目的:观察脐部敷贴通便膏联合服用乳果糖口服溶液对晚期癌痛阿片类药物相关性便秘(OIC)患者的临床疗效.方法:将129例晚期癌痛OIC患者按照随机数字表法随机分为治疗组68例和对照组61例,对照组予乳果糖口服溶液口服,治疗组在对照组治疗的基础上加用通便膏脐部敷贴,2组均治疗14?d后进行疗效观察.比较2组患者治疗前后粪便性状评分(BSFS评分)、便秘情况评分(CCS评分)、生活质量评分(PAC-QOL评分)、中医证候积分等指标改变情况,治疗后比较2组患者中医证候疗效.结果:治疗后治疗组患者BSFS评分、CCS评分、PAC-QOL评分均较治疗前明显降低(P<0.01),且均明显低于同期对照组(P<0.01,P<0.05);治疗后对照组患者BSFS评分较治疗前略有下降,但差异无统计学意义(P>0.05),CCS评分、PAC-QOL评分均明显低于治疗前(P<0.05,P<0.01).治疗后治疗组患者排便不尽感、肠鸣、腹胀、矢气等单项证候评分以及总分均明显低于治疗前(P<0.01),且均明显低于同期对照组(P<0.01);对照组患者除矢气外,其余单项证候评分及总分均明显低于治疗前(P<0.05,P<0.01).治疗组患者中医证候总有效率为98.53％,明显高于对照组的50.82％(P<0.01).结论:在乳果糖口服溶液治疗的基础上加用通便膏脐部敷贴能进一步改善晚期癌痛OIC患者的粪便性状、便秘程度和临床症状,提高患者的生活质量.

Objective To observe the effect of body acupuncture combined with scalp acupuncture on anxiety, depression, and clinical efficacy in stroke patients. Methods Sixty-five stroke patients who went to the Rehabilitation Department of Suzhou Traditional Chinese Medicine Hospital for treatment from January 2021 to January 2022 were selected and divided into a control group（32 cases） and a study group（33 cases） using a random number table method. During the process, 2 cases were lost in the control group and 3 cases were lost in the study group. Both groups were treated with conventional drugs and conventional rehabilitation exercise therapy. On this basis, the control group was only treated with body acupuncture, while the study group was treated with body acupuncture combined with scalp acupuncture. The course of treatment in both groups was 8 weeks. The changes in the scores of self-rating anxiety scale（SAS） and self-rating depression scale（SDS） before and after treatment were observed in both groups, as well as the clinical efficacy of the two groups. Results After treatment, the SAS score and SDS score of the two groups were lower than those before treatment, and the SAS score of the study group was lower than that of the control group（P ＜ 0.05）. The total effective rate of treatment in the study group（93.33%） was higher than that in the control group（73.33%, P ＜ 0.05）. Conclusion Body acupuncture therapy alone and body acupuncture combined with scalp acupuncture therapy have good clinical efficacy in treating anxiety and depression after stroke, which can significantly improve the symptoms of anxiety and depression in patients. Moreover, the combination of scalp acupuncture and body acupuncture has a synergistic effect on treating anxiety after stroke.

目的:观察调督安神针法治疗原发性不安腿综合征的临床疗效.方法:选取原发性不安腿综合征患者 40 例,随机分为对照组和观察组,每组 20 例.对照组接受常规针刺治疗,观察组在对照组基础上加用调督安神针法治疗.比较两组患者治疗前后国际不安腿综合征研究组评估量表(IRLS)、匹兹堡睡眠质量指数(PSQI)和汉密尔顿焦虑量表(HAMA)评分.结果:治疗后,两组患者IRLS、PSQI、HAMA 评分均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05).结论:调督安神针法治疗原发性不安腿综合征疗效确切,能有效改善患者临床症状,提高睡眠质量,缓解焦虑情绪.

失眠是临床常见病和多发病,患者往往依赖镇静安神药方可入眠,但长此以往会对这类药物形成依赖性、耐受性,从而导致焦虑、抑郁,进一步加重失眠的症状,形成恶性循环.针灸和中药在治疗失眠方面疗效确切,却有各自的局限性.该文主要总结欧阳八四教授运用针药结合治疗失眠的经验,一方面秉承吴门医派"推本阴阳""真阴易损"的学术思想,另一方面审时度势,注意时人以"肝郁"者居多的规律,创"调肝安神"针刺组穴配方联合中药"养阴安神"方,独具特色,临床疗效颇佳.

