杨骏认为督脉失司、阳气不足、肌肉失养、筋脉拘急是痉挛性斜颈发病的主因.治疗上以通督养阳为原则,分重镇安神、养阳柔筋,通督调轴、抑制痉挛,健侧调平,调和气血3个阶段进行治疗.杨骏重视"形神并调",先"守神"后"守形","守神"与"守形"并举,标本同治,在"形神一体"思想观基础上总结出"五调"法治疗痉挛性斜颈,分别是调神、调骨、调肌、调筋、调体,调神、调体是治本,调骨、调肌、调筋是治标,标本兼治,并加中药以期平衡阴阳.

目的 探讨化瘀通络灸治疗脑卒中后抑郁轻中度患者的临床效果.方法 选取安徽中医药大学第一附属医院2020年9月至2021年9月收治的50例脑卒中后抑郁轻中度患者,按照随机数字表法将其分为对照组(25 例,给予针刺治疗)和观察组(25例,给予化瘀通络灸和针刺治疗),每组均治疗 2周.比较两组治疗前后汉密尔顿抑郁量表(HAMD)评分、蒙哥马利阿斯伯格抑郁量(MADRS)评分、日常生活活动能力量表(ADL)评分、血清同型半胱氨酸(Hcy)水平变化及临床疗效.结果 治疗前,两组HAMD、MADRS、ADL评分及血清Hcy水平比较,差异无统计学意义(P＞0.05);治疗后,两组HAMD、MADRS评分较治疗前降低,ADL评分较治疗前升高,且观察组HAMD、MADRS评分低于对照组,ADL评分高于对照组(P＜0.05);治疗后,两组血清Hcy水平较治疗前降低,且观察组低于对照组(P＜0.05);观察组临床疗效优于对照组,差异有统计学意义(P＜0.05).结论 化瘀通络灸能明显改善脑卒中后抑郁轻中度患者的临床症状,效果良好,值得临床推广应用.

目的 观察化瘀通络灸法结合常规针刺治疗脑卒中后轻度认知障碍(mild cognitive impair-ment,MCI)患者的临床疗效及其对血液相关因子的影响.方法 将60例脑卒中后MCI患者随机分为对照组与观察组,每组30例.两组均采用常规治疗,观察组在此基础上加用化瘀通络灸法治疗.治疗2周后,观察两组患者认知功能状态和血清同型半胱氨酸(homocysteine,Hcy)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)和超氧化物歧化酶(superoxide dismutase,SOD)水平的变化.结果 观察组临床疗效明显优于对照组(P<0.05).与治疗前比较,两组治疗后蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、简易智力状态检查量表(mini-mental state examina-tion,MMSE)评分均明显升高(P<0.05),且观察组治疗后MoCA、MMSE评分升高程度显著大于对照组(P<0.05).与治疗前比较,两组治疗后血清SOD水平均显著升高(P<0.05),hs-CRP和血浆Hcy水平均明显下降(P<0.05);且治疗后观察组血清SOD升高程度明显大于对照组(P<0.05),血清hs-CRP和血浆Hcy降低程度明显大于对照组(P<0.05).结论 化瘀通络灸结合常规针刺治疗脑卒中后MCI,可降低炎症水平,清除氧自由基,显著改善患者的认知功能.

目的 比较针药结合、电针、中药3种不同疗法治疗绝经过渡期绝经相关症状的临床疗效.方法 将符合纳入标准的患者随机分为针药结合组、电针组和中药组各20例,治疗8周后观察并比较3组临床疗效、绝经症状评价量表(menopause rating scale,MRS)评分、围绝经期生存质量量表(menopause-specific quality of life questionnaire,MENQOL)评分.结果 治疗8周后,3组临床疗效的分布比较,差异无统计学意义(P＞0.05).在降低MRS、MENQOL评分方面,针药结合组与电针组、中药组比较,差异具有统计学意义(P＜0.05).针药结合组在改善心脏不适方面优于电针组和中药组(P＜0.05);电针组在治疗膀胱问题方面优于针药结合组和中药组(P＜0.05);中药组在治疗性问题方面优于电针组和针药结合组(P＜0.05);在治疗潮热汗出、失眠、情绪失控、易感疲劳方面,3组疗效差异无统计学意义(P＞0.05).结论 在改善绝经过渡期患者绝经症状方面,针药结合组疗效优于电针组和中药组.

