目的:观察微针V形穴位埋线联合生酮饮食治疗单纯性肥胖病的临床疗效.方法:选取80例单纯性肥胖病患者按随机数字表法分为对照组与观察组各40例.对照组给予生酮饮食治疗,观察组给予微针V形穴位埋线联合生酮饮食治疗.比较2组治疗前后体质量、体质量指数(BMI)、体脂肪含量(BFM)、内脏脂肪面积(VFA)、骨骼肌质量(SMM)、身体总水分(TBW)、无机盐质量,并评估2组临床疗效及不良反应发生情况.结果:治疗期间,对照组脱落3例、剔除2例,完成研究35例;观察组脱落3例、剔除3例,完成研究34例.治疗后,观察组总有效率高于对照组(P＜0.05).治疗后,2组体质量、BMI、BFM、VFA均较治疗前明显降低(P＜0.05),且观察组低于对照组(P＜0.05).治疗后,对照组TBW、SMM较治疗前明显减少(P＜0.05),观察组治疗后TBW、SMM明显高于对照组(P＜0.05).2组治疗前后无机盐质量比较及观察组治疗前后TBW、SMM比较,差异均无统计学意义(P＞0.05).2组均未出现严重不良反应.结论:微针V形穴位埋线结合生酮饮食治疗单纯性肥胖病疗效明显,能够降低体质量及内脏脂肪含量,维持肌肉量、TBW,无严重不良反应.

Objectives To assess the substantia nigra (SN) hyperechogenicity (SNH) of 6-hydroxydopamine (6-OHDA)-induced Parkinson's disease (PD) rats before and after electro-acupuncture treatment by transcranial sonography (TCS), detect the expression of tyrosine hydroxylase (TH) in the SN by immunohistochemistry and the changes of inflammatory factors IL-1β and TNF-α in serum, duodenum, and SN, and explore the value of TCS in the diagnosis and treatment of PD. Methods Sixty male SD rats were randomly divided into either a sham-operation group (15 rats) or a 6-OHDA group (45 rats). PD was induced by injecting 6-OHDA unilaterally into the SN. A total of 33 models were successfully established. They were randomly divided into a model group (16 rats) and an electro-acupuncture group (17 rats). Behavioral and ultrasonographic assessments were carried out on the 15th and 45th days after modeling. On the 45th day, four rats in each group were selected for immunohistochemical staining for TH, and the rest of the rats were used to collect heart blood and SN, and duodenum tissues for detection of IL-1β and TNF-α by ELISA. ANOVA and t-test were used to compare the differences among and between groups. Results SNH was observed in the injured SN of the model rats. After treatment, the area of injured SNH in the electro-acupuncture group was significantly less than that in the model group (t=4.01, P<0.05). TH positive area in the electro-acupuncture group was significantly increased compared with the model group (t=2.84, P<0.05). The levels of TNF-α in the serum and duodenum, IL-1β in the duodenum in the electro-acupuncture group were significantly lower than those in the model group (t=8.88, 7.64, and 10.86, respectively, P<0.05). Conclusion TCS can be used to successfully observe the manifestations of SNH in PD rats before and after electro-acupuncture treatment, suggesting that TCS can be used as one of the evaluation indicators for the diagnosis and treatment of PD. Key words: Parkinson′s disease; Ultrasonography, transcranial; Electroacupuncture; Gastrointestinal

目的 应用ESWAN序列测量正常大鼠和帕金森病(PD)模型大鼠脑黑质R2*值,探讨R2*值与多巴胺能神经元标志酶酪氨酸羟化酶(TH)阳性面积的相关性.方法 将60只雄性SD大鼠,随机抽取20只为对照组,剩余40只大鼠通过向左侧黑质输注6-羟基多巴胺(6-OHDA)诱导PD模型,于造模后第15天进行旋转实验以验证模型,最终造模成功23只,作为模型组;期间每隔10d对两组大鼠的一般情况进行观察,第45天对两组大鼠进行旋转实验、MRI测量黑质R2*值及TH免疫组化染色.结果 模型组大鼠损伤侧黑质R2*值较对照组显著升高(P＜0.05);模型组大鼠损伤侧多巴胺能神经元TH的表达较对照组减低,差异有统计学意义(P＜0.01);模型组、对照组大鼠黑质R2*值与TH阳性面积之间呈负相关.结论 ESWAN序列可以成功测量PD大鼠黑质R2*值,对早期评价PD黑质多巴胺能神经元损伤情况有指导作用.