目的:分析火炭母水提液对金黄色葡萄球菌和铜绿假单胞菌的抗菌作用,并探究其效应物质.方法:制备火炭母水提液,采用纸片琼脂扩散法测定抑菌圈大小,采用梯度稀释法测定火炭母对金黄色葡萄球菌和铜绿假单胞菌的最小抑菌浓度,采用液质联用色谱技术对火炭母水提液进行分析.结果:火炭母对金黄色葡萄球菌和铜绿假单胞菌均有较好的抑菌活性,其对金黄色葡萄球菌的最小抑菌浓度为0.3g/mL,对铜绿假单胞菌的最小抑菌浓度为0.5g/mL;采用液质联用分析发现火炭母水提液中主要为酚酸型物质,约占70.00％.结论:火炭母是一种良好的天然抗菌药物,其水提液对金黄色葡萄球菌和铜绿假单胞菌具有较好的体外抑菌效应.

腰背肌筋膜炎是针灸科常见的疾病,且发病率逐年增高,该文分享采用恢刺扳机点结合电针治疗腰背肌筋膜炎验案1则.

Objective:To study the regulatory effect of Wumen-Yiji powder on 5-hydroxytryptamine (5-HT) signal transduction system in intestine and hypothalamus of diarrhea irritable bowel syndrome (IBS-D) model rats. Methods:Sixty male SD rats were randomly divided into blank group (10 rats) and diarrhea irritable bowel syndrome group (50 rats). The diarrhea irritable bowel syndrome group formed the diarrhea irritable bowel syndrome model after 2 weeks of senna leaf gavage and restraint stress. They were randomly divided into model group, deshute group (1.5 mg/kg), low, medium and high dose group of Wumen-Yiji San (6, 12, 24 g/kg), with 10 rats in each group. After continuous administration for 2 weeks, the contents of 5-HT in serum, colon and hypothalamus were detected by ELISA; HE staining was used to observe the pathological changes of colon in each group. The protein and mRNA levels of tryptophan hydroxylase 1 (TPH-1), serotonin receptor 3 (5-HT3R), serotonin receptor 4 (5-HT4R), serotonin transporter (SERT) in colon and hypothalamus were detected by Western blot and RT-PCR, respectively. Results:Compared with the model group, the pathological morphology of colon in each treatment group was improved. Compared with the model group, the level of 5-HT in serum and colon significantly decreased ( P<0.05), and the level of 5-HT in hypothalamus of rats in the low, medium, high dose group of Wumen-Yiji San significantly increased ( P<0.05). The expression of TPH-1, 5-HT3R and 5-HT4R protein significantly decreased ( P<0.05), and the expression of SERT protein in the medium, high dose group of Wumen-Yiji San significantly increased ( P<0.05). The expression of TPH-1, 5-HT3R and 5-HT4R protein in hypothalamus increased ( P<0.05), and the expression of SERT protein in the high dose group of Wumen-Yiji San significantly decreased ( P<0.05). The mRNA levels of TPH-1 (4.778 ± 0.604, 3.278 ± 0.668, 1.670 ± 0.361 vs. 6.877 ± 0.148), 5-HT3R (3.807 ± 0.463, 2.697 ± 0.455, 1.132 ± 0.136 vs. 6.322 ± 0.778), 5-HT4R (4.521 ± 0.234, 2.801 ± 0.351, 1.331 ± 0.142 vs. 6.741 ± 0.293) in colon tissue of low, medium and high dose groups of Wumen-Yiji San decreased ( P<0.05). The level of 5-HT4R mRNA (0.616 ± 0.208, 0.726 ± 0.226 vs. 0.521 ± 0.062) increased ( P<0.05), and the level of SERT mRNA (1.563 ± 1.023 vs. 2.612 ± 1.035) in medium, high dose group of Wumen-Yiji San decreased ( P<0.05). Conclusion:The result showed that Wumen-Yiji San could regulate the expression of 5-HT signaling system relating proteins and mRNA in the colon and hypothalamus of IBS-D rats within a certain dose range, so as to improve the symptoms of IBS-D.

