目的:应用Image IR8855型红外热像仪,观察正常状态左右手心包经穴区自身温度差异和疗法干预右手内关穴后双侧穴区温度变化,分析经络生理状态和不同疗法干预下的经络效应,为经络理论探索和疗法效应机制及临床应用提供研究依据.方法:招募45名健康受试者,随机分为空白对照组、砭贴组、毫针组,标记双手手厥阴心包经大陵穴、内关穴、间使穴、郄门穴、郄门上1寸的同经非穴及其尺侧旁开1 cm的非经非穴点,并采集和分析标记穴区皮肤温度变化情况.结果:生理状态下不做任何干预的心包经左手相关穴区皮肤温度均高于右手对应穴区,差异均有统计学意义(P<0.05);空白对照组前后比较:左手大陵、内关、间使、郄门、非经非穴温度均高于观测前,差异均有统计学意义(P<0.05);3组干预后组间比较,差异均无统计学意义(P>0.05),可能和不做手法、刺激量较小有关.砭贴组左右手大陵温度高于干预前,差异均有统计学意义(P<0.05);毫针组右手大陵和左手大陵、内关、非经非穴温度高于干预前,差异均有统计学意义(P<0.05);两组相对空白对照组而言右侧温度有所上升,而左侧上升不明显.结论:人体生理状态下存在左右侧皮肤温度差异现象和人体的气血运行规律有一定相关性,经穴左侧温度高于右侧的规律可能和中医"左升右降"理论有关;长时间固定姿势下的左右温度变化趋势的相对平衡性会改变,以左升太过为主要表现;不加手法刺激下,侵入性的毫针疗法和非侵入性的砭贴疗法均可以通过刺激局部经气和以右治左的作用来调节左右温度以保持相对平衡.

OBJECTIVE:To observe the effect of Biantie (bian stone plaste) pretreatment on serum level of prolyl hydroxylase domain 2 (PHD2) and hypoxia-inducible factor-1α (HIF-1α) in rats with acute hypobaric hypoxia induced-brain injury, and to explore the possible mechanism of Biantie on preventing brain injury at high altitude.METHODS:Forty-five male SD rats were randomly divided into a blank group, a model group, a Biantie group, a medication group and a Biantie+inhibitor group, 9 rats in each group. The rats in the Biantie group the and the Biantie+inhibitor group were pretreated with Biantie at "Taiyuan" (LU 9), "Neiguan" (PC 6) and "Renying" (ST 9), 2 h each time, once a day; the rats in the medication group were treated with intragastric administration of rhodiola capsule solution (280 mg/kg) for 14 d; the rats in the Biantie+inhibitor group were intraperitoneally injected with the PHD inhibitor dimethyloxalyl glycine (DMOG) at a dose of 40 mg/kg 24 h before the establishment of the model. After the intervention, except for the blank group, the rats in the remaining 4 groups were placed in the oxygen chamber to simulate a high-altitude environment to establish the acute hypobaric hypoxia brain injury model. The arterial blood-gas analysis indexes [blood oxygen saturation (SaO2), lactic acid (Lac), blood sodium (Na+), blood potassium (K+)] and brain water content were detected in each group; the histomorphology of cerebral cortex was observed by HE staining; the serum levels of PHD2 and HIF-1α as well as vascular endothelial growth factor (VEGF) were detected by ELISA; the VEGF protein expression in brain tissue was detected by Western blot; the VEGF mRNA expression in brain tissue was detected by real-time fluorescent quantitative PCR.RESULTS:Compared with the blank group, the levels of SaO2 and Na+ in the model group were decreased (P<0.05), while the levels of Lac and K+ as well as the water content of brain tissue were increased (P<0.05). Compared with the model group, the level of SaO2 in the Biantie group and the medication group was increased (P<0.05), while the levels of Lac, K+ and the water content of brain tissue were decreased (P<0.05); the level of Na+ in the Biantie group was increased (P<0.05). Compared with the Biantie group, the level of SaO2 in the Biantie+inhibitor group was decreased (P<0.05), and the level of Lac and the water content of brain tissue were increased (P<0.05). In the model group, the cortical tissue cells were loose and disordered, the cortical blood vessels were dilated, and the cells were obviously swollen; the anoxic injury in the Biantie group and the medication group was lighter, and the anoxic injury in the Biantie+inhibitor group was more obvious than that in the Biantie group. Compared with the blank group, the serum PHD2 content in the model group was decreased and the HIF-1α content was increased (P<0.05), and the content of VEGF in serum and VEGF protein and mRNA expressions in brain were increased (P<0.05). Compared with the model group, the content of PHD2 in serum in the Biantie group and the medication group was increased (P<0.05), and the level of HIF-1α was decreased (P<0.05), and the content of VEGF in serum as well as VEGF protein and mRNA expressions in brain were decreased (P<0.05). Compared with the Biantie group, the serum PHD2 content in the Biantie+inhibitor group was decreased and HIF-1α level were increased (P<0.05), and the content of VEGF in serum as well as VEGF mRNA expression in brain were increased (P<0.05).CONCLUSION:Biantie at "Taiyuan" (LU 9), "Neiguan" (PC 6) and "Renying" (ST 9) could regulate serum PHD2/HIF-1α to down-regulate VEGF expression, reduce brain edema and enhance anti-hypoxia ability, so as to achieve the purpose of preventing brain injury at high altitude.

