复发性口腔溃疡是临床上较为常见的一种疾病,其表现形式多为口腔中黏膜局限性的溃疡,容易复发是其主要的特点,对患者的生活造成较大困扰.中医药在治疗该病上发挥了重要作用,但是目前治疗观点和思路各异,中医辨证也是证型颇多,缺乏统一的观点.笔者现将"从心论治"复发性口腔溃疡的相关文献做一整理和归纳,探究口腔溃疡病的病因病机及中医治疗经验,从而佐证"从心论治"的理论依据,并开拓"从心论治"该病的新思路.

目的 观察火针赞刺联合放血疗法治疗急性期带状疱疹的疗效及对其外周血清P物质的影响,以期优化带状疱疹临床治疗方案及探讨外周血清P物质与疼痛的相关性.方法 将60例患者随机分成观察组与对照组各30例,观察组采用火针赞刺联合放血疗法治疗,隔日1次,7次为1疗程,治疗1个疗程,若治疗期间痊愈则停止治疗.对照组予常规西药口服,连续服用14 d.比较两组患者止疱、结痂、脱痂时间、VAS评分、SP含量,评定两组临床疗效,并计算后遗神经痛发生率.结果 治疗后观察组止疱、结痂、脱痂时间均明显早于对照组(P＜0.05);观察组VAS评分下降程度较对照组明显(P＜0.05);两组外周血SP含量与治疗前比较均有不同程度下降(P＜0.01),观察组下降程度较对照组明显(P＜0.05);观察组总有效率为93.33％,高于对照组83.33％(P＜0.05).观察组后遗神经痛发生率明显低于对照组(P＜0.05).结论 火针赞刺联合放血疗法治疗急性期带状疱疹具有镇痛快、促进皮损恢复、临床疗效好、降低后遗神经痛发生率等优点,其止痛机制可能与降低外周血清SP含量有关.

Objective:Based on the Muli-Cervical Unit(MCU)and three-dimensional finite element analysis(3D-FEA),this study explored whether the"Tuo tian zhuang"exercise in the Southern Shaolin Yi Jin Jing can improve the efficacy of electroacupuncture in the treatment of cervical spondylosis.Methods:Patients who met the inclusion criteria for cervical spondylosis of cervical type were randomized assigned by age stratification into control group and experimental group. A total of effective cases were 156 with 78 cases in each group. Both the control group and the experimental group were treated with electroacupuncture for 4 weeks, and the experimental group was continued to practise the Southern Shaolin Yi Jin Jing"Tuo tian zhuang"exercise for 12 weeks. A finite element model, the visual and analogue scale(VAS)of pain and MCU were used to compare the pain changes, including cervical spine mobility in all directions, disc stress between C4-C7during forward flexion and joint capsule stress in the hooks of the two groups before and after treatment.Results:After 4 weeks of electroacupuncture treatment, the VAS scores of both groups were improved significantly compared with scores before treatment(P<0.05), with no significant differences between the ages groups within the group and the subgroups between the groups(all P>0.05). After 12 weeks of treatment, VAS scores were lower in the experimental group and in all subgroups than in the control group(P<0.05 and P<0.017, respectively);and there was a statistical difference in the degree of pain relief in each age subgroup(P<0.05), suggesting that young patients had better pain relief than middle-aged and elderly patients. Patients in both groups showed varying degrees of increase in cervical mobility and muscle strength in all directions(P<0.05), 12 weeks of treatment with significant differences between the experimental and control groups and between subgroups(P<0.05 and P<0.017, respectively);the C4-C7disc stress and C4-C7crotal joint capsule stress were reduced to varying degrees between age subgroups compared to the pre-treatment period in this group. The stresses in the C4-C7 disc and C4-C7capsular joint were reduced to varying degrees between the ages subgroups compared with those before treatment(P<0.05).Conclusion:The combination of electroacupun-cture with the Southern Shaolin Yi Jin Jing"Tuo tian zhuang"is more effective than electroacupuncture alone in relieving pain, impro-ving the mobility of the cervical spine, improving muscle strength and reducing stress in the cervical. The young group of patients have the best therapeutic effect.

