Objective To observe the effect of electroacupuncture(EA)on the regulation of microglia polarization in anterior cingulate cortex(ACC)by α7 nicotinic acetylcholine receptor(α7nAChR)-Toll-like receptor 4(TLR4)/nuclear factor kappa B(NF-κB)signaling pathway in chronic inflammatory pain-depression comorbidity(CIPDC)rats,so as to explore its central"analgesic-antidepressant"mechanism underlying improvement of CIPDC.Methods Thirty-six adult male SD rats were randomly divided into blank,CIPDC model and EA groups,with 12 rats in each group.The CIPDC model was established by plantar injection of complete Freund's adjuvant.On the 14th day after modeling,EA(1.5 Hz,1 mA)was applied to bilateral"Hegu"(LI4)and"Taichong"(LR3)for 20 min,once a day for 14 consecutive days.The mechanical paw withdrawal threshold(MWT)and thermal paw withdrawal latency(TWL)were detected at the 0,14th,and 28th day after modeling.The open field test(OFT),forced swim test(FST)and sucrose preference test were used to evaluate the rats'depression-like behavior.Hematoxylin-eosin(H.E.)staining was used to observe the histopathological changes of ACC.The contents of tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-6,IL-4 and IL-10 in the ACC tissue were detected by enzyme-linked immunosorbent assay(ELISA).Double immunofluorescence staining was used to detect the co-expression of M1 microglia marker CD86 and ionized calcium binding adapter molecule 1(Iba-1),and M2 microglia marker CD206 and Iba-1 in the ACC tissue.The protein expression levels of α7nAChR,TLR4,myeloid differentiation primary response protein 88(MyD88),NF-κB p65 and p-NF-κB p65 in the ACC tissue were detected by Western blot.Results Compared with the blank group,the MWT,TWL,sucrose preference rate,total distance traveled and time spent in the center zone of OFT were significantly decreased(P<0.05),and the immobility time of FST was obviously increased(P<0.05)in the model group.In comparison with the model group,the MWT,TWL,sucrose preference rate,total distance traveled and time spent in the center zone of OFT were apparently increased(P<0.05),while immobility time of FST was strikingly decreased(P<0.05)in the EA group,suggesting an amelioration of pain and depression-like behavior after EA.The contents of TNF-α,IL-1β and IL-6,immunofluorescence area of CD86/Iba-1 and the expression levels of TLR4,MyD88,p-NF-κB p65,and the ratio of p-NF-κB p65/NF-κB p65 were significantly higher(P<0.05),and the contents of IL-4 and IL-10,CD206/Iba-1 immunofluorescence-positive area and the expression level of α7nAChR were significantly lower(P<0.05)in the model group than in the blank group.Following EA intervention,the increased levels of TNF-α,IL-1β and IL-6,CD86/Iba-1 immunofluorescence-positive area and the expression levels of TLR4,MyD88,p-NF-κB p65,and the ratio of p-NF-κB p65/NF-κB p65 and the decreased levels of IL-4 and IL-10,immunofluorescence area of CD206/Iba-1 and the expression level of α7nAChR after modelling were all reversed(P<0.05).H.E.staining showed disordered arrangement of tissues,neuronal cells shrinking,reduced number and deeply stained pyramidal cells,with vacuoles and nerve fiber tangles appeared in the interstitial spaces in the ACC of model group,which was relatively milder in the injury degree in the EA group,including a small number of neurons being deeply stained and smaller space between neurons and tissues.Conclusion EA can exert central"analgesic-antidepressant"effect in CIPDC rats,which may be related to its functions in alleviating central inflammatory response,reducing neuronal damage and promoting microglial polarization mediated by α7nAChR-TLR4/MyD88/NF-κB signaling in the ACC tissue.