目的 探究电针联合高压氧对脑损伤后昏迷患者的促醒作用.方法 共纳入脑损伤后昏迷患者64例,每组32例,观察组采用电针联合高压氧的治疗方法,对照组单纯使用高压氧治疗,分别于纳入时、治疗1个月、治疗3个月、治疗6个月,对患者进行GCS评分.结果 两组对患者的GCS评分均有改善作用,与对照组[治疗3个月(8.25±1.96),治疗6个月(8.58±1.45)]相比,观察组[治疗3个月(10.0±2.11),治疗6个月(11.0±1.79)]改善作用更为明显,差异具有统计学意义(P<0.05),且远期疗效更为显著.结论 电针联合高压氧较单纯运用高压氧治疗,对昏迷患者的促醒作用更为显著,对长期意识障碍的患者,电针联合高压氧治疗对提高患者GCS评分更有效.

目的:探讨基于动脉自旋标记(arterial spin labeling imaging,ASL)灌注成像技术在fMRI针刺作用机制研究的可行性.方法:选取健康志愿者40例,根据扫描技术方法的不同分为ASL组与BOLD组,每组各20例(男女各10例);采用相同的改良组块设计方案,并由相同的针灸医师针刺,分别对2组数据进行处理确定脑功能激活区,比较2组研究对象激活区的异同,并对ASL组激活区区域性脑血流量(regional cerebral brain,rCBF)变化幅度及变化率进行统计学分析.结果:ASL组除了显示BOLD组的体感相关脑区(双侧SⅡ、岛叶、丘脑及中扣带回)及运动相关脑区(SMA)激活之外,还在SⅠ、额叶、顶下小叶、前扣带回等脑区显示激活,但较BOLD组相对多见的脑白质区域激活显著减少,同时ASL组信号变化幅度较大,rCBF变化率为(9.21±2.82)％.结论:针刺引起的ASL信号变化幅度更大,能够敏感地检出针刺引起的大脑激活区,且伪影很少.同时,基于ASL技术的针刺fMRI研究不受针刺方案限制,更加符合临床针刺fMRI研究的需要,值得推荐使用.

周围性面瘫为临床常见病、多发病,好发于季节变化、冷热交替之时,任何年龄均可发病,男性略多.大量的临床实践和文献报道显示,针灸是治疗周围性面瘫的有效手段1,神经电图对于周围性面瘫面神经损伤的预后评估具有重要价值[2].本课题组检测了周围性面瘫针灸治疗前后的神经电图数据,并与HousBrackmann(H-B)面神经功能分级系统、Sunnybrook(多伦多)面神经评定系统结合,探讨影响针灸治疗周围性面瘫的因素.

Objective:To explore the neurophysiological mechanisms of acupuncture on Hegu(LI4)and Houxi(SI3)curing diseases and the functional specificity of them based on the technique of fMRI.Methods:Forty healthy right-handed volunteers,divided into Hegu (LI4)point group and Houxi(SI3)point group,20 cases in each group.The experiment took the modified block design.All healthy vol-unteers were stimulated at left Hegu(LI4)or Houxi(SI3),acquiring the fMRI data with the same scanning sequences.All fMRI data were analyzed by AFNI program and the results were corrected with Monte Carlo method(P =0.002,α≤0.05).Results:1)Many brain areas were actived with increased signal by stimulating at the left Hegu(LI4)which included:bilateral cerebellum,right thalamus and subthalamic nucleus,bilateral lentiform nucleus and putamen,right caudate,right cingulate gyrus,bilateral precentral gyrus,right posterior central gyrus,bilateral superior parietal lobule,right inferior parietal lobule,left inferior frontal gyrus,right middle frontal gyrus,right mid-dle temporal gyrus,bilateral superior temporal gyrus,right supramarginal gyrus,left middle occipital gyrus,left insula.2)As well as many brain areas were actived with increased signal by stimulating at the left Houxi(SI3)which included:bilateral cerebellum,left thala-mus and ventral posterior medial,right caudate,right precentral gyrus,right middle frontal gyrus,left cingulate gyrus,bilateral insula.3) It showed significant defferences between the Intergroup analysis results of stimulating at Hegu(LI4)vs Houxi(SI3):the increased signal in left cingulated,precentral gyrus and decreased signal in right middle frontal gyrus,inferior frontal gyrus of Hegu(LI4)than Houxi (SI3).Conclusion:Present research directly illustrated the link of Hegu(LI4)with the face and mouth,as well as Houxi(SI3)with the neck and torso at the levels of central nervous system.And it also offered the objective neurophysiological evidence to the traditional Chi-nese medical theory-“fall and hand controlled by Hegu”and “Houxi associating with the governor vessel”.In addition,it explained the mechanism of Hegu treatment to hyperhidrosis,Houxi(SI3)treatment to neck lumbar diseases,and the analgesic function of both acu-points in some degree.Nevertheless,it provided the objective basis of functional specificity of the acupoints which were closed in loca- <br> tion.