Objective: To explore the therapeutic effect of acupoint catgut embedding combined with ginger-separated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography (sEMG) can be an outcome to evaluate the effect of this disease. Methods: Thirty-five patients with sequelae of peripheral facial paralysis were treated with catgut embedding at the acupoints selected according to their individual symptoms and traditional Chinese medicine (TCM) differentiated syndromes. At the same time, the ginger-separated moxibustion was applied at Yifeng ((sic) TE17) and Qianzheng ((sic) EX-HN16) of the affected side. The catgut embedding was applied once every 15 days, one time of treatment is of one course, and a total of three courses were given. The moxibustion would be taken after 5 days of catgut embedding each time, once every other day, 5 times as one course, a total of 3 courses are given. After treatment, the recovery of facial nerve functions was evaluated by House-Brackmann (H-B) facial nerve function evaluation grading system. Before and after treatment, the surface electromyography (sEMG) was used to detect the root-mean-square (RMS) of frontal muscles, cheek muscles, and orbicularis oris muscles to compare the RMS ratio of these muscles of affected side and healthy side. Results: After 3 courses of treatment, 9 cases were cured, 22 cases were effective, and 4 cases were ineffective. The total effective rate was 88.6% (31/35). After treatment, the RMS of frontal muscles, cheek muscles, and orbicularis oris muscles of the affected side were 31.56 +/- 4.25, 34.13 +/- 4.28, and 7.46 +/- 1.53 respectively, significantly increased in comparing with 11.69 +/- 2.45, 12.98 +/- 3.34, and 2.62 +/- 1.41 respectively before treatment (all P<0.05). After treatment, the RMS ratios of frontal muscles, cheek muscles, and orbicularis oris muscles of the affected side and healthy side were 0.73 +/- 0.09, 0.71 +/- 0.11, and 0.68 +/- 0.08 respectively, greatly increased in comparing with 0.28 +/- 0.10, 0.27 +/- 0.08, and 0.22 +/- 0.09 respectively before treatment (all P<0.05). Conclusion: Acupoint catgut embedding and ginger-separated moxibustion in combination can significantly improve the facial nerve functions, and sEMG used for evaluating the therapeutic effect can objectively reflect the effect of treatment. (c) 2020 Published by Elsevier B.V. on behalf of World Journal of Acupuncture Moxibustion House.

To explore the therapeutic effect of acupoint catgut embedding combined with ginger-separated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography (sEMG) can be an outcome to evaluate the effect of this disease. Thirty-five patients with sequelae of peripheral facial paralysis were treated with catgut embedding at the acupoints selected according to their individual symptoms and traditional Chinese medicine (TCM) differentiated syndromes. At the same time, the ginger-separated moxibustion was applied at Yīfēng (翳风 TE17) and Qiānzhèng (牵正 EX-HN16) of the affected side. The catgut embedding was applied once every 15 days, one time of treatment is of one course, and a total of three courses were given. The moxibustion would be taken after 5 days of catgut embedding each time, once every other day, 5 times as one course, a total of 3 courses are given. After treatment, the recovery of facial nerve functions was evaluated by House–Brackmann (H-B) facial nerve function evaluation grading system. Before and after treatment, the surface electromyography (sEMG) was used to detect the root-mean-square (RMS) of frontal muscles, cheek muscles, and orbicularis oris muscles to compare the RMS ratio of these muscles of affected side and healthy side. After 3 courses of treatment, 9 cases were cured, 22 cases were effective, and 4 cases were ineffective. The total effective rate was 88.6% (31/35). After treatment, the RMS of frontal muscles, cheek muscles, and orbicularis oris muscles of the affected side were 31.56±4.25, 34.13±4.28, and 7.46±1.53 respectively, significantly increased in comparing with 11.69±2.45, 12.98±3.34, and 2.62±1.41 respectively before treatment (all P<0.05). After treatment, the RMS ratios of frontal muscles, cheek muscles, and orbicularis oris muscles of the affected side and healthy side were 0.73±0.09, 0.71±0.11, and 0.68±0.08 respectively, greatly increased in comparing with 0.28±0.10, 0.27±0.08, and 0.22±0.09 respectively before treatment (all P<0.05). Acupoint catgut embedding and ginger-separated moxibustion in combination can significantly improve the facial nerve functions, and sEMG used for evaluating the therapeutic effect can objectively reflect the effect of treatment.