目的:分析中药生物发酵温灸膏治疗瘀滞型肩周炎对患者肩关节活动功能和炎症反应水平的影响.方法:选取瘀滞型肩周炎患者200例,采用随机数字法分成两组,对照组采用天和骨痛膏治疗,试验组采用中药生物发酵温灸膏治疗,分析两组患者治疗后的临床效果.结果:试验组患者总有效率为91.00％,对照组为81.00％,试验组患者总有效率高于对照组,差异有统计学意义(P＜0.05).治疗前,两组患者VAS评分、肩关节活动功能评分比较,差异无统计学意义(P＞0.05).治疗后,试验组患者肩关节活动功能评分高于对照组,VAS评分低于对照组,差异有统计学意义(P＜0.05).治疗前,两组患者炎症因子、SP、5-HT、GM-CSF水平比较,差异无统计学意义(P＞0.05).治疗后,试验组患者TNF-α、IL-6、SP、5-HT、GM-CSF水平低于对照组,IL-10水平高于对照组,差异有统计学意义(P＜0.05).结论:中药生物发酵温灸膏治疗瘀滞型肩周炎疗效显著,可降低SP、5-HT、GM-CSF水平,减轻炎症反应,改善肩关节活动功能.

目的 观察电针双侧天枢对帕金森病伴便秘患者肛门直肠动力学及统一帕金森病评定量表(UPDRS)评分的影响.方法 将93例帕金森病伴便秘患者随机分为针刺组(电针双侧天枢,1次/d,共治疗28d)47例和对照组46例(口服聚乙二醇,共治疗28d),比较两组患者便秘症状评估结果、肛门直肠动力学指标及UPDRS评分.结果 针刺组便秘症状总有效率为82.12％,明显高于对照组的67.39％(P＜0.05).两组患者治疗前后肛门直肠动力学指标、UPDRS各因子及总分(UPDRSI除外)比较,差异均无统计学意义(均P ＞0.05);治疗后,组间比较差异亦均无统计学意义(均P＞0.05);治疗后,针刺组UPDRS l低于治疗前(P＜0.05),且低于对照组(P＜0.05).结论 与口服聚乙二醇比较,电针双侧天枢改善帕金森病患者便秘的疗效更优,对肛门直肠动力学及UPDRS评分的影响不大.

目的 探讨针刺结合核心肌群训练对缺血性脑卒中偏瘫患者平衡功能的影响及其作用机制.方法 采用随机数字法将192例缺血性脑卒中偏瘫患者分为2组,每组96例.对照组给予核心肌群训练治疗,观察组在对照组的基础上结合针刺治疗.治疗后,比较2组躯干控制能力(PASS评分)、下肢运动功能(FMA评分)、平衡能力(BBS评分)、步行能力(Holden评分)、生活质量(SF-36健康问卷)及治疗前后双侧大脑中动脉搏动指数(PI)、阻力指数(RI)与平均血流速度(Vm)的变化.结果 治疗后,2组PASS评分、FMA评分显著升高(P＜0.05),且观察组明显高于对照组(P＜0.05).治疗后,2组BBS评分、Holden评分均明显升高(P＜0.05),且观察组显著高于对照组(P＜0.05).治疗后,观察组在生理功能、生理职能、躯体疼痛、健康状况、精力、社会功能、情感职能与精神健康等方面的评分均低于对照组(P＜0.05).治疗后,2组RI、PI明显降低(P＜0.05),且观察组低于对照组(P＜0.05);2组Vm明显升高(P＜0.05),且观察组高于对照组(P＜0.05).结论 针刺结合核心肌群训练治疗可明显改善缺血性脑卒中偏瘫患者的平衡功能,提高日常生活质量,其作用机制可能与针刺结合核心肌群训练能有效改善缺血性脑卒中偏瘫患者脑血流动力学有关.

