stagnant blockade of heart blood in both groups were significantly decreased,and the treatment group was significantly lower than those of the control group（P ＜ 0.01）. After treatment,the left ventricular end-systolic diameter（LVESD）and left ventricular end-diastolic diameter（LVEDD）were significantly decreased,left ventricular ejection fraction（LVEF）was significantly increased,and above cardiac function indexes in treatment group were significantly better than those in control group（P ＜ 0.01）. The total effective rate of treatment group was 90.20%,which was better than 72.55%of the control group（P ＜ 0.05）. Conclusion:Based on the conventional intervention measures of western medicine,Tongyu Decoction in treating acute attack of SAP cases with syndrome of stagnant blockade of heart blood has a better curative effect,which can relieve the spread of angina pectoris,improve traditional Chinese medicine syndrome and heart function.

目的 基于CIPP评价模型探究"BOPPPS+虚实结合"教学模式在中医骨科技能实训课程中的应用效果.方法 在中医骨科技能实训课程中,将北京中医药大学第一临床医学院2019级专业型硕士研究生及规培生随机分为采用传统教学模式的对照组与采用"BOPPPS+虚实结合"教学模式的观察组,并在技能操作考核基础上,以CIPP理论模型为指导,搜集两组学生对课程背景、输入、过程、输出等方面的评价.结果 "BOPPPS+虚实结合"教学模式可显著提高学生骨科技能实践操作考核成绩(P＜0.05),并在展现专业特色、场地合理、内容充实、方法创新、信息智能、形式多样、课时合理、课程设计、学习趣味、课堂参与、知识记忆、技能掌握、自主思考、思维拓宽等方面较传统教学模式具有不同程度的优势(P＜0.05),可有效提高学生对此课程的总体满意度(P＜0.05).结论 "BOPPPS+虚实结合"教学有机融合线上线下混合与虚拟仿真教学模式,是实现骨科技能实训课程教学创新、提高教学质量的重要途径,CIPP理论模型指导下的多维度评价模式在骨科技能实训课程中的应用,为临床技能实训课程评价体系改革与实训课程建设的不断完善提供了启发与参考.

赵吉平教授针刺治疗不寐,从病机入手,首先"调神",脑神、心神同调,调脑神选头部腧穴,轻症、病程短者选"头三神",重症、病程久者选"头十二针";实证、虚证分别施以不同的刺激量,实现虚补实泻.调心神选心经、心包经远端腧穴,虚证、热象不著者,选原穴、络穴,实证、热盛者,选荥穴、井穴.次重调阴阳,阴阳跷脉与任督脉并用.再以四诊合参定证候,从脏腑辨证角度辨证配穴.针刺时强调从针具、针刺方向、深度、针刺手法的灵活配合,达到相应的刺激量.

天人相应观是中医的核心思想,时间作用于人体的内涵是阴阳消长、气血浮沉.以纪时之干支配属五脏,又由五行生克演化出五脏病变趋势.营气流注的时间规律能提示经脉的开阖状态.由此产生了因时制宜的治疗原则.本文归纳了《黄帝内经》提出的日节律、月节律、年节律、超年节律及其对人体的影响,总结了时间节律指导针刺选穴,确定针灸刺激量,明确针刺深度,选择治疗时机,提示针刺禁忌等方面的临床应用方法.

基于红外热像图分析以温针灸翳风穴(TE17)为主疏通少阳经络,苍龟探穴行针手法解筋结、调经筋治疗耳闭验案1则,为临床从中医经络、经筋理论入手治疗耳闭提供思路.