目的 观察矫形按摩结合南少林易筋经“托天式”治疗颈型颈椎病的疗效. 方法 将60例颈型颈椎病患者随机分为对照组和观察组,2组均为30例.对照组采用矫形按摩手法,观察组在对照组基础上配合易筋经“托天式”,治疗时间为8周.采用疼痛视觉模拟评分法(VAS)以及颈椎多功能训练评估系统(MCU),检测2组治疗前后疼痛情况、颈椎活动度以及最大肌力. 结果 与治疗前比较,2组治疗后VAS评分、颈椎关节活动度、颈椎肌力均明显改善(P＜0.05),且观察组改善程度优于对照组(P＜0.05). 结论 矫形按摩结合易筋经“托天式”能更好地缓解颈型颈椎病患者的颈部疼痛,改善颈部肌肉力量和颈椎活动度.

Objective: To observe the effects of the thumb-tack needling therapy on knee joint pain and joint function in the elderly patients with knee osteoarthritis (KOA) and compared with medication. Methods: A total of 60 patients were randomized into a thumb-tack needling group and a medication group, 30 cases in each one. In the thumb-tack needling group, the therapy with the thumb-tack needle retaining and waiting for qi was adopted. The acupoints were Hed ng (EX-LE2), Neixy an (EX-LE4), Dubi (ST35), Xueh ai (SP10), Liangqi u (ST34) and Ashi points on the affected side. The needles were retained for 24 h. This therapy was given once every two days, 3 times a week. The treatment for 2 weeks was as one course and consecutive 2 courses of treatment were required. In the medication group, diclofenac sodium sustained release tablets were taken orally, 75 mg each time, once daily, consecutively for 4 weeks. Successively, the score of visual analogue scale (VAS) at the affected knee before treatment, after treatment and 3 months after treatment as well as Lequesne indicator before and after treatment were evaluated. The clinical therapeutic effect was observed in the patients of the two groups after treatment. Results: (1) After treatment, VAS scores were reduced as compared with those before treatment in the patients of the two groups (both P < 0.05). After treatment, VAS score in the thumb-tack needling group was lower than that in the medication group (P < 0.05). (2) After treatment, the scores of all the items of Lequesne indices reduced as compared with those before treatment in the patients of the both groups, indicating significance differences (all P < 0.05). After treatment, compared with the medication group, the score of pain, morning stiffness and walking ability as well as the total score were all lower in the thumb-tack needling group, indicating significant differences (all P < 0.05). (3) The curative and remarkably effective rate and the total effective rate were 66.7% and 93.3% in the thumb-tack needling group, higher than 56.7% and 86.7% in the medication group respectively (both P < 0.05). Conclusion: The thumb-tack needling therapy effectively relieves knee joint pain and improves joint function in the patients and the therapeutic effect is better than medication group. Hence, this therapy deserves to be promoted in clinical practice. (C) 2020 Published by Elsevier B.V. on behalf of World Journal of Acupuncture Moxibustion House.

To observe the effects of the thumb-tack needling therapy on knee joint pain and joint function in the elderly patients with knee osteoarthritis (KOA) and compared with medication. A total of 60 patients were randomized into a thumb-tack needling group and a medication group, 30 cases in each one. In the thumb-tack needling group, the therapy with the thumb-tack needle retaining and waiting for qi was adopted. The acupoints were Hèdĭng (EX-LE2鹤顶), Nèixīyăn (内膝眼EX-LE4), Dúbí (犊鼻ST35), Xuèhăi (血海SP10), Liángqiū (梁丘ST34) and Ashi points on the affected side. The needles were retained for 24 h. This therapy was given once every two days, 3 times a week. The treatment for 2 weeks was as one course and consecutive 2 courses of treatment were required. In the medication group, diclofenac sodium sustained release tablets were taken orally, 75 mg each time, once daily, consecutively for 4 weeks. Successively, the score of visual analogue scale (VAS) at the affected knee before treatment, after treatment and 3 months after treatment as well as Lequesne indicator before and after treatment were evaluated. The clinical therapeutic effect was observed in the patients of the two groups after treatment. (1) After treatment, VAS scores were reduced as compared with those before treatment in the patients of the two groups (both P < 0.05). After treatment, VAS score in the thumb-tack needling group was lower than that in the medication group (P < 0.05). (2) After treatment, the scores of all the items of Lequesne indices reduced as compared with those before treatment in the patients of the both groups, indicating significance differences (all P < 0.05). After treatment, compared with the medication group, the score of pain, morning stiffness and walking ability as well as the total score were all lower in the thumb-tack needling group, indicating significant differences (all P < 0.05). (3) The curative and remarkably effective rate and the total effective rate were 66.7% and 93.3% in the thumb-tack needling group, higher than 56.7% and 86.7% in the medication group respectively (both P < 0.05). The thumb-tack needling therapy effectively relieves knee joint pain and improves joint function in the patients and the therapeutic effect is better than medication group. Hence, this therapy deserves to be promoted in clinical practice.