OBJECTIVE:To evaluate the effectiveness and safety of multiple acupuncture therapies in the treatment of allergic rhinitis(AR)using a network Meta-analysis. METHODS:This network Meta-analysis adhered to the PRISMA-NMA guideline.Eight databases were systematically searched from inception to December 31,2023,and retrieved references were managed using EndNote 20.The risk of bias in individual studies was assessed with the Cochrane RoB 2.0 tool(ROB 2.0).Data analysis was performed using R 4.2.1 and STATA 15.1. RESULTS:A total of 56 studies that had enrolled 4859 patients with AR were included.Hand acupuncture(HA)combined with acupoint catgut embedding(AE),hand acupuncture with heat sensitive moxibustion(HA+HSM),and acupoint application were the most effective in attaining the clinical effective rate.HA+AE,hand acupuncture with indirect moxibustion(HA+IM),and electroacupuncture(EA)with AE ranked the highest with respect to the Rhinoconjunctivitis Quality of Life Questionnaire Score.HA+IM,HA,and HA+EA yielded the best Total Nasal Symptom Score,whereas HA+AE,EA+AE,and HA had the best results for the Total Non-Nasal Symptom Score.However,subgroup analyses of clinical efficacy revealed that HA+HSM had the best therapeutic effects in the short term,whereas HA+AE was the most effective in the medium to long term. CONCLUSION:Combined acupuncture and moxibustion therapy may be a safe and effective intervention for patients with AR.HA+IM and HA+AE exhibited the most desirable therapeutic effects compared with other acupuncture and moxibustion therapies.

Objective To observe the effect of electroacupuncture (EA) on the regulation of microglia polarization in anterior cingulate cortex (ACC) by u03B17 nicotinic acetylcholine receptor (u03B17nAChR)-Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-u03BAB) signaling pathway in chronic inflammatory pain-depression comorbidity (CIPDC) rats, so as to explore its central u201Canalgesic-antidepressantu201D mechanism underlying improvement of CIPDC. Methods Thirty-six adult male SD rats were randomly divided into blank, CIPDC model and EA groups, with 12 rats in each group. The CIPDC model was established by plantar injection of complete Freundu2019s adjuvant. On the 14th day after modeling, EA (1.5 Hz, 1 m A) was applied to bilateral u201CHeguu201D (LI4) and u201CTaichongu201D (LR3) for 20 min, once a day for 14 consecutive days. The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were detected at the 0, 14th, and 28th day after modeling. The open field test (OFT), forced swim test (FST) and sucrose preference test were used to evaluate the ratsu2019 depression-like behavior. Hematoxylin-eosin (H. E.) staining was used to observe the histopathological changes of ACC. The contents of tumor necrosis factor-u03B1(TNF-u03B1), interleukin (IL)-1u03B2, IL-6, IL-4 and IL-10 in the ACC tissue were detected by enzyme-linked immunosorbent assay (ELISA). Double immunofluorescence staining was used to detect the co-expression of M1 microglia marker CD86 and ionized calcium binding adapter molecule 1 (Iba-1), and M2 microglia marker CD206 and Iba-1 in the ACC tissue. The protein expression levels of u03B17nAChR, TLR4, myeloid differentiation primary response protein 88 (My D88), NF-u03BAB p65 and p-NF-u03BAB p65 in the ACC tissue were detected by Western blot. Results Compared with the blank group, the MWT, TWL, sucrose preference rate, total distance traveled and time spent in the center zone of OFT were significantly decreased (Pu0026lt;0.05), and the immobility time of FST was obviously increased (Pu0026lt;0.05) in the model group. In comparison with the model group, the MWT, TWL, sucrose preference rate, total distance traveled and time spent in the center zone of OFT were apparently increased (Pu0026lt;0.05), while immobility time of FST was strikingly decreased (Pu0026lt;0.05) in the EA group, suggesting an amelioration of pain and depression-like behavior after EA. The contents of TNF-u03B1, IL-1u03B2 and IL-6, immunofluorescence area of CD86/Iba-1 and the expression levels of TLR4, My D88, p-NF-u03BAB p65, and the ratio of p-NF-u03BAB p65/NF-u03BAB p65 were significantly higher (Pu0026lt;0.05), and the contents of IL-4 and IL-10, CD206/Iba-1 immunofluorescence-positive area and the expression level of u03B17nAChR were significantly lower (Pu0026lt;0.05) in the model group than in the blank group. Following EA intervention, the increased levels of TNF-u03B1, IL-1u03B2 and IL-6, CD86/Iba-1 immunofluorescence-positive area and the expression levels of TLR4, My D88, p-NF-u03BAB p65, and the ratio of p-NF-u03BAB p65/NF-u03BAB p65 and the decreased levels of IL-4 and IL-10, immunofluorescence area of CD206/Iba-1 and the expression level of u03B17nAChR after modelling were all reversed (Pu0026lt;0.05). H. E. staining showed disordered arrangement of tissues, neuronal cells shrinking, reduced number and deeply stained pyramidal cells, with vacuoles and nerve fiber tangles appeared in the interstitial spaces in the ACC of model group, which was relatively milder in the injury degree in the EA group, including a small number of neurons being deeply stained and smaller space between neurons and tissues. Conclusion EA can exert central u201Canalgesic-antidepressantu201D effect in CIPDC rats, which may be related to its functions in alleviating central inflammatory response, reducing neuronal damage and promoting microglial polarization mediated by u03B17nAChR-TLR4/My D88/NF-u03BAB signaling in the ACC tissue.

