金课,又称为一流课程.吴岩司长首提"两性一度"的金课标准,主张合理运用现代信息技术手段,开辟"智能教育"新途径,打造金课,淘汰水课,努力营造积极热烈的课堂教学氛围.2020年,团队主讲的针灸学课程荣获辽宁省级线上线下混合式一流课程.在"互联网+"带来的巨大技术变革时代背景之下,笔者将现代信息技术与针灸学课程优质教学资源有机结合,不断建立与完善针灸学一流课程,逐渐探索与实践"线上线下混合式金课"教育教学改革,以期中医院校各专业学生针灸学教学质量以及学生自主学习能力、综合素质的提高.

随着"互联网+"时代的来临,云计算、大数据、计算机网络、移动互联等技术为高校的教育教学提供了巨大的技术变革.将这些现代信息技术与针灸学优质的教学资源有机结合,构建一个高质量、大容量的针灸学数字化教学资源库,对于加强针灸学教学改革,促进针灸学专业教育的发展是十分必要的.针灸学多媒体资源库的建设,不但能为教师的教学研究工作提供丰富的资源,同时也能更好地为广大医学院校学生提供一个直观、自主、个性化的针灸学习平台,进一步为针灸学课程教学的信息化、网络化和自动化奠定基础.

脑缺血再灌注损伤是一种具有较高致残率和病死率的危重疾病,近年来呈现出逐年增长且年轻化的趋势,有极高的伤残率和病死率,严重危害人们健康的同时也降低了生活质量.针刺治疗作为中医传统疗法,应用于脑缺血再灌注损伤取得了不错的疗效,文章对近年国内有关针刺治疗脑缺血再灌注损伤的机理进行归纳总结,为脑缺血再灌注损伤的针刺治疗提供理论依据.

随着"互联网+"时代的来临,云计算、大数据、移动互联等技术为高校的教育教学提供了巨大的技术变革.将现代信息技术与针灸学优质的教学资源有机结合,打造针灸学"校园慕课""金课",进行线上线下混合式教育教学改革,必将对提高中医院校各专业学生针灸学教学质量、学生的自主学习能力以及学生的综合素质大有裨益.

功能性消化不良是临床上较为常见的胃肠道相关疾病.近年来大量研究显示:肠道菌群失调及其相关代谢产物与功能性消化不良的发生具有明显的相关性.针刺可有效的调控并改善肠道菌群及其相关代谢产物,文章就针刺调控肠道菌群及菌群主要代谢产物短链脂肪酸与功能性消化不良相关性做一综述.

目的 探讨CBL联合LBL教学法在针灸学课程教学中的应用效果.方法 将辽宁中医药大学16级第一临床学院中西医结合专业的60名学生随机分为实验班和对照班,每个班30名学生.实验班采用案例教学法(Case based learning,CBL)联合传统教学法(Lecture-based learing,LBL)教学模式,对照班采用LBL教学模式.比较2个班期末笔试成绩、实训考试成绩、自拟笔试考试成绩以及总成绩,以评价教学效果.结果 实验班期末笔试成绩(42.50±3.60)分、实训考试成绩(24.63±2.68)分、自拟综合笔试成绩(15.77±1.07)分以及总成绩(82.90±6.00)分均高于对照班(40.37±2.09)分、(19.83±1.70)分、(13.43±1.91)分以及(73.63±4.05)分(P<0.05).结论 CBL联合LBL能明显增强学生对针灸学课程基础理论知识的掌握,提高学生的综合分析应用能力.

