目的 探讨脊柱定点旋转复位手法联合中医药枕治疗颈型颈椎病的临床疗效.方法 使用随机数表法将2021 年12月～2022 年12 月在郑州中医骨伤病医院就诊的140 例颈型颈椎病患者分为对照组(n=70)和观察组(n=70).两组均接受常规治疗,对照组在此基础上接受脊柱定点旋转复位手法治疗,观察组在对照组基础上接受中医药枕治疗.比较两组治疗前后颈椎曲度、疼痛程度、颈椎功能及血流动力学指标水平.结果 治疗2 周、4 周后,两组Borden值均高于治疗前(P＜0.05),而VAS评分和颈椎功能障碍指数(neck disability index,NDI)均低于治疗前(P＜0.05),且观察组治疗2 周、4 周后的Borden值高于对照组(P＜0.05),而VAS评分和NDI评分低于对照组(P＜0.05);治疗 4 周后,两组基底动脉(basilar artery,BA)、左侧椎动脉(left vertebral artery,LVA)、右侧椎动脉(right vertebral artery,RVA)的平均血流速度(mean blood flow velocity,Vm)水平均高于治疗前(P＜0.05),且观察组治疗4 周后BA、LVA、RVA的Vm水平高于对照组(P＜0.05).结论 脊柱定点旋转复位手法联合中医药枕治疗可有效改善颈型颈椎病患者的血流动力学和颈椎曲度,对于缓解患者疼痛、提高患者颈椎功能有积极作用.

OBJECTIVES:Neuropathic pain (NP) is a chronic pain caused by somatosensory neuropathy or disease, and genistein (Gen) might be a potential drug for the treatment of NP. Therefore, this study aims to investigate the effect of Gen on lipopolysaccharide (LPS)-induced inflammatory injury of dorsal root ganglion neuron (DRGn) in rats and the possible molecular mechanism.METHODS:The DRGn of 1-day-old juvenile rats were taken for isolation and culture. The DRGn in logarithmic growth phase were divided into a control group, a LPS group, a tubastatin hydrochloride (TSA)+LPS group, a Gen1+LPS group, a Gen2+LPS group, a Gen2+LPS+TSA group, a Gen2+pcDNA-histone deacetylase 6 (HDAC6)+LPS group, and a Gen2+pcDNA3.1+LPS group. The LPS group was treated with 1 μg/mL LPS for 24 h; the TSA+LPS group, the Gen1+LPS group, the Gen2+LPS group were treated with 5 μmol/L TSA, 5 μmol/L Gen, 10 μmol/L Gen respectively for 0.5 h, and then added 1 μg/mL LPS for 24 h; the Gen2+TSA+LPS group was treated with 10 μmol/L Gen and 5 μmol/L TSA for 0.5 h and then added 1 μg/mL LPS for 24 h; the Gen2+pcDNA-HDAC6+LPS group and the Gen2+pcDNA3.1+LPS group received 100 nmol/L pcDNA-HDAC6 and pcDNA3.1 plasmids respectively, and 24 h after transfection, 10 μmol/L Gen was pretreated for 0.5 h, and then added 1 μg/mL LPS for 24 h. Real-time RT-PCR was used to detect the HDAC6 mRNA expression in DRGn; CCK-8 method was used to detect cell viability of DRGn; flow cytometry was used to detect cell apoptosis of DRGn; ELISA was used to detect the levels of IL-1β, IL-6, and TNF-α in DRGn culture supernatant; Western blotting was used to detect the protein expression of HDAC6, Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), and NF-κB p65 in DRGn.RESULTS:Compared with the control group, the expression levels of HDAC6 mRNA and protein, the expression levels of TLR4 and MyD88 protein in DRGn of LPS group rats were significantly up-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly increased, and the activity of DRGn was significantly decreased, the apoptosis rate was significantly increased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly increased (all P<0.05). Compared with the LPS group, the expression levels of HDAC6 mRNA and protein, TLR4 and MyD88 protein expression levels in DRGn of the TSA+LPS group, the Gen1+LPS group, the Gen2+LPS group and the Gen2+TSA+LPS group were significantly down-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly decreased, the activity of DRGn was significantly increased, the apoptosis rate was significantly decreased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly decreased (all P<0.05), and the above changes were most obvious in the Gen2+TSA+LPS group. Compared with the Gen2+LPS group, the expression levels of HDAC6 mRNA and protein, TLR4 and MyD88 protein expression levels in DRGn of the Gen2+pcDNA-HDAC6+LPS group were significantly up-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly increased, the activity of DRGn was significantly decreased, and the apoptosis rate was significantly increased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly increased (all P<0.05).CONCLUSIONS:Gen can alleviate LPS-induced DRGn inflammatory injury in rats, which might be related to down-regulating the expression of HDAC6 and further inhibiting the activation of TLR4/MyD88/NF-κB signaling pathway.