目的 科学评价经筋三刺法治疗周围性面瘫的临床疗效,为该方法 的临床治疗提供可靠的应用依据和指导原则.方法 采用多中心、随机、对照的试验方法,将126例周围性面瘫急性期患者随机分为经筋三刺治疗组以及传统针刺对照组,分别接受4个疗程的治疗,并在入组前、治疗4个疗程后观察治疗后临床疗效,治疗后1月、3月随访中分别采用H-B分级量表、面部残疾指数量表(FDI)、面瘫自身健侧对照评分法等进行疗效评价.结果 两组患者治疗后H-B量表评分均较本组治疗前明显升高,差异有统计学意义;治疗组治疗后H-B量表评分高于对照组,差异有统计学意义.两组患者治疗后面瘫自身健侧对照量表评分均较本组治疗前明显降低,差异有统计学意义;治疗组治疗后面瘫自身健侧对照量表评分低于对照组,差异有统计学意义.两组治疗后FDI评分均较本组治疗前明显改善,且治疗组第1～5项总分改善程度优于对照组,差异有统计学意义,第6～10项总分与对照组比较差异无统计学意义.急性期周围性面瘫治疗后1个月,两组H-B量表评分、自身健侧对照评分、静态评分、动态评分及FDI量表第1～5项、第7～10项总分比较差异有统计学意义,而FDI量表第6项总分比较差异无统计学意义.治疗后3个月,两组FDI量表第7～10项总分比较差异有统计学意义,而H-B量表评分、自身健侧对照评分、静态评分、动态评分及FDI量表第1～6项比较差异无统计学意义.结论 经筋三刺疗法能够降低周围性面瘫患者面部残疾风险,缩短临床痊愈时间,且安全有效.

总结近年来腹针治疗腰椎间盘突出症的临床研究现状,分别概述了腰椎间盘突出症腹针标准处方的临床应用及认识,论述了腹针联合传统体针激发先后天经络之气、调衡阴阳的疗效机理,归纳了各种腹针联合疗法的特点与突出疗效.

Professor Jiping ZHAO has unique thoughts on the diagnosis and treatment of peripheral facial paralysis. She pays the great attention to clinical differentiation in treatment with acupuncture, especially meridian differentiation. She believes that the differentiation of lesion is core and the early judgment is critical for the better therapeutic effects on intractable facial paralysis. The local acupoints are selected in the guide of the theory of meridian sinew and stimulated on the base of three-needling theory. The distal acupoints are decided in light of the syndrome differentiation, of which, Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3) are the basic acupoints. Additionally, Professor ZHAO lays the emphasis on the 5th branch of facial nerve ( cervical branch) in diagnosis and treatment. (C) 2019 World Journal of Acupuncture Moxibustion House. Published by Elsevier B.V. All rights reserved.

今人或因饮食不节,或因嗜食肥甘厚腻之品,亦或因情志不遂等,脾胃病者十之八九,而脾运失常者其达病所之药力能有几何;加之药不雄峻,其疾不了,中药、西药实乃以毒制毒之品,其毒性副作用甚是严峻;再者随着环境污染的严重,杂病怪病愈来愈多,故单凭内治之法难免有独脚难行,孤掌难鸣之感.中医外治法通过药物或者针灸等器具作用于孔窍、腧穴、经络避免胃肠吸收,在急症、疑难杂症治疗上独具一格,当然也存在其一定的局限性. 尤在泾在《医学读书记》中说道:"兵无向导,则不达贼境;药无引使,则不达病所."中药内治疗人以四气五味之偏性,而中医外治法善引经通络,直达病源,故两者结合治疗内科疾病有势如破竹,直捣黄龙之势. 现将临床内科疾病外治的重要性及其临床分类、应用总结如下,以飨读者.

As a vital part of acupuncture and moxibustion,the theory of penetration needling obviously lags behind the practice. This article summarizes the thoughts andmethods of penetration needling by professor ZHAO Jiping. Based on the three basic elements of penetrating acupuncture, including the acupoint, needle and manipulation, the academic origins, the application of penetrating acupuncture at present and the clinical cases are reviewed; the essential content and the extension meaning of needle penetration are summarized, which is based on the identification of the location, pathology and characteristics of disease, combined with the characteristics of acupoints and the tissue structure of the part, we quantify the intensity of stimulation, so as to provide featured reference clinical practice.