目的 观察皱肺定喘膏联合西医常规治疗慢性阻塞性肺疾病(COPD)稳定期肺肾两虚证的疗效及安全性.方法 将65例COPD稳定期患者随机分为对照组31例及观察组34例,对照组给予常规西医治疗,观察组在西医常规治疗基础上加服皱肺定喘膏,每次20 g,每日1次,连续服用10周.两组均从服药开始随访1年,治疗前及随访1年时(治疗后)检测肺功能指标[包括第一秒用力呼气的容积占预计值的百分比(FEV1％Pre)、用力肺活量占预计值百分比(FVC％Pre)、第一秒用力呼气量与用力呼气量百分比(FEV1/FVC)],比较慢性阻塞性肺疾病评估测试(CAT)评分、六分钟步行距离(6MWD)、随访期间急性加重次数,并观察不良反应.结果 与本组治疗前比较,观察组治疗后6MWD、FEV1％Pre、FEV1/FVC升高,CAT评分降低(P＜0.05或P＜0.01),而对照组治疗后各指标差异无统计学意义(P＞0.05).治疗后组间比较,观察组6MWD、FEV1％Pre、FVC％Pre、FEV1/FVC均明显高于对照组,CAT评分低于对照组(P＜0.05).两组患者在随访期间急性加重次数比较差异无统计学意义(P＞0.05),两组均未见明显药物不良反应.结论 皱肺定喘膏联合西医常规治疗COPD稳定期肺肾两虚证患者,较单纯西医常规治疗,可明显改善患者肺功能、提高运动耐力及生活质量,且安全性好.

Objective To observe the effects of acupoint thread-embedding therapy and low-carbohydrate diet therapy on obese patients with food addiction. Methods Sixty-five eligible patients were randomized into a thread-embedding group of 33 cases and a diet group of 32 cases to respectively receive 12-week treatment. Before treatment, after treatment and at 6-month follow-up, the two groups were observed and compared in terms of body mass (BM), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), body mass index (BMI), body fat rate (BFR), basal metabolic rate (BMR) and Yale food addiction scale version 2.0 (YFAS 2.0). Results At the end of treatment, there were no significant differences in the general efficacy, and the improvements in BM, BMI, WC, HC, WHR and BFR between the thread-embedding group and diet group (all P >0.05). At follow-up, the thread-embedding group showed more significant improvements in all the aforementioned indicators compared with the diet group except HC (all P <0.05). At the end of treatment and follow-up, BMR and YFSA 2.0 had more significant improvements in the thread-embedding group than in the diet group (all P <0.05). Conclusion Acupoint thread-embedding therapy can produce significant efficacy in treating obese patients with food addiction; it can improve the food addiction state and work better in maintaining the efficacy compared with low-carbohydrate diet therapy.

目的:观察穴位埋线治疗脾虚湿盛型单纯性肥胖的临床疗效.方法:将60例脾虚湿盛型单纯性肥胖患者随机分为电针组和埋线组,每组30例.比较两组患者的临床疗效及治疗前后体质量、体质量指数、腰围、体脂率及中医证候积分.结果:埋线组总有效率为93.33％(28/30),高于电针组的73.33％(22/30),差异有统计学意义(P<0.05).治疗后,两组患者体质量、体质量指数、腰围、体脂率、中医证候积分均低于治疗前(P<0.05),且埋线组体质量、体质量指数、中医证候积分方面均优于电针组(P<0.05).结论:穴位埋线治疗脾虚湿盛型单纯性肥胖疗效确切.

目的 探究温针灸联合温经散寒通络汤应用于寒湿痹阻型腰肌劳损患者的临床治疗效果.方法 选取2018年1月～2020年12月南京中医药大学附属苏州市中医医院收治的寒湿痹阻型腰肌劳损患者62例,按照随机数表法随机分为对照组和观察组,每组31例,对照组予以温经散寒通络汤联合普通针刺治疗,而观察组予以温经散寒通络汤联合温针灸治疗,观察对比两种治疗方式的临床治疗效果.结果 观察组JOA评分高于对照组,差异有统计学意义(P<0.05);观察组MPQ评分低于对照组低,差异有统计学意义(P<0.05).结论 对寒湿痹阻型腰肌劳损患者采用温针灸联合温经散寒通络汤治疗,能够增强患者JOA评分,降低MPQ评分,取得良好的临床治疗效果,促进其疾病康复,值得临床应用.