目的 探讨中药涌泉穴穴位敷贴助睡眠对老年人原发性高血压病的影响.方法 通过简单的随机抽样将病区老年原发性高血压患者随机分为观察组40例和对照组37例,两组均不改变患者原来用药情况,观察组在此基础上坚持睡前中药涌泉穴穴位敷贴,比较6个月后两组血压控制情况.结果 干预后两组收缩压、脉压差差异有统计学意义(P ＜0.01),舒张压及心率差异有统计学意义(P＜0.05);观察组干预前后收缩压、脉压差及心率差异有统计学意义(P＜0.01);两组血压控制率差异有统计学意义(P＜0.01).结论 中药涌泉穴穴位敷贴助睡眠可以辅助老年原发性高血压患者有效降压,特别是降低收缩压及脉压差,可以减慢心率,值得进一步研究和推广.

Objectives To investigate the efficacy of the shear wave velocity (SWV) based on acoustic radiation force impulse (ARFI) elastography in the differentiation of normal population with chronic kidney disease (CKD) and acute kidney injury (AKI) in middle aged and elderly patients.Methods Sixty-four middle aged and elderly patients referred to China-Japan Friendship Hospital and Zhejiang Provincial People's Hospital with AKI or CKD were enrolled in this study from February 2015 to December 2016 (kidney disease group).Among them,43 patients were CKD (CKD group),and 21 patients were AKI (AKI group,15 patients combined with prior CKD,6 patients without prior CKD).Twenty-nine middle aged and elderly healthy volunteers from China-Japan Friendship Hospital were enrolled at the same time (healthy control group).The SWV values of the renal middle pole cortex were acquired using the ARFI elastography.The differences of the kidney length,cortical thickness and SWV values among healthy control group,AKI and CKD group were compared by variance analysis.The LSD-t analysis was used for the advanced comparison between any two groups.The differences of cortical SWV values among healthy control group,AKI combined with prior CKD group,AKI without prior CKD group and CKD group were compared by variance analysis.The LSD-t analysis was used for the advanced comparison between any two groups.The receiver operating characteristic (ROC) curves of the cortical SWV values for diagnosing kidney disease was drawn.Results The mean cortical SWV values of healthy control group,AKI and CKD groups were (2.88±0.63),(2.42±0.83) and (2.06±0.72) m/s,respectively.The SWV values of AKI and CKD groups were significantly lower than that of healthy control group (t=2.158,P=0.033;t=5.234,P ＜ 0.001).The SWV values of CKD group were lower than that of AKI group,but there were no significant differences.The SWV values of AKI without previous CKD group and AKI combined with prior CKD group were (2.60±0.84) and (1.80±0.45) m/s,respectively.The SWV values of AKI combined with prior CKD group and CKD group were significant lower than that of healthy control group and AKI without prior CKD group (compared with healthy control group:t=2.916,P=0.004 and t=5.318,P ＜ 0.001;compared with AKI without prior CKD group:t=2.054,P=0.043 and t=-2.517,P=0.013).But there were no significant differences between AKI combined with prior CKD group and CKD group,so as to the AKI without prior CKD group and healthy control group.The cutoff value of cortical SWV for diagnosing kidney disease was 2.40 m/s,with an area under ROC curve was 0.767 (95％ CI 0.689-0.898,P=0.000).The sensitive and specificity were 57.1％ and 81.9％,respectively.Conclusions The SWV values of kidneys in middle aged and elderly CKD and AKI patients were significantly lower than those of apparently normal kidneys.The SWV values of AKI patients combined with prior CKD were lower than AKI patients without prior CKD.Determining cut-off SWV values based on ARFI elastography between normal and damaged renal parenchyma can help in the diagnosis of kidney disease in middle aged and elderly patients.