目的 观察电针对神经根型颈椎病(CSR)大鼠脊髓组织突触后致密物95(PSD-95)、生长相关因子43(GAP-43)、突触素(SYN)蛋白表达及脊髓背角突触超微结构的影响,探讨电针改善CSR大鼠疼痛的作用机制.方法 雄性SD大鼠随机分为空白组、假手术组、模型组和电针组,每组12只.采用颈椎椎管插线法制备CSR模型,造模成功7 d后,电针组予"合谷""太冲"电针干预,每次20 min,每日1次,连续7 d.干预前后对大鼠进行步态障碍评分,测量机械痛阈值;Western blot检测脊髓组织PSD-95、GAP-43蛋白表达,RT-PCR检测脊髓组织PSD-95、GAP-43 mRNA表达,免疫荧光染色检测脊髓组织PSD-95、GAP-43、SYN表达,透射电镜观察脊髓背角突触超微结构变化.结果 与假手术组比较,模型组大鼠步态障碍评分明显升高,机械痛阈值明显降低,脊髓组织PSD-95、GAP-43蛋白及mRNA表达,SYN表达明显升高,差异均有统计学意义(P<0.01);脊髓背角突触前膜内突触囊泡向待释放区聚集,突触前活性区变长,突触后致密区面积增大,突触间隙增宽.与模型组比较,电针组大鼠步态障碍评分明显降低,机械痛阈值明显升高,脊髓组织PSD-95、GAP-43蛋白及mRNA表达,SYN表达明显降低,差异均有统计学意义(P<0.01);脊髓背角突触前膜内突触囊泡均匀分布,突触前活性区缩短,突触后致密区面积减小,突触间隙减小.结论 电针"合谷""太冲"干预CSR大鼠具有良好的镇痛效应,其机制可能与下调脊髓组织PSD-95、GAP-43、SYN蛋白表达,调节脊髓背角神经元突触超微结构,从而缓解脊髓节段中枢敏化有关.

目的 探讨"心胆同治"麦粒灸治疗抑郁共病失眠可能的作用机制.方法 ①选用SPF级SD大鼠24只,雌雄各半,随机分为空白组、模型组、麦粒灸组、西药组,每组6只.②模型组、麦粒灸组、西药组均采用慢性不可预测性温和应激结合孤养法联合改良多平台水环境睡眠剥夺法制备抑郁共病失眠大鼠模型,连续造模21天.造模结束后采用行为学评分及戊巴比妥钠翻正实验进行模型评价.③造模成功后第2天,麦粒灸组取大鼠双侧"心俞"及"胆俞"穴麦粒灸干预,每穴每天连续灸3壮,持续10天;西药组予盐酸文拉法辛合地西泮混合溶液(盐酸文拉法辛:13.5 mg·kg-1,地西泮:0.9 mg·kg-1)灌胃,1次/天,连续灌胃10天;空白组、模型组予0.9％氯化钠溶液(10 mL·kg-1)灌胃,1次/天,连续灌胃10天.④干预结束后,采用行为学实验及戊巴比妥钠翻正实验评价各组大鼠抑郁及失眠样行为,以酶联免疫吸附测定法(ELASA)测定各组大鼠海马5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)表达水平,并通过苏木素-伊红(HE)染色观察各组大鼠海马组织的病理改变.结果 与空白组比较,模型组行为学评分、睡眠时长均降低(P<0.01),睡眠潜伏期增加(P<0.01),海马5-HT、DA、NE表达水平降低(P<0.01),海马组织损伤较明显,且细胞排列松散,细胞间隙增大,染色模糊不均,出现明显空泡状结构;与模型组比较,麦粒灸组、西药组行为学评分、睡眠时长上升(均P<0.01),睡眠潜伏期缩短(P<0.01),海马5-HT、DA、NE表达水平均显著升高(均为P<0.01),且麦粒灸组上述指标升高更为明显(P<0.05),海马组织中细胞排列整齐,胞体受损情况有不同程度改善.结论 "心胆同治"麦粒灸可有效改善抑郁共病失眠大鼠抑郁及失眠行为,其治疗机制与上调海马单胺类神经递质水平,修复受损海马细胞相关.