目的 应用多媒体生物反馈系统观察头针针刺病灶侧顶颞前斜线上肢运动区对Brunnstrom分级在Ⅲ级或以上、改良Ashworth分级在2级或以下、能主动配合手功能训练的脑梗死患者手功能的疗效.方法 将符合纳入标准的40例患者按照随机信封方式分为试验组和对照组,对照组患者单纯应用多媒体生物反馈系统进行训练,试验组患者在进行多媒体生物反馈训练的同时进行头针病灶侧顶颞前斜线上肢运动区的治疗,采用静留针的方法,不实施任何提插捻转手法,两组患者治疗时间为30分钟.在首次治疗前和两周治疗后进行手功能评价,包括多媒体生物反馈系统及FMA量表(Fugl-Meyer Assessment,FMA)手功能评价部分FMA789评价,以比较两组患者的疗效.结果 两组患者治疗后多媒体生物反馈系统评价及FMA789的结果均有提高,其中手腕及手指各关节总屈曲范围缺失值、手腕及手指各关节最大运动频率下最大活动度之和及FMA789均提高明显,有统计学意义(P<0.05),手腕及手指各关节总伸展范围缺失值、手腕及手指各关节最大运动频率之和虽有提高,但未显示出统计学意义(P>0.05);在各疗效指标治疗后与治疗前差值的组间比较中,仅手腕及手指各关节总屈曲范围缺失值、手腕及手指各关节最大运动频率下最大活动度之和两指标显示试验组优于对照组,有统计学意义(P<0.05),其他指标虽然试验组优于对照组,但未显示统计学意义(P>0.05).结论 头针病灶侧顶颞前斜线上肢运动区对Brunnstrom分级在III级或以上、改良Ashworth分级在2级或以下、能主动配合手功能训练的脑梗死患者手功能恢复有促进作用,后续研究会延长试验周期及增加样本量,以进一步深入研究,验证当前结论.

目的将模块化实训教学法应用于住院医师规范化培训技能教学中,分析其培训效果,并进行评价.方法选取北京中医药大学东直门医院进行住院医师规范化培训的2014级研究生80人,运用模块化实训教学法进行临床技能实训教学.实训前后进行涵盖实训相关知识点的笔试.结果80名学生4个模块实训教学后成绩均高于实训前(P<0.05),轮转过穿刺、针灸相关科室的学生实训后成绩高于未轮转相关科室学生(P<0.05).结论将模块化实训教学法运用于住院医师规范化培训的临床技能教学中可有效提高教学效果.

In the diagnosis and treatment of chronic low back pain (CLBP) by acupuncture,the modern medicine knowledge could elaborate the diagnosis.We can differentiate the disease more precisely with modern examination techniques,and modern anatomy knowledge could help to locate the disease more accurately.Modern medicine knowledge could also guide the practitioners to determine the therapeutic plans,including selecting local points more precisely,determining the direction and depth of acupuncture more accurately,and controlling needling sensation and comfortability.In acupuncture,modern acupuncture knowledge could contribute to point selection and acupuncture manipulation,thus guiding the clinic practice.

目的:探讨冠心病心绞痛寒凝血瘀证与血管内皮功能的相关性.方法:采用垂体后叶素大剂量静脉注射建立冠心病心绞痛寒凝血瘀证动物模型,检测模型大鼠血管活性物质ET-1、NO、TXB2、6-Keto-PGF1α水平的变化.结果:模型组大鼠血ET-1、NO、TXB2水平显著升高,6-Keto-PGF1α水平降低,TXB2/6-Keto-PGF1α值显著升高,与正常组相比差异有统计学意义(P＜0.05或P＜0.01).结论:血管活性物质失衡参与了冠心病心绞痛寒凝血瘀证的病理变化过程,血管内皮功能紊乱主导了寒凝血瘀证的内在病理机制,冠心病心绞痛寒凝血瘀证与血管内皮功能紊乱密切相关.

目的:提高针灸留学生的临床教学质量.方法:根据针灸留学生的背景和特点,有针对性的制定教学内容和进度,综合运用归纳式、互动式、故事式、类比式、案例式结合PBL教学等多种教学方法.结果:激发了学生学习的兴趣和热情,克服了学习困难,变被动灌输为主动求索和讨论,提高了临床教学质量.结论:针对针灸留学生的特点安排教学内容,创新教学方法,可提高教学质量.

目的 建立心络绌急动物模型,观察心络绌急大鼠心肌细胞凋亡及超微结构变化.方法 采用垂体后叶素大剂量静脉注射建立心络绌急动物模型,观测心电图变化、心肌表面微循环及心脏表面血流量,评价大鼠模型;通过TUNEL染色及电镜技术手段,观察心肌细胞凋亡及超微结构变化.结果 模型组大鼠心电图ST段显著抬高,心肌表面微动脉收缩,心脏表面血流量减少,与正常组相比差异有统计学意义(P<0.05);模型组大鼠心肌凋亡细胞数量显著增加,透射电镜下可见肌纤维排列紊乱,线粒体聚集、肿胀,部分膜破裂,嵴降解等超微结构变化.结论 心络绌急大鼠模型成功建立,心肌细胞凋亡参与了心络绌急心肌缺血损伤的病理过程.