Objective The clinical manifestations of Parkinson''s disease (PD) are divided into non-motor symptoms and motor symptoms.Constipation is one of the common symptoms of non-motor symptoms of the disease.Constipation symptoms in PD generally occur earlier for 5~20 years, while drug treatment for PD constipation can lead to gastrointestinal damage.This study investigated the improvement in the treatment of anorectal dynamics and constipation symptoms in Parkinson''s disease by oral mosapride and press-needle therapy of Shu-Mu point.Methods 60 patients diagnosed as constipation of Parkinson''s disease were randomly divided into control group and treatment group, 30 cases in each group;patients in the control group were treated with oral mosapride tablets, while patients in the treatment group received press-needle therapy, three times per week.The observation course in both groups last for three months and follow-up visits were conducted before and after the course.Efficacy evaluation, PAC-QOL scale and anorectal dynamic examination were applied in the follow-up visit.Results The efficiency of treatment group was 81.7%, significantly higher than control group (70%), representing significant difference between the two groups (P<0.05).Both the methods could improve the PAC-QOL scale, and significant difference was found in comparison to that before the treatment(P<0.01), while no statistical significance was found between treatment group and control group after treatment(P>0.05).As to the anorectal dynamics, significant difference was found before and after the treatment in both groups (P<0.05, P<0.01), while no statistical significance were found between the two groups after treatment(P>0.05).Conclusion Both oral mosapride and press-needle can improve the quality of life and anorectal dynamics for PD patients, representing no significant difference.However, compared with mosapride, the overall efficacy of press-needle is better in improving the symptoms of constipation in PD, featuring more convenience, higher safety, less pain and no side effect, and it is worthy of clinical application.

Objective To evaluate the effect of electroacupuncture respectively at 2 Hz/100 Hz and 100 Hz on muscle rigidity in Parkinson’s disease (PD) by comparing it to oral administration of Levodopa and Benserazide Hydrochloride tablets. Method Ninety-one PD patients were randomized into a medication group of 31 cases, electroacupunture group 1 (2 Hz/100 Hz) of 30 cases and electroacupuncture group 2 (100 Hz) of 30 cases. Electroacupuncture group 1 and 2 were respectively intervened by electroacupuncture at 2 Hz/100 Hz and 100 Hz in addition to the treatment given to the medication group. The Unified Parkinson’s Disease Rating Scale (UPDRS) and TAS were evaluated prior to intervention, after 30-day treatment, 90-day treatment, and in the 180-day follow-up study. Result Compared to that before intervention, the UPDRS and TAS scores were insignificantly changed after 30-day and 90-day treatment, but significantly changed in the 180-day follow-up study (P<0.01) in electroacupuncture group 2;the UPDRS and TAS scores were insignificantly changed after 30-day treatment, but significantly changed after 90-day treatment and in the 180-day follow-up study (P<0.01) in electroacupuncture group 1 and the medication group. Compared to that of the medication group after 90-day treatment and in the 180-day follow-up study, the UPDRS and TAS scores of electroacupuncture group 2 were significantly different (P < 0.01); the UPDRS and TAS scores of electroacupuncture group 1 were insignificantly different from that of the medication group after 30-day treatment, 90-day treatment, and in the 180-day follow-up study(P > 0.05). Conclusion Compared to electroacupuncture at 2 Hz/100 Hz plus medication and medication alone, electroacupuncture at 100 Hz plus medication can produce a better therapeutic efficacy in improving muscle rigidity of PD.

目的:观察温灸膏改善瘀滞型肩周炎肩关节活动度的临床疗效。方法:100例肩周炎患者随机分为治疗组和对照组,治疗组50例采用温灸膏加针刺治疗,对照组50例予单纯针刺治疗,日1次,两周为1疗程,两个疗程后统计疗效。结果:治疗组总有效率为86%,对照组总有效率为62%,两组疗效比较有显著性差异(P<0.05);治疗组与对照组对改善肩周炎肩关节活动度均有显著效果,但治疗组效果明显优于对照组(P<0.05)。结论:温灸膏加针刺对改善肩周炎肩关节活动度具有显著疗效。

<正>颈性眩晕是指椎动脉的颅外段受颈部病变的影响导致椎基底动脉系统血流障碍引起的以眩晕为主要临床表现的综合征[1]。多见于中老年人,但近年来随着计算机的普及、生活方式的改变有明显年青化趋势,发病率逐年上升,是针