目的:探究吴门调脂颗粒方对非酒精性脂肪性肝病(NAFLD)大鼠肝组织核转录因子NF-κB(NF-κB)p65、P38丝裂原活化蛋白激酶(MAPK)蛋白表达的影响.方法:选用SD大鼠50只,随机分为空白组、模型组、西药组(灌服80mg/kg/d多烯磷脂酰胆碱)和中药低、高剂量组(灌服4g生药/kg/d、8g生药/kg/d剂量的吴门调脂颗粒方),每组10只大鼠.采用高脂饲料喂养8周复制大鼠脂肪肝实验动物模型后开始给药4周,空白组和模型组给予同体积生理盐水.给药结束后以对应的试剂盒检测血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、还原型谷胱甘肽(GSH)、血清白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6),HE染色观察脊髓形态变化,应用免疫组化法(IHC)检测肝组织NF-κBp65、P38MAPK蛋白的表达.结果:吴门调脂颗粒方干预NAFLD大鼠4W后.与模型组比较,吴门调脂颗粒方大剂量血清TG、LDL-C、AST、IL-1β、IL-6明显下降(P＜0.05或P＜0.01或P＜0.001)且GSH明显升高(P＜0.05),肝组织NF-κBp65过表达明显下调(P＜0.05),肝组织脂肪变性及炎症浸润情况亦有不同程度的改善.总体优于吴门调脂颗粒方小剂量且与西药组情况相当.结论:吴门调脂颗粒方能明显减轻NAFLD大鼠的病情,并推测与抑制大鼠肝组织NF-κBp65蛋白过表达密切相关.

目的 观察皱肺定喘膏对慢性阻塞性肺疾病(COPD)患者BODE指数、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)的影响,探讨皱肺定喘膏治疗该病的可能有效机制.方法 107例COPD患者纳入研究,随机分为对照组58例、治疗组49例,对照组予噻托溴铵吸入剂18μg 1吸,日1次.治疗组在对照组治疗的基础上加用皱肺定喘膏,比较两组患者治疗前后体质量指数(BMI)、气流阻塞程度(FEV1％)、呼吸困难指数(mMRC)、运动耐力6 min步行距离(6MWT)、BODE指数积分、炎症指标IL-8、TNF-α的变化情况.结果 (1)组内比较:两组患者FEV1％pred、6MWD、mMRC、BODE指数积分治疗后较治疗前改善(P<0.05),BMI无明显改善(P>0.05).治疗组患者血清TNF-α、IL-8水平较治疗前明显降低(P<0.05),对照组患者血清IL-8水平较治疗前降低(P<0.05),TNF-α无明显改善(P>0.05).(2)组间比较:除BMI外,治疗组治疗后FEV1％pred、6MWD、mMRC、BODE指数积分、血清TNF-α、IL-8水平均较对照组治疗后明显改善(P<0.05).结论 皱肺定喘膏联合噻托溴铵吸入既可显著降低COPD稳定期患者的BODE指数积分,又可抑制COPD稳定期患者体内的TNF-α、IL-8水平,从而发挥治疗作用.

目的:探讨以颈夹脊穴为主针刺治疗颈源性耳鸣的临床疗效.方法:将60例颈源性耳鸣患者随机分为对照组和治疗组,每组30例.对照组给予耳周穴位针刺治疗,治疗组在对照组基础上针刺颈夹脊穴治疗.比较两组患者的临床疗效及治疗前后Northwick Park颈痛量表(NPQ)百分比、耳鸣严重程度评分.结果:治疗组总有效率为93.33％(28/30),高于对照组的73.33％(22/30),差异有统计学意义(P＜0.05).治疗后,两组NPQ百分比及耳鸣严重程度评分均较治疗前降低(P＜0.05),治疗组NPQ百分比及耳鸣严重程度评分均低于对照组(P＜0.05).结论:以颈夹脊穴为主针刺治疗颈源性耳鸣疗效明显.

