目的:探讨体针与耳穴贴压并用治疗肝火旺盛型经行头痛的作用机制.方法:将85例患者按随机数字表法分为治疗组(43例)、对照组(42例).治疗组采用体针与耳穴贴压并用的方法治疗,对照组给予口服盐酸氟桂利嗪胶囊(西比灵)治疗.观察2组临床疗效,同时随机对部分患者(2组各30例)治疗前后及正常人经期血浆ET-1(内皮素)和血清NO(一氧化氮)含量进行检测.结果:2组临床疗效比较,治疗组明显优于对照组.治疗后2组血浆ET-1含量较治疗前均有明显降低,但治疗组较对照组降低更加明显,且恢复至正常组水平;治疗后2组血清NO含量较治疗前均有明显升高,并均恢复至正常组水平.结论:体针与耳穴贴压并用对肝火旺盛型经行头痛有明显的治疗作用,其作用机制可能是通过调节血浆ET-1和血清NO的异常水平而发挥止痛效应.

OBJECTIVE To observe the therapeutic effect of body acupuncture combined with auricular acupressure for treatment of menstrual headache of hyperactivity of "liver fire". METHODS A total of 85 menstrual headache patients with hyperactivity of "liver-fire" were randomly divided into control group (n = 42) and treatment group (n = 43). Patients of the control group were treated by oral administration of Flunarizine Hydrochloride Capsules (Sibelium, 5 mg/time, twice daily) for 5 days beginning at the headache attack in the first menstrual cycle, and for two weeks (except weekends) in the second and third menstrual cycles. Patients of the treatment group were treated by manual acupuncture stimulation of body acupoints Baihui (GV 20), Fengchi (GB 20), Sanyinjiao (SP 6), Taichong (LR 3), Xiaxi (GB 43), Taiyang (EX-HN 5), Hanyan (GB 4), Xuanlu (GB 5) and Shuaigu (GB 8) beginning from the headache attack, and otopoint-pellet pressure of otopoints unilateral Endocrine, Ovaries, Shenmen, Cortex, Liver, Spleen and Kidney (beginning 5 days before menstrual onset) and bilateral Shenmen, Nie, Liver, Gallbladder, Subcortex and Jiaogan during headache attack. Clinical symptom scores were assessed according to the "Guiding Principles for Clinical Research on New Chinese Herbal Drugs" issued by the Chinese Ministry of Health. RESULTS After the treatment, of the 42 and 43 cases in the control and treatment groups, 9 (21.43%) and 20 (46.51%) were cured, 12 (28.57%) and 14 (32.56%) had a marked improvement, 13 (30.95%) and 7 (16.28%) were effective, 8 (19.05%) and 2 (4.65%) invalid, with the effective rates being 80.95% and 95.35% , respectively. The curative effect of the treatment group was significantly better than that of the control group (P<0.05). The symptom score and VAS score after the treatment and 3 months post-treatment in the treatment group were significantly lower than those of the control group (P<0.01). The headache scores and VAS scores were significantly reduced following the treatment and 3 months after the treatment in both control and treatment groups (P<0.01). After the treatment for 2-3 therapeutic courses, the headache attack duration during menstruation was markedly and gradually shortened in both groups (P<0.01), and therapeutic effect of the treatment group was significantly better than that of the control group (P<0.01). CONCLUSION Body acupuncture combined with auricular acupressure treatment can effectively relieve menstrual headache in menstrual women with hyperactivity of "liver fire".

目的 观察体针与耳穴贴压并用治疗经行头痛的临床疗效及不良反应.方法 将85例患者随机分为两组.治疗组43例,采用体针与耳穴贴压并用的方法治疗;对照组42例,口服盐酸氟桂利嗪胶囊治疗.观察两组疗效和不良反应,并进行评价.结果 治疗组总有效率为95.35％,对照组总有效率为80.95％,治疗组优于对照组(P＜0.05).两组总体疗效比较,治疗组明显优于对照组(P＜0.01).治疗组患者均未出现不良反应,属于安全性评价Ⅰ级;对照组患者出现有不同程度的不良反应,安全性评价Ⅱ级、Ⅲ级各3例.两组不良事件/不良反应发生率比较,差异有显著性意义(P＜0.05).结论 体针与耳穴贴压并用治疗经行头痛疗效显著,且安全可靠.