目的 观察冠心病心绞痛寒凝血瘀证大鼠心肌组织形态学改变.方法 采用垂体后叶素大剂量静脉注射建立冠心病心绞痛寒凝血瘀证动物模型,监测心电图变化;通过心肌组织HE染色、Nagar-Olsen特殊染色及电镜技术手段,观察心肌组织病理形态学的改变.结果 与正常组相比,模型组大鼠光镜下心肌组织HE染色切片未见明显的形态学改变;Nagar-Olsen特殊染色可见大片红染的阳性反应区;透射电镜下可见肌纤维排列紊乱,线粒体聚集、肿胀,部分膜破裂,嵴降解等超微结构变化.结论 冠心病心绞痛寒凝血瘀证大鼠心肌组织出现缺血病理形态学改变.

O bjective To explo re expressions o f Bax, Bcl 2 and p53 o fm yocardium in ra ts w ith contraction o f heart colaterals. M e thods The anim a lm ode lw ith contraction o f heart co la tera ls w as established in ra ts by sing le high dose intravenous injection o f pituitrin. The apopto tic index, the expression o fBax,Bcl 2 and p53 o fm yocardium w ere respective ly de term ined by term ina ldeoxy-nucleo tide transferase m edia ted dUTP nick end labe ling ( TUNEL) assays and imm unohistochem ica l sta ining. Results C om-pared w ith no rm a lg roup, the apoptosis index,the expression o fBax, p53 and the ra tio o fBax/Bcl 2 in m ode lg roup w ere significantly increased ( P < 0.05 o r P < 0.01). Conclusion The m yocardia l apoptosis w as invo lved in the pa tho log ica l process o fm yocardia l ischem ia injury w ith contraction o f heart colaterals. Expressions o f Bax, Bcl 2 and p53 o fm yocardium w ere invo lved in regula ting apoptosis o fm yocardium in ra ts w ith contraction o f heart colaterals.

Objective: Analyzing the literature on guinea pig usage for allergic rhinitis research,in order to determine the best evaluation model. Method: China Hospital Knowledge Database( CHKD) was used to search the terms‘allergic rhinitis' and‘guinea pig'in the period between 1979 and 2013. Result: A total of 208 articles were found,of which 51 articles described the model evaluation methods,which included behavior score, nasal secretions smear, passive cutaneous anaphylaxis( PCA), and pathological observation. Conclusion: Behavioral score evaluation method is the most commonly used,currently the method proposed by Zhao is more fairly reliable,but there is not uniform standard on procedure. On this basis,combined with nasal secretions smear,and PCA evaluation model is more reliable,but for PCA and pathology observation there is the need to increase the number of animals,thus making it difficult to operate. Therefore,the current literature still does not provide adequate support for the best model evaluation method.

OBJECTIVE: To compare the efficacy of an acupuncture regimen for persistent allergic rhinitis(PER), aimed at improving a patient’s mind or Shen in Traditional Chinese Medicine, to that of a second-generation H1-receptor antagonist, cetirizine hydrochloride.METHODS: This multicenter, randomized, controlled clinical trial on PER will be conducted at three institutions in China. The total study period will be 9 weeks. After a 1-week preparatory screening period, 240 eligible participants with PER willbe randomized to receive acupuncture or pharmacotherapy(1∶1) for 4 weeks with a 4-week follow-up. The primary outcome will be changes in7-day average total nasal symptom score. Secondary outcome measures include rhinoconjunctivitis quality of life questionnaire score and total non-nasal symptom score.RESULTS:The presence and seriousness of psychological and emotional impairments should be considered in therapeutic programs for allergic rhinitis.No clinical trial for treating allergic rhinitis via acupuncture regulation of psychological and emotionalactivitieshasbeenreported.CONCLUSION:The findings of the trial will allow us to determine the effects of the mind(Shen)-regulation treatment approach. We will also be able to confirm if the effects of acupuncture are equivalent to those of the conventional drug cetirizine hydrochloride.