目的:观察穴位埋线结合易筋经托天桩治疗颈型颈椎病的临床疗效.方法:将颈型颈椎病患者60例随机分为对照组和治疗组,对照组采用单纯穴位埋线治疗,治疗组在对照组的基础上联合易筋经托天桩练习.两组均干预2个月,干预前后采用颈椎多功能评估训练系统(Multi-Cervical Unit,MCU)评测,以颈椎活动度、最大肌力、疼痛评分为观察指标.结果:治疗组脱落3例,对照组脱落2例.治疗组颈椎活动度、最大肌力、疼痛评分的改善程度明显优于对照组,差异有统计学意义(P<0.05).结论:穴位埋线结合易筋经托天桩治疗优于单纯穴位埋线治疗,具有一定临床推广价值.

Objective To explore the clinical curative effect of myofascial chain training in treatment of cervical instability. Methods 60 cases of cervical instability patients were selected. They were randomLy divided into the observation group and the control group, 30 cases in each group. The observation group was given myofascial chain training while the control group was treated with traditional massage. Clinical effects, isometric strength, activity and pain index of patients in two groups were observed. Results Isometric strength, activity and pain degree before treatment had no significant difference. After treatment, it showed that isometric strength, activity and pain degree of most patients all had improvement of different degrees (P<0.05). Isometric strength, activity and pain degree after treatment of the observation group were significantly better than those of the control group (P<0.05). Conclusion Myofascial chain training in treatment of cervical instability has a good clinical curative effect.

目的 观察易筋经"托天桩"对大学生阳虚型体质的影响.方法 经体质评分与判定,纳入本校阳虚质志愿者40名,随机分为练功组和对照组,20名/组.练功组进行为期12周的易筋经"托天桩"规范化练习;对照组不作任何处理.于干预前、12周练功后,进行阳虚体质转化分、症状积分的评分.结果 练功组干预前后阳虚体质转化分、手脚冰凉、畏寒、腰膝酸冷积分比较,具有统计学差异(P<0.01或P<0.05),腹泻便溏积分比较,无统计学差异(P>0.05);对照组干预前后阳虚体质转化分、手脚冰凉、畏寒、腰膝酸冷、腹泻便溏积分比较,均无统计学差异(P>0.05);2组干预后阳虚体质转化分、畏寒、腰膝酸冷积分比较,具有统计学差异(P<0.01或P<0.05),手脚冰凉、腹泻便溏积分比较,无统计学差异(P>0.05).结论 易筋经"托天桩"可改善阳虚体质的偏颇状态,尤其对畏寒、腰膝酸冷症状的改善作用较为明显.