目的 通过患者背俞穴、募穴、原穴等特定穴位红外温度的组间比较研究与自身对照研究,观察中药穴位贴敷法对冠心病的红外热成像及中医症状积分的影响.方法 采用红外热成像技术分析冠心病患者与健康志愿者比较的温度特异性穴位;再将患者随机分为治疗组与对照组,比较各组中医症状积分变化.结果 (1)与健康组相比,发现治疗组体表温度特异性穴位心俞(左)、心俞(右)、大陵(左)、大陵(右)、膻中(P＜0.05);(2)在治疗后进行红外热成像的前后对照研究发现膻中、心俞穴有体表温度变化(P＜0.05);(3)治疗后,中医症状积分表评分,治疗组治疗前后积分比较有统计学差异(P＜0.05).结论 冠心痛患者背俞穴、募穴、原穴有红外温度低温表现.该研究的贴敷治疗对冠心病患者穴位的刺激可以影响心区体表代谢;贴敷方法还可以缓解胸痹心痛患者中医症状.

目的 运用坐骨神经功能指数检测(SFI)与坐骨神经运动神经传导速度(MNCV)及形态学角度探讨在相同时间内,不同针刺深度刺承扶穴对坐骨神经损伤大鼠神经修复的作用机制.方法 48只SPF级SD大鼠,采用随机数字表法分为空白对照组(C),模型组(M),浅刺承扶组(T1组)、深刺承扶组(T2组),每组各12只.M组、T1组、T2组建立慢性神经卡压模型大鼠,于造模后的第28天检测坐骨神经功能指数检测(SFI)与坐骨神经运动神经传导速度(MNCV).结果 坐骨神经功能指数治疗前无统计学意义,治疗后,T2组与T1组、M组比较差异有统计学意义,表明深刺承扶穴组在神经修复及再生方面,具有更好的治疗作用.坐骨神经运动神经传导速度检测提示,M组、C组比较,MNCV值降低,表明大鼠慢性卡压模型对神经电传导产生了影响,T1组、M组间比较差异无统计学意义,T2组与T1组间比较差异有统计学意义,可推测承扶穴深刺方法具有促进神经恢复的作用.小动物超生检测,模型组与针刺组在治疗第14天,硅胶管卡压位置的近、远端都出现水肿现象,但组间比较差异无统计学意义.超微结构观察发现,M组、T2组都有瓦勒变性(WD)形成.结论 通过对大鼠坐骨神经功能指数、神经电传导检测的方法,来观测不同深度针刺承扶穴,对大鼠神经损害及恢复的差异性影响,发现深刺在改善神经功能指数改善方面有一定的治疗优势,但是从神经微观形态方面证据不足,有待于深入研究和探索.

金课建设具有开创性和高瞻远瞩的教育发展战略性,针灸学的线下课程建设同样站在国家本科教育历史的转折点.在本次一流本科课程建设中,针灸学课程将根据国家对提升大学生综合素质要求,打造金课,消灭水课,将经络穴位知识、临床技能、人文素质有机融合.帮助学生建立中医思维模式,培养学生临床解决复杂问题的综合能力,以及提高临床治疗技术的反思、改进、创新的高级能力.

针灸学是中医学重要的治疗手段,是中医学大学生重要的理论与操练课程.笔者发现,实训过程和中大学生暴露出来的人文素养普遍缺失,急需在课堂上予以强化和提升训练.本文以提升大学生人文素质为教学目标,以情景化模拟教学为主要教学方法,以毫针刺法为示例,展示了人文素质教育如何与针灸学教学相融合的实际案例.为学生建立好一个从尝试到反思再到改进的学习模式,提升中医学大学生的人文素质内核,为培养合格的中医药接班人,建立良好的临床思维模式打好基础.