目的:探讨体针与耳穴贴压并用疗法治疗肝火旺盛型经行头痛的作用机制.方法:法:将85例经行头痛患者随机分为两组.治疗组43例,采用体针与耳穴压丸并用的方法治疗;对照组42例,口服西比灵(盐酸氟桂利嗪胶囊)治疗.并对两组各30例患者治疗前后经期血清前列腺素F2 α(PGF2α)和前列腺素E2(PGE2)进行检测.结果:治疗组疗效优于对照组(P＜0.01).两组血清PGF2α含量治疗后较治疗前均明显降低(P ＜0.01,P＜0.05);两组血清PGE2含量治疗后较治疗前均明显升高(P＜0.01,P＜0.05),但对照组治疗后仍低于正常组(P＜0.05);两组PGF2α/PGE2比值治疗后较治疗前均明显降低(P＜0.01,P＜0.05),但对照组治疗后仍大于正常组(P＜0.05).结论:体针与耳穴贴压并用对肝火旺盛型经行头痛有显著治疗作用,其作用机制可能与调节患者异常PGF2α和PGE2水平,降低PGF2α/PGE2比值有关.

Objective:To expolore the therapeutic mechanism of body acupuncture and auricular acupressure on menstrual headache of hyperactivity of liver fire .Methods:85 patients of menstrual headache were randomly di-vided into treatment group ( n=43 ) that was treated with body acupuncture and auricular acupressure treatment , control group ( n=42 ) that was asked to take Sibelium ( oral medicine Flunarizine Hydrochloride Capsules ) . Comparison of two groups ’ clinical efficacy and headache symptom scores .30 patients in both groups were ran-domly chosen to determine the contents of plasma AVP before and after treatment in two groups .Results:The to-tal effective rate in treatment group was 95 .35%, and the control group was 80 .95%.The curative effect of treatment group was significantly better than that of the control group ( P <0 .01 ) .Two groups ’ headache symptom scores were significantly lower than those of pre -treatment (P<0.01), and the treatment group was significantly lower ( P<0 .01 ) .After treatment , the plasma AVP contents in treatment group and control group were significantly lower than those of pre -treatment (P<0.05).Conclusion:Body acupuncture with auricular acupressure treatment is effective in relieving patients ’ abdominal pain , which may be closely associated with its actions in adjusting abnormal contents of plasma AVP .

目的：观察体针与耳穴压丸并用治疗经行头痛的临床疗效。方法：将67例患者随机分为两组。治疗组34例，采用体针与耳穴压丸并用的方法治疗；对照组33例，口服西比灵（盐酸氟桂利嗪胶囊）治疗。结果：治疗组和对照组痊愈率分别为44.12％、24.24％，总有效率分别为97.06％和81.82％，两组比较差异有显著性（ P＜0.05），治疗组疗效明显优于对照组。结论：体针与耳穴压丸并用治疗经行头痛疗效显著。

OBJECTIVE To investigate the influence of electroacupuncture (EA) on lipid metabolism in both sexes of obesity model rats. METHODS A total of 30 male and 30 female SD rats were randomized into normal control, model and EA groups respectively, with 10 rats in each group. EA (2 Hz, 1-2 mA) was applied to the ipsilateral "Zusanli" (ST 36)-"Sanyin-jiao"(SP 6) and bilateral "Fenglong" (ST 40) for 30 min, once daily for 28 days. In addition,"Quchi" (LI 11),"Zhongwan" (CV 12) and "Guanyuan" (CV 4) were punctured with filiform needles and stimulated by manipulating the needle for 1 min, separately. Obesity model was duplicated by subcutaneous injection of 15% glutamic sodium (0.2 mL/10 g) once daily for 5 days and by feeding the animal with high fat forage for 36 days. Lee's index was calculated, and plasma triglyeride (TG) concentration detected by glycerol-phosphoric acid oxidase-peroxydase method, total cholesterol (TC) detected by cholesterol oxidase method, and plasma low-density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C) contents were assayed by one-step method, respectively. RESULTS In both male and female rats, compared to their own normal groups, the Lee's index, plasma TG, TC and LDL-C contents were increased significantly and plasma HDL-C contents decreased obviously in the model groups (P<0.01), while compared to their own model groups, the Lee's index, plasma TG, TC and LDL-C levels in the EA groups were down-regulated considerably and plasma HDL-C contents up-regulated remarkably after the treatment (P<0.01, P<0.05). The efficacies of the EA intervention were obviously better in reducing Lee's index for male rats, and in down-regulating plasma TG and TC contents in female rats (P<0.05). No significant differences were found between male and female rats in EA intervention for plasma LDL-C and HDL-C levels. CONCLUSION EA intervention can effectively regulate obesity rats' Lee's index and plasma TG, TC, LDL-C and HDL-C levels. The effects are different in male and female rats.