目的 运用数据挖掘技术探讨针灸治疗良性前列腺增生症(BPH)的选穴规律.方法 检索中国知识资源总库(CNKI)、万方数据知识服务平台(万方数据)、维普期刊全文数据库(维普网)、中国生物医学文献数据库(CBM)、PubMed、Embase、Cochrane Library建库至2023年2月10日收录的有关针灸治疗BPH的临床研究类文献,利用Excel2019建立用穴处方数据库,对腧穴进行频次、归经、部位、特定穴统计,采用SPSS Modeler 18.0、SPSS Statistics 26.0软件进行关联规则分析、因子分析、聚类分析,探究针灸治疗BPH的选穴规律.结果 共纳入303篇文献,涉及303首处方、103个腧穴,总频次为1 424.高频腧穴为关元、中极、三阴交等,常用经脉为任脉和足太阳膀胱经,腧穴多位于腹部和腰骶部,以交会穴、募穴居多.核心穴组为"关元-中极-三阴交",得到21组关联规则、8个公因子和7个有效聚类群.结论 针灸治疗BPH遵循温肾纳气的治疗原则,以"关元-中极-三阴交"为核心腧穴,根据实际情况配穴.

Background: Chronic pain (CP) as a long-lasting stressor can often cause mood disorders, such as depression or anxiety. The comorbidity of CP and mood disorders poses challenges for treatment and increases healthcare costs. Acupuncture has emerged as a widely utilized approach to alleviate both CP and mood disorders. However, there is a lack of well-established bibliometric analyses in this area of research. Therefore, this study aimed to identify the current hotspots and research trends regarding the use of acupuncture for treating CP-related depression or anxiety. Methods: We searched the Web of Science Core Collection spanning from 2003 to 2023 to identify relevant literature about the use of acupuncture for treating CP-related depression or anxiety. Bibliometric and visualization analyses were performed using CiteSpace 5.7.R5 and Vosviewer 1.6.19 software.Results: A total of 254 articles published between 2003 and 2023 were included, revealing an upward trajectory with some fluctuations in publication numbers over the past two decades. China and the Beijing University of Chinese Medicine were the most productive country and institution in this field. Fang JQ and Vickers AJ ascended as the most prolific and influential authors, respectively. Trials was the journal with the highest number of publications, while Pain and BMJ-British Medical Journal exhibited the highest citation and centrality, respectively. "Acupuncture", "depression", and "chronic pain" were the top three keywords. The hotspots in this domain encompass types of chronic pain that predispose to negative mood, including fibromyalgia, irritable bowel syndrome (IBS), and neuropathic pain. Randomized controlled trials (RCTs), mechanisms, and evidence-based evaluations are the main research directions.Conclusion: This study uses bibliometric techniques to analyze the research hotspots and forefronts of acupuncture as a therapeutic approach for CP-related depression or anxiety. Our objective is to provide researchers with valuable references and identify research focal points for future investigations.