Objectives: To observe the clinical effect on the sequela of peripheral facial paralysis treated with the penetrating-sticking-pulling technique of acupuncture. Methods: A total of 53 patients with the sequela of peripheral facial paralysis were diagnosed and divided into an observation group (26 cases) and a control group (27 cases) according to the visiting sequence. In the observation group, the penetrating-sticking-pulling technique of acupuncture was adopted. The Sibai ( ST 2), Quanliao (SI 18) and Jiache (ST 6) et al. were needling toward Dicang (ST 4) separately. The combined acupoints were selected according to clinical symptoms of individual patient. In the control group, the routine acupuncture was used, in which, ST 2, EX-HN 5, ST 7, ST 6, and ST 4 as well as Hegu ( LI 4) on the healthy side were selected. The treatment was given once every two days and a 7-treatment made one course. There were 3 days at interval between the courses. After 2 courses of treatment, the facial nerve function, e.g., Hourse-Brackmann (H-B) grading, Sunnybrook score and clinical effect were observed. Results: ( )(1) After treatment, H-B grading and Sunnybrook score were better than those before treatment in either of the observation group or the control group (P < 0.05, P<0.01). H-B grading and Sunnybrook score were (2.23 +/- 0.64) and (96.62 +/- 2.59), respectively, in the observation group after treatment and they were (3.21 +/- 0.43) and (80.33 +/- 3.16) respectively in the control group. H-B grading and Sunnybrook score in the observation group were better than the control group, indicating the significant differences (P < 0.05, P < 0.01). (2) The curative rate and the total effective rate were 69.23% and 96.15%, respectively, in the observation group and they were 37.04% and 81.48%, respectively, in the control group, presenting the significant differences (both P < 0.05). Conclusion: The penetrating-sticking-pulling technique of acupuncture achieves the definite effect on the sequela of peripheral facial paralysis and this therapy deserves to be promoted in clinical practice. (C) 2019 Published by Elsevier B.V. on behalf of World Journal of Acupuncture Moxibustion House.

目的 观察易筋经“托天桩”对阳虚质志愿者督脉红外热成像影响的远期效应,从经络代谢热值的角度探讨其效应机制.方法 经中医体质分类与判定后,纳入阳虚质志愿者19名(男8名,女11名),进行易筋经“托天桩”的规范化培训,于功法训练前常态下、3个月练功后,应用热扫描成像系统进行红外辐射轨迹及大椎、至阳、命门穴及督脉线体表代谢热值(温度)的观察,共2次.结果 ①红外辐射轨迹观察:通过易筋经“托天桩”的练习,可诱发受试者的督脉循经红外辐射轨迹,并使原有的轨迹变得更长、更宽、更加连续.②各检测区体表代谢热值:3个月练功后督脉线上体表代谢热值较功法训练前常态下明显升高,具有统计学差异(P＜0.01或P＜0.05).结论 易筋经“托天桩”可提高阳虚质志愿者督脉的体表代谢热值,为经络参与人体功能的调控提供了有利条件.

Objective To observe the effect of Yijinjing "Supporting Pile" on the superficial microcirculation blood perfusion units (MBPU) on Du meridian in subjects with yang-deficiency constitution.Methods After the classification and determination of constitution according to the traditional Chinese medicine,19 volunteers (8 males and 11 females) with Yang-deficiency constitution were selected and provided with standard Yijinjing "Supporting Pile" training for 3 months.The laser Doppler flowmeter system was used to detect the superficial MBPU on the acupoints of Du meridian including Dazhui,Zhiyang and Mingmen,Results Before the training,the average MBPU value of Zhiyang was higher than Mingmen,but lower than Dazhui (P＜0.05,P＜0.01).After the training,the average MBPU value of all the acupoints increased significantly (P＜0.01).Conclusion Yijinjing "Supporting Pile"can improve the superficial MBPU of Du meridian in subjects with Yang-deficiency constitution,and regulate the energy metabolism of the Du meridian.

Health Qigong is a method with characteristic of traditional Chinese sports.Its benign adjustment effect to human body health and mind has been confirmed by modem science.Yijinjing is one of the types which has been studied a lot.The author carried on the summary of Yijinjing modern application research in recent years as following aspects.Yijinjing has positive fitness on heart effect,performing for physiological function,the shape of the human body,mental state,the movement system diseases in all aspects,which is an ideal mode of exercise.Increasing Yijinjing exercise can significantly improve the clinical efficacy.Yijinjing plays its role in disease prevention and treatment,being related to characteristics that natural breathing,keeping within the spirit and power of variation bones.

颈椎病是目前临床常见的脊柱相关性疾病之一,其病因主要包括颈椎间盘退行性改变、颈椎肥厚增生以及颈部损伤等引起的颈椎骨质增生、椎间盘突出、韧带增厚刺激或者压迫颈部神经.颈型颈椎病为多种类型颈椎病的发病早期病变,临床表现以颈部疼痛为主,针灸可有效缓解疼痛症状,但远期疗效不佳,因此临床常配合其他手段进行干预.南少林易筋托天桩可以改善骨性增生、减轻疼痛,改善颈椎软组织生物力学环境,增进和恢复颈椎的活动功能,不失为一种有效的防治结合的养生功法.