[Objective] Observing the influence of electroacupuncture on Leptin of both sexes in the hypothalamic obesity rats through the animal experiment.[Methods] Duplicated rat hypothalamic obesity model by injecting L-MSG under the skin of neck.They were randomly divided into model male groups,model female group,EA male group,EA female group and setting normal control male and female group.Electroacupuncture male and female groups were fellowed by switching WQ2F-type electroacupuncture.Measuring 6 rats weight,Lees' index,serum leptin and hypothalamic leptin.[Results] EA male and female groups of Lees index and serum leptin levels,respectively,and model male and female between the two groups were significntly lower(P<0.01),while hypothalamic leptin levels were significantly higher(P<0.01).EA Lees index of male group were significantly lower than the female group(P<0.05);EA female group of serum leptin levels lower than the EA male group significantly(P<0.05);EA female hypothalamic leptin levels were highter than the EA male(P<0.05).[Conclusion] Electroacupuncture of the male and female obese rats with varying degrees of weight loss,but the lower Lees index regulates lipid metabolism,both the existence of certain differences between the EA can significantly reduce the Lees index of male rats and adjust the Leptin.

目的 探讨电针刺激对雌、雄两性实验性肥胖大鼠血清和下丘脑神经肽Y(NPY)调节的差异性及其可能作用机制.方法 采用谷氨酸钠和高脂饮食诱导的下丘脑性肥胖模型,随机分为模型雌组、模型雄组、电针雌组、电针雄组,并设正常雌组和正常雄组进行对照.电针雌组、雄组针刺后接通韩氏电针仪,采用2Hz同步疏密波刺激.观察电针干预前后雌、雄两组大鼠Lee's指数及血清、下丘脑NPY含量的变化,并进行比较.结果 电针雌、雄两组的Lee's指数及血清、下丘脑NPY的含量分别较模型雌、雄两组明显降低(P＜0.01),电针雄组降低明显(P＜0.05).结论 电针刺激对雌雄两性肥胖性大鼠均有不同程度的减肥作用,但在降低Lee's指数和血清、下丘脑NPY方面,二者间存在着一定的差异,电针干预对雄性大鼠的调节作用略明显.

OBJECTIVE:To observe the effect of mild moxibustion on the number of macrophages and contents of collagen I and III in the raw surface tissue in chronic skin ulcer rats so as to study its mechanism underlying promoting scar formation. METHODS:Eighty male SD rats were randomly divided into normal (n = 8), model (n = 24), TDP (n = 24) and moxibustion (n = 24) groups. Chronic refractory skin ulcer was established by making an open wound at the back and local intramuscular injection of hydrocortisone sodium succinate. For rats of the TDP and moxibustion groups, TDP irradiation or mild moxibustion was applied to the raw surface, bilateral "Shenshu" (BL 23) and "Zusanli" (ST 36) for 15 min, once daily for 7, 10 and 14 days, respectively. The number of macrophages in the raw surface tissue was counted under light microscope after H. E. staining and col- lagen I and III expressions of the raw surface tissue were detected by immunohistochemistry. RESULTS:In comparison with the normal group, the numbers of macrophages in the raw surface tissue were increased significantly in the model group on day 7, 10 and 14 (P < 0.05); while compared with the model group, the numbers of macrophages were increased further obviously in the moxibustion group on day 7 and 10 and in the TDP group on day 10 after the treatment (P < 0.05). Compared with the model group, the numbers of macrophages in both TDP and moxibustion groups were down-regulated obviously (P < 0. 05). In regard to collagen I and III expression of the raw surface tissue, compared with the normal group, the collagen I protein expression level was down-regulated markedly in the model group on the 7th day (P < 0.01); whereas in comparison with the model group, the expression levels of collagen I and III were increased considerably in the TDP and moxibustion groups on day 7 and 14 after the treatment (P < 0.05, P < 0.01). The ratios of collagen I/III expression were remarkably higher in the model group than in the normal group on day 7 and 14 (P < 0.05), and significantly lower in the TDP group on day 7 and 14 and in the moxibustion group on day 14 than in the model group (P < 0.05, P < 0.01). The effects of moxibustion were obviously superior to those of TDP in up-regulating macrophage number on day 10, up-regulating collagen I and III expressions on day 14, and down-regulating macrophage number on day 14 after the treatment (P < 0.05, P < 0.01). No significant differences were found between the TDP and moxibustion groups in up-regulating macrophage number, and collagen I and III protein expressions, and in down-regulating the ratios of collagen I/III expression on day 7 after the treatment (P > 0.05). CONCLUSION:Mild moxibustion can regulate the number of macrophages and strengthen the expression of collagen proteins in the raw surface tissue in the chronic skin ulcer rats, which may contribute to its effect in promoting wound healing and reducing scar formation.