Background Carpal tunnel syndrome (CTS), as the most common compression neuropathy in the upper limb, can lead to upper limb dysfunction in patients. The effectiveness of acupuncture in treating CTS has been validated based on numerous clinical trials and meta-analyses, but questions remain, such as how to select the best acupoints. Our purpose is to conduct the first data mining analysis to identify the most effective acupoint selection and combinations for treating CTS. Methods We will search 7 electronic bibliographic databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database and Chongqing VIP Database) from inception to March 2023. Clinical trials assessing the effectiveness of acupuncture therapy on the management of CTS will be selected. Reviews, protocols, animal trials, case reports, systematic reviews, and meta-analyses will be excluded. The primary outcome measure will be clinical result associated with CTS. Descriptive statistics will be performed in Excel 2019. Association rule analysis will be performed in SPSS Modeler 18.0. Exploratory factor analysis and cluster analysis will be performed in SPSS Statistics 26.0. Results This study will investigate the most effective acupoint selection and combinations for patients with CTS. Conclusion Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupoint application for patients with CTS, helping clinicians and patients make a more informed decision together.

Background:Piriformis syndrome (PS) is a neuromuscular condition characterized by discomfort in the gluteal region. The efficacy of acupuncture as a treatment modality for PS has been substantiated through a multitude of clinical trials. However, certain queries persist, such as the optimal approach for identifying the most efficacious acupoints. The objective of this study is to perform an initial data mining analysis aimed at identifying the optimal acupoint selection and combinations for the treatment of PS.Methods:We will search 7 electronic bibliographic databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database and Chongqing VIP Database) from inception to June 2023. We will select clinical trials that evaluate the efficacy of acupuncture therapy in the management of PS. Exclusions will be made for reviews, protocols, animal trials, case reports, systematic reviews, and meta-analyses. The primary outcome measure will be clinical outcomes associated with PS. Descriptive statistics will be performed in Excel 2019. Association rule analysis will be performed in SPSS Modeler 18.0. Exploratory factor analysis and cluster analysis will be performed in SPSS Statistics 26.0.Results:This study will investigate the most effective acupoint selection and combinations for patients with PS.Conclusion:Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupoint application for patients with PS, helping clinicians and patients make a more informed decision together.

中风偏瘫是中风后最常见的后遗症,主要表现为一侧肢体运动功能障碍,属中医"偏枯""偏风"范畴,其病位及病理表现与维筋相交"伤左角,右足不用"的理论一脉相承.巨刺属古代九刺之一,通过"左病针右,右病针左"的操作方法调整机体气血阴阳,是维筋相交理论指导临床实践的一种特殊针法.维筋与肢体功能活动联系密切,对中风偏瘫的治疗意义重大.分期巨刺则是根据偏瘫早期、恢复期及后遗症期的不同临床表现,辨其经络及部位所采取以刺健侧为主的方法,针对患肢运动功能障碍方面疗效突出.本研究从维筋相交与中风偏瘫的关系出发,认为维筋受损是偏瘫的核心病机,治疗应首辨偏瘫分期,采用分期巨刺,早期调益元神,恢复期疏导经气,后遗症期温运阳气,进而达到平衡阴阳、通经养筋的目的.故基于维筋相交理论指导临床,以期为治疗中风偏瘫及传承巨刺疗法提供思路.

Background: Piriformis syndrome (PS) is a common disease that is difficult to clinically treat, which seriously affects people's health and living quality. Multiple clinical studies have demonstrated that acupuncture therapy is an effective treatment for PS, but the optimal method of various acupuncture methods has remained unknown. The aim of this study protocol is to compare the efficacy and the safety of different acupuncture methods for PS.Methods: We will search seven electronic bibliographic databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Chongqing VIP Database) from inception to June 2023. Randomized controlled trials (RCTs) will be selected for assessing the effectiveness of acupuncture therapy on PS. Primary outcome measure for this study is pain intensity, and the secondary outcomes are clinical symptoms and signs, physical activity, effective rate, and adverse events. Study selection, data extraction, and risk of bias assessment will be independently completed by at least two reviewers. Then, standard pairwise meta-analysis and network meta-analysis will be conducted using Revman 5.3, Stata V.15.1 and OpenBUGS V.3.2.3. The heterogeneity will be explored by subgroup, meta-regression, and sensitivity analysis, if applicable. Finally, Grading of Recommendations, Assessment, Development and Evaluation (GRADE) pro system will be used to evaluate the quality of evidence.Results: Our systematic review and network meta-analysis will identify the best acupuncture treatment method for PS patients. Conclusion: The results of our review will help decision-makers make educated choices regarding evidence-based acupuncture management options for PS.