目的 探讨灸法对Lewis肺癌小鼠血清IL-8、TGF-β1、VEGF表达的影响.方法 将成功建模后的Lewis肺癌小鼠分随机分为4组.①模型组:腹腔注射生理盐水,0.1 mL/10 g,1次/周,给药2次;②顺铂组:腹腔注射顺铂,0.05mg/10 g,1次/周,给药2次;③艾灸组:将自制小艾炷贴于“中府”“足三里”穴区并点燃,燃完1炷为1壮,10壮/次,1次/d,连续灸治14 d;④顺铂联合艾灸组:腹腔注射顺铂,0.05 mg/10 g,1次/周,给药2次.同时艾炷施灸,10壮/次,1次/d,连续14d.采用酶联免疫吸附法(ELISA)检测血清白细胞介素-8(IL-8)、转化生长因子β1(TGF-β1)、血管内皮生长因子(VEGF)水平.结果 ①与模型组比较,顺铂组、艾灸组以及顺铂联合艾灸组小鼠血清IL-8、VEGF的表达水平均明显下调(P＜0.01).②与模型组比较,顺铂组和顺铂联合艾灸组的小鼠血清TGF-β1的表达水平均明显下调(P＜0.01),而单纯艾灸组对小鼠血清TGF-β1表达水平的干预作用无统计学意义(P＞0.05).结论 灸治Lewis肺癌小鼠“中府”“足三里”穴具有抑瘤增效的作用,其机制可能与明显下调IL-8、VEGF表达有关.

目的:对传统的中医中筋骨辨证体系进行归纳研究,推进中医理论系统化.方法:按照时间前后,分析正骨推拿、筋伤推拿以及筋骨辨证理论的产生发展的过程,对不同时期各个医家的骨伤、筋伤以及筋骨并重的相关文献内容进行整理.结果:通过对相关古籍材料的整理,对当前的正骨推拿、筋伤推拿以及筋骨并重的相关理论体系进行完善优化,有效满足当前中医临床发展的需要,促进了中医推拿学科的创新发展.结论:通过对中医古代筋伤、正骨推拿学科中筋骨辨证体系进行整理,有效传承了传统中医精髓,有效推动了中医药的发展,对于临床有着重要的指导意义.

目的 基于“培土生金”理论,研究灸法对Lewis肺癌小鼠肿瘤组织增殖及其对caspase-3、bcl-2表达的影响,探索其抑瘤抗癌的作用机制.方法 将24只Lewis肺癌模型小鼠按照给药方案随机分为4组:Lewis模型组、化疗药物组、灸疗组与灸疗联合化疗药物组,每组6只,并连续施治14d后,对比观察各组别间肿瘤组织增殖的影响及其抗肿瘤效应,同时采用RT-PCR法检测caspase-3、bcl-2的mRNA表达水平.结果 ①与模型组比较,化疗药物组、灸疗组和灸疗联合化疗药物组对瘤重的减轻以及肿瘤增殖的抑制均具有统计学意义(P＜0.01).②化疗药物组、灸疗组以及灸疗联合化疗组的小鼠肿瘤组织caspase-3的mRNA表达水平均明显上调(P＜0.01).bcl-2的mRNA表达水平则显著下降(P＜0.01).各组间比较亦具有统计学差异,其中灸疗联合化疗药物组对于诱发小鼠肿瘤组织细胞凋亡的作用最优(P＜0.01).结论 灸法能够促进Lewis肺癌小鼠肿瘤组织细胞凋亡,进而起到抑制肿瘤组织增殖的作用.

建设了规范化、多元化、系统化的针灸多媒体教学资源库,再以学校网络教学平台为依托,率先创建针灸学立体化教材,营造立体化教学空间,构建立体化教学生态,施行"立体化的教"与"立体化的学"相结合的教学模式改革。通过教师开展课堂教学、实践教学、网络教学、翻转课堂等多元立体化的教学活动以及学生参与式学习、碎片化学习、自主性学习以及个性化学习等多元立体化的学习实践,使针灸学课程的教学更加人性化,更有利于构建"以学生为中心"的教学环境,更有利于素质教育以及创新人才的培养。