目的 观察艾灸命门对阳虚质督脉红外热像的影响,从经脉代谢热值角度探讨经络与体质的相关性,并为艾灸干预阳虚质的可行性提供实验依据.方法 经中医体质判定后,纳入阳虚质志愿者11名,采用红外热像仪观察艾灸命门过程中督脉红外热成像的改变,比较艾灸前、艾灸10min、艾灸20min检测区代谢热值,红外图像每隔2min采集1次,共11次.结果 ①红外辐射轨迹(IRRTM)观察:自然状态下,2例志愿者可见与督脉线一致的IRRTM,艾灸命门后使该轨迹更加连续规整,并且可以使其余9例阳虚质者诱发沿督脉线2/3以上的IRRTM,其中3例可达督脉线全程;②检测区温度变化:至阳、脊中、腰阳关穴区温度在艾灸10min、艾灸20min温度均有上升,差异具有统计学意义(P＜0.01或P＜0.05),身柱穴在艾灸时穴区温度较前升高,艾灸20min较前略有下降,但均无统计学差异(P＞0.05).③检测区时间-温度变化关系:艾灸干预后,检测穴区温度平稳上升,于艾灸后10min左右达到一个峰值,而后趋于平稳,并持续至艾灸结束后.结论 阳虚质具有与正常人相同的经络传热特性,艾灸命门可使阳虚质者督脉代谢热值升高,可作为阳虚质的干预方法,艾灸时间以大于10min为宜,一般10 ～ 15min.

诸多研究表明经络具有客观存在性,但其实质尚不明确,它的热学特性是研究的一个方向,笔者对近年来腧穴的红外辐射特性以及循经红外辐射轨迹进行了以下几方面的总结归纳.腧穴区具有高温和低电阻特性,而经脉线上穴区的ATP能量代谢及导热性高于非穴区,表明腧穴具有较多特殊的生理功能,承载着重要的生理病理信息.循经红外辐射轨迹是人群中普遍存在的现象,与皮肤的微循环和经脉线下的传热通道有关,并且处于动态变化的过程,其诱发方式以温和灸最佳.

目的:观察易筋经“托天桩”对阳虚体质志愿者督脉红外热成像影响的即刻效应.方法:经中医体质分类与判定后,纳入阳虚质的志愿者12名,进行易筋经“托天桩”的规范化培训,于练功首次应用红外热像仪观察阳虚质受试者的练功过程,记录练功前、练功1 min、2 min、3 min、4 min、5 min督脉红外图像,分析练功过程中大椎、至阳、命门穴及督脉线温度变化.结果:(1)3例受试者在练功前呈现连续性较差、宽度较小的督脉红外辐射轨迹,易筋经“托天桩”干预后部分志愿者督脉红外辐射轨迹增宽、增长.(2)检测区温度总体呈下降趋势,练功5 min时,至阳穴温度显著低于练功前(P＜0.05),命门穴温度显著低于练功前及练功3 min时(P＜0.05);大椎穴、督脉线温度变化无显著性.(3)穴区温度随练功的进行先升后降.结论:易筋经“托天桩”对阳虚质督脉的代谢热值具有调节作用,可能是先“聚能”后“耗能”的过程.

目的 观察针刺、多视点雾视镜矫治、耳穴压贴的三联疗法对青少年轻度近视的疗效. 方法 选择轻度近视学生60例(117只眼),随机分为三联疗法组、针刺组、西药组,三联疗法组用针刺、多视点雾视镜矫治、耳穴压贴治疗,针刺组用针刺治疗,西药组用双星明滴眼液治疗,10次为1个疗程,第1、2个疗程后复查患眼视力及屈光度. 结果 3种疗法对轻度近视患者视力均有不同程度的改善,但三联疗法组起效快,疗效显著,优于针刺组,针刺组疗效优于西药组,差异具有统计学意义. 结论 三联疗法对改善轻度近视患者的视力,疗效确切,起效较快.