中医药治疗产后抑郁多采用经典方剂、自拟方剂、中成药、中药外用及针灸疗法等,可调节下丘脑-垂体-肾上腺轴、下丘脑-垂体-性腺轴,进而改善相关神经递质水平、神经内分泌因子及激素水平,营养兴奋脑神经,显著改善患者焦虑抑郁状态以及躯体症状,降低抑郁量表评分.目前,仍存在以下不足:①初产妇缺乏对分娩过程的了解,易产生紧张、焦虑、恐惧等不良心理反应,既往有不良孕产史的产妇伴随焦虑、抑郁的比例更大;②产后抑郁的中医辨证分型难以统一,多是辨病而治;③产后抑郁发病具有隐匿性、反复性等特征,应当重视不同干预时间的临床疗效及相关指标变化,以期评估最佳治疗周期方案,远期观察及巩固治疗十分有必要.今后,应重视妊娠期身体及情志的护理,运用五音疗法、中医外治、传统功法锻炼等指导孕产妇,达到身心同调、防患于未然的目的.此外,应加强对产后抑郁不同人群、不同证型进行辨证论治的临床研究.

术后皮肤瘙痒症是由于使用某些镇痛或抗凝药物所导致的机体过敏现象,以全身泛发性皮肤瘙痒等过敏反应为主要临床表现."针至病所"以针尖直刺病所达到"以针调气"进而治疗疾病.术后皮肤瘙痒的发生与机体免疫力降低有关,针刺夹脊穴可直达病所激发机体的免疫功能,从而拮抗瘙痒介质减轻并缓解瘙痒,达到"针至病所"的目的.

目的 系统评价单纯针刺治疗慢性下腰痛的有效性.方法 检索2009年1月-2019年12月中国知网(CNKI)、万方数据库(WF)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)及PubMed、Em-base、Cochrane Library,纳入的针刺治疗慢性下腰痛的随机对照试验(RCT),使用Cochrane中心推荐的方法进行文献质量评价.采用RevMan 5.3软件对符合标准的RCT研究进行Meta分析.结果 共纳入13个RCT研究,涉及患者1042例.Meta分析结果显示,单纯针刺在改善疼痛方面优于安慰剂组和药物组(MD=-2.60,95％CI:-3.89～-1.31,P<0.0001)、(SMD=-0.72,95％CI:-0.98～-0.46,P<0.00001);在改善功能障碍方面,单纯针刺组ODI评分优于安慰剂组和药物组(SMD=-0.94,95％CI:-1.68～-0.19,P=0.01)、(MD=-8.67,95％CI:-10.90～-6.45,P<0.00001);单纯针刺组RMDQ评分与安慰剂组无显著差异(SMD=-0.57,95％CI:-1.27～0.14,P=0.12),但优于药物组(MD=-3.40,95％CI:-5.53～-1.27,P=0.002).结论 单纯针刺治疗慢性下腰痛可减轻腰部疼痛症状,并改善功能障碍水平.

目的 观察调任补肾针法联合西药治疗早发性卵巢功能不全的临床疗效.方法 60例早发性卵巢功能不全患者随机分为试验组和对照组,每组30例.对照组给予口服雌二醇地屈孕酮片治疗,试验组在对照组治疗基础上加用调任补肾针法治疗.观察两组治疗前后血清促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E2)、抗苗勒氏管激素(AMH)、窦状卵泡数(AFC)变化,观察并记录中医症状评分变化情况.结果 两组治疗后中医症状积分均较治疗前有所下降,差异有统计学意义(P<0.05);两组治疗后的中医症状评分比较,差异有统计学意义(P<0.05).两组治疗后血清FSH、LH水平均明显低于治疗前,差异有统计学意义(P<0.05);两组血清E2、AMH及AFC水平高于治疗前,差异有统计学意义(P<0.05).试验组治疗后血清FSH、AMH及AFC水平优于对照组(P<0.05).结论 调任补肾针法联合西药在改善早发性卵巢功能不全患者血清FSH、AMH、AFC水平及中医症状方面均有疗效.