Objective: To observe and compare the differences among acupoint sticking method,pediatric massage,the combination of the two methods of children with chronic cough so as to provide the reference for treatment. Methods: Ninety cases of children with chronic cough were randomly divided into acupoint sticking group,pediatric massage group,the combination group,each group 30 cases. Acupoint sticking group selected Fujiu plaster in the First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,every 10 days,3 times as a course of treatment. Pediatric massage group selected the acupoints in lung,liver meridians and internal Bagua and Danzhong,once a day,10 days for a course of treatment. The combination group used Fujiu paste and the combination of pediatric massage method,the times and treatment course were the same as the other two groups’. By observing the change of the score of syndrome scale,we can compare the different curative effects of the two therapy. Results: The total effective rates of acupoint sticking group,pediatric massage group and combination group were 90. 0%,86. 7% and 93. 3%respectively. The scores of the three groups after treatment were statistically significant( P < 0. 05). Conclusion: Acupoint sticking therapy,pediatric massage therapy and the combination of the two methods have a good therapeutic effect on children with chronic cough,but the combination of the two is more significant,safe and effective for promotion.

Objective Fragmentation teaching design was applied to improve the classroom learning efficiency. Methods The research took 4 classes with 120 students that should learn Science of Acup-Mox Manipulations in teaching program. Students were divided into control group and experimental group. The fragmentation of teaching plans was applied in the experimental group, while tradi-tional teaching methods were applied in the control group. And then the analysis was taken according to practice scores. Results The difference was statistically significant in scores of warm acupuncture, ginger moxibustion, suspended moxibustion as while as the total scores( P < 0.05). Conclusion The knowledge of moxibustion was refined, the class time was fragmented with different learning points, the fragmentation teaching has increased the interests within students, and it helped individualized teaching.

Objective To investigate the application effect of case-based learning (CBL) teaching method and clinical Pathway (CP) on Internal Medicine of Acupuncture and Moxibustion in Traditional Chinese Medicine.Methods 60 students were divided into control class and experimental class randomly (n=30 in per class).The control class was taught by the traditional teaching method,and the experimental class was taught by the combined teaching method of CBL and CP.The theoretical exam and practical skills assessment were conducted at the end of the semester.All the scores were analyzed by SPSS 17.0.Results The theoretical scores and practical skills scores of experimental class were higher than that in control class,and there were obvious difference between these two classes (P=0.002,P=0.000).Conclusions Bringing CBL teaching method and CP to our class of Internal Medicine of Acupuncture and Moxibustion in Traditional Chinese Medicine can improve students' ability in clinical practice.

Objective To mobilize students’ self-efficacy and coping the gradually appeared fragmentation of learning and to improve students’ learning ability eventually. Methods 120 students were divided into control group and experimental group. The flipped class-room teaching plan was applied in the experimental group. And then the analysis was taken according to acupuncture grades and the questionnaire survey. Results The acupuncture scores in Baihui(DU20), Yintang(EX-HN3) and Sanyinjiao(SP6) was higher in the experimental group than the control group, respectively(P < 0.05). At the same time, the total scores of the experimental group was higher than that of the control group(P<0.05). Conclusion The mode in training class based on the flipped classroom could enhance students’ self-efficacy, and and improve students’ learning ability in basic courses eventually.

敲(跻)道人盼蟾子刘即刘名瑞,乃全真道教南无派第二十代宗师,是一位著名的近代高道,其人力主佛、儒、道三教贯通之学,兼通医术,有《敲(跻)洞章》《瀊熻易考》《道源精微歌》《元汇医镜》4书行世.其中《元汇医镜》一书少为学者所知,甚至连其弟子赵避尘也将此书误记为《医宗金鉴》.该书撰于光绪戊中年(1908),完成于宣统二年(1910).民国己巳年(1929)刊本是将初刻原板改换扉页重印而成.该书分为5卷,内容丰富,以医学为主兼涉相术,具有浓郁的道医色彩.

本研究提出了以学生为中心的针灸经典背诵的自主考核方法,确定了自主考核以针灸歌赋为主的三级背诵考试内容,经过初步考核运行,效果良好.