Objective: To compare the clinical therapeutic effect on epiphora as sequela of peripheral facial paralysis treated with pricking technqiue of fire needling therapy at Chéngqì(承泣 ST1) and acupuncture treatment at conventional acupoints.Methods: From September 2018 through to October 2018,64 cases of epiphora as sequela of peripheral facial paralysis were collected from the Department of Acupuncture-Moxibustion in Suzhou TCM Hospital.According to random number table,they were divided into an observation group and a control group,32 cases in each one.In the observation group,pricking technique of fire needling therapy was used at ST1,once every two days.In the control group,acupuncture with filiform needle was applied to Jīngmíng(睛 明BL1),Tàiyáng(太阳EX-HN5),Tóngzǐliáo (瞳子髎GB1),Sìbái (四白ST2) and Quánliáo (颧髎SI18) on the affected side as well as Hégū (合谷LI4) on the contralateral side,once per day.The 10-day treatment wa as one 1 course and the consecutive 3 courses of treatment were required in either of the groups.Before and after treatment,Munk grade,clinical effective rate and the number of treatments were observed in the evaluation of therapeutic effect.Results: After treatment,Munk grade was improved in the patients of the two groups (both P ＜ 0.05).The improvement range in the observation group was larger than that of the control group (P ＜ 0.05).The treatment in either group achieved the obviously therapeutic effect on epiphora as sequela of peripheral facial paralysis.The effective rate in the observation group was 90.32％,higher than 61.29％ in the control group (P ＜ 0.05).The mean number of treatments of the curative case were 5.11 in the observation group and were 13.73 in the control group,indicating the statistical significance in difference (P ＜ 0.05).Conclusion: Pricking technique of fire needling therapy at ST1 achieves the better effect on epiphora as sequela of peripheral facial paralysis as compared with acupuncture at conventional acupoints.

目的:观察针刺局部穴位在淡化法令纹中的应用效果.方法:将56例参与面部祛皱(淡化法令纹)的女性患者随机分为对照组和观察组,每组28例.对照组使用洁面、按摩及补水等干预方法,观察组在对照组基础上采用针刺疗法,共治疗10周.治疗结束后,观察两组淡化法令纹的效果.结果:治疗10周后,观察组优良率为75.0％(21/28),高于对照组的53.6％(15/28),差异有统计学意义(P<0.05).结论:针刺面部局部穴位有助于淡化法令纹,改善面部状态,临床效果显著.

目的 观察短刺结合电针治疗膝关节鹅足滑囊炎(pes anserinus bursitis)的临床疗效.方法 选择2018年1月～2019年1月在我院针灸科及骨伤科门诊经过查体及影像学表现等综合诊断为膝关节鹅足部滑囊炎的患者80例,通过随机数字表法的分类方法分为观察组和对照组,每组各40例.观察组采用短刺结合电针+口服洛索洛芬治疗,对照组采用单纯口服洛索洛芬钠治疗,采用Lysholm评分量表及VAS评分量表对患者治疗前、后膝关节功能及疼痛情况进行评估,对血清IL-6的检测结果进行比较.结果 经过2周的治疗后可见观察组Lysholm评分较对照组高,观察组VAS评分较对照组低,两组差异有统计学意义(P<0.05).治疗2周后观察组有效率为95.0％,对照组为75.0％,其差异具有统计学意义(P<0.05).而两组治疗前炎性因子水平差异无统计学意义(P>0.05),而治疗后差异具有统计学意义(P<0.05).观察组IL-6水平低于对照组(P<0.05).结论膝关节鹅足滑囊炎患者采用短刺结合电针配合口服洛索洛芬治疗疗效显著,治疗便捷,能有效减少治疗疗程,更好地改善患者膝关节功能.

该文介绍深刺关元穴治疗良性前列腺增生症验案1例.

目的:观察易筋经结合穴位埋线治疗肥胖的临床疗效.方法:将肥胖患者90例随机分为训练组、治疗组和联合组3组,训练组采用易筋经训练,治疗组采用单纯穴位埋线治疗,联合组在训练组的基础上联合穴位埋线治疗.3组均治疗3个月,治疗前后以体脂率、生化指标、减肥疗效等指标进行测定.结果:训练组脱落1例.联合组体质量、体质量指数(BMI)、平均腰围、平均臀围、体脂率、脐周下脂肪厚度和血清甘油三酯(TG)、总胆固醇(CHOL),以及满意度和总体减肥疗效均优于单纯训练组和治疗组(P＜0.05).结论:易筋经结合穴位埋线治疗优于单纯易筋经训练和单纯穴位埋线治疗,具有一定临床推广价值.