临床上,中髎穴的定位存在一定难度,针刺的角度、深度亦有差异,针刺中醪产生的针感强弱、感传的方向不同会导致治疗的结果不同.目前对于中髎穴的机制研究尚不够完善,多为临床研究,且关于其作用于靶向器官产生调节功能的分子生物学机制有待深入探讨.今后应尽早规范中髎穴的临床操作,制定相应标准,临床取穴结合文献所测定的值以提高精准度;深入探究中髎穴的不同针刺深度对不同疾病效应结果的差异;进一步研究针刺中髎穴的生物学机制;加强针刺中髎的大样本随机双盲对照临床试验.

慢性下腰痛是影响人类生活质量的重要原因,具有病因不明、病程缠绵难愈,造成经济损失大的特点.近年来随着中医针灸的发展,众多研究发现针灸对慢性下腰痛具有较好的疗效,笔者通过检索近5年来针灸治疗慢性下腰痛的相关临床文献,发现针灸治疗慢性下腰痛方法多样,分别为单纯针刺、电针、穴位埋线、蜂针、针刀、拔罐、灸法、耳穴贴压及针灸综合治疗等方法.通过对慢性下腰痛的病因病机及针灸治疗方法进行分析与概述,为针灸及其相关疗法治疗慢性下腰痛提供参考.

夹脊穴电针与脊髓电刺激是临床上常用于疼痛的非药物治疗方式,二者在镇痛治疗上均以电刺激为手段,在脉冲电流、刺激频率与波宽有重合之处,同时受疼痛门控理论的影响,且刺激量大小可根据病情调节.夹脊穴电针与脊髓电刺激植入刺激部位相同,但两种方法植入的方式不同;具有部分类似的镇痛机制,如5-羟色胺、γ-氨基丁酸和乙酰胆碱的介导,镇痛机制的区别是脊髓电刺激可调节脊柱-脑干-脊髓环发挥作用;夹脊穴电针镇痛机制为调节疼痛相关蛋白基因的表达、调控信号通路.此外,夹脊穴与脊髓神经节段有对应关系,二者作用的靶器官存在联系.

目的 系统评价针刺配合三阶梯镇痛与单纯三阶梯镇痛比较治疗癌性疼痛的有效性与安全性.方法 计算机检索中国期刊全文数据库(CNKI)、万方数据库(WanFang)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Embase、Cochrane library数据库,纳入有关针刺配合三阶梯镇痛治疗癌性疼痛的随机对照试验,采用Cochrane偏倚风险评估工具对文献进行质量评价,使用Rev Man 5.3软件进行Meta分析.结果 共纳入16篇文献,共计1140例患者.Meta分析结果显示,与单纯三阶梯镇痛相比,针刺配合三阶梯镇痛在疼痛缓解有效率方面疗效更佳[RR=1.21,95％CI(1.15,1.28),P<0.00001],在镇痛起效时间方面起效更快[SMD=﹣0.83,95％CI(﹣1.06,﹣0.60),P<0.00001],在镇痛持续时间方面更有优势[SMD=0.64,95％CI(0.41,0.87),P<0.00001],不良反应发生率更低[RR=0.46,95％CI(0.31,0.67),P<0.0001].结论 从现有临床证据看,针刺联合三阶梯镇痛治疗癌性疼痛疗效优于单纯使用三阶梯镇痛治疗,但受目前文献质量的影响,应谨慎看待上述结论,还需更多高质量、大样本的随机对照试验进一步研究.

近年来,针灸治疗中风后抑郁症(PSD)因便捷安全、治疗方法多样、副作用少等优势逐渐被更多人关注及接受.通过检索近5年针灸治疗PSD的相关文献,发现针灸治疗PSD方法多样且疗效显著,主要包括醒脑开窍、通督调神、调任通督、醒神启闭、养血柔肝、子午流注等针灸特色疗法,和针灸结合经颅磁刺激、耳穴贴压、穴位放血、中药西药、康复及音乐治疗等综合疗法.其中,针灸治疗抑郁在症状改善、神经功能评分及调节血清神经递质含量、神经细胞因子及炎症细胞因子等方面不弱于抗抑郁药治疗,针灸特色疗法治疗PSD优于单纯体针治疗、针灸综合疗法治疗PSD优于单一方法治疗.