目的 观察毫针疗法和砭贴疗法对手厥阴心包经相关穴区血流灌注量的影响.方法 招募45名健康受试者,随机分成砭贴组、毫针组、空白对照组各15名,采用激光微循环血流成像技术,观察相关穴区血流灌注量.结果 空白对照组的内关穴血流灌注量随干预时间增加而下降,差异有统计学意义(F=2.995,P<0.05),血流灌注量在干预12 min、结束后4 min与干预前4 min比较,均有下降,差异均有统计学意义(P<0.05).毫针组内关穴血流灌注量随干预时间增加而上升,差异有统计学意义(F=10.042,P<0.05),血流灌注量在干预0 min、干预4 min、干预8 min、干预12 min、干预16 min、结束后4 min与干预前4 min比较,均有升高,差异均有统计学意义(P<0.05).干预16 min、干预后4 min,3组内关穴血流灌注量差异有统计学意义(P<0.05),毫针组均高于砭贴组与空白对照组,差异均有统计学意义(P<0.05).空白对照组间使穴、郄门穴、同经非穴、非经非穴血流灌注量随干预时间增加均下降,差异均有统计学意义(P<0.05).砭贴组郄门穴血流灌注量随干预时间增加而下降,差异有统计学意义(F=2.346,P<0.05),血流灌注量在干预0 min、干预4 min、干预12 min与干预前4 min比较,均有下降,差异均有统计学意义(P<0.05).结论 毫针疗法和砭贴疗法均可提升心包经相关穴区的皮肤血流灌注量,但不同疗法调节微循环的规律有其特异性.

目的:观察砭贴预处理对急性低压缺氧肺水肿(即高原肺水肿)大鼠肺组织损伤的保护作用及其对NF-κB及相关炎症因子表达的影响.方法:将32只雄性SD大鼠随机分成正常组、模型组、砭贴组、药物组,每组8只.正常组和模型组正常饲养,砭贴组于太渊、内关、人迎穴每天贴砭贴2 h,药物组用大株红景天胶囊按280 mg/kg的剂量每天灌胃1次,均预处理14 d.除正常组外,其余3组于第15天置于低压低氧实验舱24 h建立急性低压缺氧肺水肿大鼠模型(即高原肺水肿模型).出舱后采集腹主动脉血及肺组织,HE染色观察肺组织病理变化,测定肺含水量(LWC),血气分析仪检测血液酸碱度(pH)、动脉血二氧化碳分压(PaC02)、动脉血氧气分压(Pa02),ELISA法测定肺组织肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-1β水平,RT-PCR检测肺组织核转录因子-κB p65(NF-κB p65)mRNA表达.结果:与正常组比较,模型组肺组织损伤明显,LWC显著增加(P＜0.01),血液pH、Pa02、PaCO2均显著降低(P＜0.01),肺组织中TNF-α、IL-6、IL-1 β水平显著升高(P＜0.01),NF-κB p65 mRNA表达显著升高(P＜0.01);与模型组比较,砭贴组与药物组肺组织损伤减轻,LWC显著降低(P＜0.01),血液pH、PaO2、PaCO2显著升高(P＜0.01),肺组织中TNF-α、IL-6、IL-1β水平显著降低(P＜0.05,P＜0.01),NF-κB p65 mRNA表达显著降低(P＜0.05,P＜0.01).结论:砭贴预处理对急性低压缺氧肺水肿大鼠有明显保护及抗炎作用,其作用机制可能是通过下调NF-κBp65mRNA表达,减少炎症因子的释放,从而抑制炎性损伤.

此文基于临床与实验文献中内关穴对心、三焦、肝、脾、肾、胃、胞宫调治作用的分析,探讨"经穴-脏腑相关"理论.笔者搜集中国知网1984—2020年关于内关穴的临床观察和实验研究的文献,归纳相关脏腑的生理功能,结合具体病症,梳理与内关穴直接相关的心与三焦的途径,以及内关穴与肝、脾、肾、胃、胞宫间接相连的途径,通过刺灸内关穴可调治心、三焦疾患,亦能调节肝、脾、肾、胃、胞宫的脏腑功能,从而起到一穴调多脏的治疗作用.内关穴可对其直接或间接相连的脏腑功能产生治疗作用,体现了经穴效应通过经络的联结形成的多维网状样经穴-脏腑关联系统来协调运行的.通过搜集临床研究和实验研究文献,以腧穴对脏腑的调治功能为支点,探寻印证经穴脏腑相关性,对深入挖掘和阐释经穴脏腑理论的科学内涵有重要意义.

目的:新冠肺炎(COVID-19)疫情突发后,为更好地为医护人员、高校师生及居家居民提供康复护养范式和健康自我评价,本研究根据中医非药物疗法设计开发了“北京中医药大学身心康”康复护养应用平台.方法:基于微信小程序技术,根据中医“治未病”思想,利用“身心同调,杂合以治”的优势,通过专业心理、生理测试量表,并结合新冠肺炎疫情特点以及北京中医药大学专家组临床经验,综合设计完成了新冠肺炎康养平台——身心康.结果:新冠肺炎康养平台,可有效辅助使用者快捷、高效地完成身心调节和远程康养指导.结论:身心康小程序,通过线上线下相结合的模式,可以有效为医护人员、高校师生和居家居民提供康复护养范式,为用户最大程度地促进机体康复和心理健康提供支持.