目的:观察中药生物发酵温灸膏联合针刺治疗瘀滞型肩周炎的临床疗效。方法:将100例肩周炎患者随机分为治疗组和对照组,治疗组50例采用中药生物发酵温灸膏联合针刺治疗,对照组50例单纯针刺治疗,每天治疗1次,2周为1个疗程,2个疗程后进行疗效对比观察。结果:治疗组总有效率94.0%,对照组68.0%,两组比较有显著性差异(P<0.05)。结论:中药生物发酵温灸膏联合针刺治疗瘀滞型肩周炎有显著疗效。

[Objective]To observe the clinical effect and safety of"point plaster"made from herbs in treating insomnia.[Methods] Eighty cases were randomly divided into two groups:40 cases in treatment group treated with"point plaste"and Estazolam,while 40 cases in control group received Estazolam,with a course of two months.The scores of SPIGEGL scale and the clinical efficacy was evaluated.[Results]There was no significant difference between the two groups in clinical efficacy(P>0.05).Compared with the control group,there were significant differences in in PSQI scale in the treatment group(P<0.01).[Conclusion]"Point plaster"is effective for insomnia,espically in improving sleep quality,daytime dysfunction,drug dependence.

<正>1990年以来应用六透穴埋置羊肠线法治疗"陈旧性面瘫"患者2195例,效果满意,现介绍如下。资料与方法病例概况及临床症状:2195例中,男1261例,女934例,年龄12～76岁,职业以农民为多,病程2个月～6年,其中2～4年者55.6%。临床症状主要以口眼歪

目的观察头穴久留针对血管性痴呆的临床疗效。方法本研究将纳入试验的60例患者随机分配到治疗组(留针4h)和对照组(留针30min)各30例,共治疗6周。治疗前后进行简易精神状态检查量表(MMSE)和改良ADL积分量表(ADL-R)评定,结果 2组对血管性痴呆症状均有改善,差异有显著意义(P<0.05,P<0.01);2组疗效比较,差异有非常显著意义(P<0.01)。结论头穴留针4h效果优于留针30min治疗。

[Objection] To observe therapeutic effect of cervical headache treated by Close Needling.[Methods] Eighty cases were randomly divided into observation group(n=40) and control group(n=40).The observation group were treated with Close Needling,while the control group were treated with normal needling.To observe the change of visual analogue scale(VAS) and range of motion(ROM) of cervical spine between two groups before and after treatment.[Results] There were significant statistics between the two groups compared with those of before treatment(P0.05).There were statistic difference between the two groups after treatment(P0.05),the observation group improved better than the control group.The observation group had 25 cured,11 excellence,4 improvement and zero inefficacy cases;while the control group had 18 cured,11 excellence,9 improvement and 2 inefficacy cases.There were significant statistics between two groups of cured and excellence cases(P0.05).[Conclusion] The therapeutic effect of Close Needling had a better effect on cervical headache.

目的:观察中药发酵温灸贴治疗慢性浅表性胃炎的临床疗效。方法:将80例患者随机分为治疗组和对照组各40例,治疗组用中药发酵温灸贴,对照组用温针灸治疗。结果:胃脘痛、痞满、纳少、反酸、嗳气五个症状两组治疗前后积分变化均有显著性差异(P<0.01);治疗组痞满症状改善优于对照组(P<0.01),对照组胃脘痛症状改善优于治疗组(P<0.01);两组症状总积分变化及总有效率比较无显著性差异(P>0.05)。结论:中药发酵温灸贴治疗慢性浅表性胃炎有较好的临床疗效,与温针灸疗效相当。

随着社会老龄化的到来,帕金森病的发病率在逐年上升,提供有效、无副作用、耐受性小、遵循多巴胺节省原则的疗法已成为必然.笔者将"九针"中大针和长针结合而创新研制成粗针,在临床上运用其治疗帕金森病取得了较好的疗效.现报告如下.

回顾近年针灸疗法治疗帕金森病的临床研究现状,应用计算机检索CNKI数据库2000年1月至2007年1月针灸治疗帕金森病的中医研究专著,检索词"帕金森病""且针灸疗法"。初审最新研究成果,选取对写作有意义的文章,然后对22篇原文进行分类综合。明确针灸是目前疗效可靠、毒副作用小的治疗方法。