目的:通过文献计量学对国内外颈源性头痛的研究现况进行分析,为迅速了解该领域的知识脉络、研究进展、热点提供参考.方法:检索Web of Science核心合集数据库和中国知网数据库2001-2020年颈源性头痛相关文献,通过软件CiteSpace 5.7.R2对发文量、作者、发文机构、关键词等方面进行可视化分析.结果:筛选后纳入中文文献929篇、英文文献581篇,国内外发文量总体呈上升趋势;中英文文献发文量较高的分别是国内作者倪家骧、黄洪、范刚启以及国外作者SJAASTAD OTTAR、HALL TOBY、GWENDOLEN JULL等.国内研究热点以临床观察为主,侧重于物理、药物、微创介入等治疗方案的研究.国外研究涉及颈源性头痛的流行病学、病理机制、诊疗手段以及颈源性头痛患者预后等各方面,较之国内更为全面.结论:国内外颈源性头痛领域的研究整体呈上升态势,研究内容和热点主要集中于更加细致明确的诊断标准与疗效更为明确的治疗手段.本研究对颈源性头痛研究领域的概况、研究热点、前沿进行了梳理与分析,以期为快速掌握颈源性头痛的研究现况以及选题提供参考.

目的 熄风通络法配合疏经通督推拿手法治疗椎动脉型颈椎病(CSA)的效果.方法 将我院收治的98例CSA患者随机分为对照组和观察组,各49例.对照组采用常规西医方法治疗,观察组在对照组的基础上采用熄风通络法配合疏经通督推拿手法.比较两组的治疗效果.结果 治疗后,两组颈部前屈和后伸50％MVC均增大,且观察组大于对照组(P<0.05).治疗后,两组中医证候积分均降低,且观察组低于对照组(P<0.05).观察组治疗总有效率高于对照组(P<0.05).结论 熄风通络法配合疏经通督推拿手法治疗CSA效果显著,其不仅可改善患者的颈肌力学性能,而且可以缓解患者的临床症状,提高治疗效果.

目的:观察通经蠲痹胶囊对大鼠实验性膝骨关节炎血清中IL-1β、MMP-3含量的影响.方法:将40只健康SD大鼠随机分为通经蠲痹胶囊组(A组)、筋骨痛消丸组(B组)、模型组(C组)和空白组(D组)各10只,采用Hulth造模法建立大鼠膝骨性关节炎模型.以通经蠲痹胶囊、筋骨痛消丸为干预治疗手段,检测比较各组大鼠血清中IL-1β及MMP-3的含量.结果:试验后各组大鼠血清中IL-1β及MMP-3的含量有所差异,其中A、B、C三组明显高于D组(P＜0.01);A、B两组明显低于C组(P＜0.05);A、B两组比较无明显差异(P＞0.05).结论:通经蠲痹胶囊对Hulth造模所致的膝骨关节炎具有一定的治疗效果.

Objective:To investigate the effects of shexiang baoxinwan(SXBXW) on blood serum C-response protein level in patient with unstable angina(UA).Methods:We select 80 example patient in my department treatment from October 2009 to May 2010.They are divided into SXBXW group and conventional group.Use immunity compare muddy method to quota determination blood serum C-response protein level.Results:About the blood serum C-response protein content.Sxbxw group by 28.4±4.62% mg/L falls to 12.58±3.97%mg/L.Conventional group by 27.8±5.8%mg/L falls to 18.4±4.26%mg/L.Treats the latter two groups of content to have remarkable difference after statistics processing.Conclusion:SXBXW reduce the blood serum C-response of UA patient and is safe more effective treatment.