目的观察隔物灸治疗前后神阙、关元穴穴位电阻值变化,以探讨胞宫相关经穴电阻值变化与原发性痛经的相关性,以及隔物灸对原发性痛经相关经穴电阻的影响,为临床应用隔物灸法治疗原发性痛经提供科学的理论根据。方法采用随机、对照、单盲法,以60例原发性痛经患者为治疗组,采用神阙隔盐灸、关元隔姜灸的治疗方法;以30例正常女性为正常组。观察原发性痛经患者治疗前后神阙、关元穴位电阻值变化,并与正常组电阻值进行比较。结果治疗组治疗前与正常组神阙穴、关元穴位电阻值比较,差异有统计学意义(P<0.01),治疗组治疗后神阙穴、关元穴位电阻值较治疗前明显降低,差异有统计学意义(P<0.01)。结论原发性痛经患者神阙、关元穴位电阻明显增高,隔物灸法可明显降低痛经患者神阙、关元穴位电阻。

目的:探讨体针与电针对实验性肥胖大鼠血清和下丘脑神经肽Y(NPY)调节作用的差异。方法:采用谷氨酸钠和高脂饮食诱导的下丘脑性肥胖模型,随机将其分为体针组、电针组、模型组并设正常组进行对照。体针组采用传统捻转手法,平补平泻法;电针组采用疏密波,频率为100Hz。测量4组大鼠的体重、体长,计算Lee’s指数,并观察针刺干预后肾周脂肪细胞病理形态学以及血清、下丘脑NPY含量的变化。结果:体针组和电针组Lee’s指数及血清、下丘脑NPY含量较模型组均有下降(P<0.01,P<0.05);肾周脂肪细胞直径、面积、体积较模型组均有减小(P<0.01),但体针组均明显优于电针组(P<0.05,P<0.01)。结论:体针和电针均具有减肥减脂及调节血清和下丘脑NPY异常水平的作用,但体针的调节作用更加明显。

To review the acupuncture treatment of menstrual headache during the past ten years and to analyze the treatment of this disease from the aspects including body acupuncture,ear acupuncture,integrated treatment and make a number of views and prospects concerning the existing problems of this treatment.

创面修复是一个复杂的生物化学活动,也是医学中古老的问题之一,在临床中尤其以慢性难愈性创面的修复愈为棘手.在促进创面的愈合方面,西医有一定的效果,尤其是近十年来,随着分子生物学在医学中的应用与发展,对于创面组织修复的机理认识已有长足的进展,但是尚缺乏安全有效的加速创面愈合积极措施.

球后视神经炎一般可分为急性和慢性2类,以后者多见.由球后视神经炎受累部位不同,可将其分为以下几种类型:①病变最先侵犯乳头黄斑束纤维,因该束纤维在球后眶内段视神经轴心部分,故称轴性球后视神经炎;②病变主要侵犯球后视神经鞘膜及其周围神经纤维束时,则称球后视神经周围炎,以梅毒多见,特征为视野呈向心性缩小,临床上难确诊;③病变累及整个视神经横断面,则表现为无光感即黑矇,称横断性视神经炎,为最严重类型,视力恢复后用小视标常可检查出中心暗点[1].当代中医眼科教科书将本病称为目系"暴盲"[2].<审视瑶函·暴盲>:"此症谓目平素别无他症,外不伤于轮廓,内不损乎瞳神,倏然盲而不见也.其故有三:曰阴孤,曰阳寡,曰神离,乃闭塞关格之病."[3]现将球后视神经炎的中医药针灸治疗进展综述如下.