目的 基于专家调查法研究总结膝骨关节炎常见经筋病灶点的分布特征.方法 根据文献分析及专家访谈结果,编制膝骨关节炎常见经筋病灶点专家调查问卷,面向全国相关领域专家进行调查.结果 46位专家对膝关节4个面的18个经筋病灶点意见集中程度较高,包括膝前侧4个、外侧4个、后侧4个、内侧6个.结论 基于德尔菲法的专家问卷调查能较好地总结膝骨关节炎经筋病灶点分布特征,为膝骨关节炎的早诊早治及疗效评价提供了新的思路和方法.

目的 以2020年1-2020年3月各地新型冠状病毒肺炎中医药防治方案为对象,系统整理治疗期中医证候和各类证候用药规律,探索中医药新冠肺炎临床中的方证关系.方法 从2020年3月29日前各地卫生管理部门、医疗机构、中医专家发布的新冠防治方案中系统整理证候和处方,采用中医传承辅助平台对各类证候频次、各类证候用药频次、组方规律、核心组方进行分析.结果 新冠肺炎治疗期主要证候共88种,分属于8类,最多的前2类为毒证类、湿证类;经对各类证候处方进行用药规律分析,毒证类核心处方为宣白承气汤、湿证类核心处方为三仁汤、热证类核心处方为麻杏石甘汤,寒证类和风证类核心处方无相似成方;邪证类、燥证类、其他证类因数据不足未加分析.结论 各地对重症和危重症证候的共识度较高,对轻型和普通型证候的共识度较低;各类证候和相应用药规律呈现明显的方证对应关系,可为提高中医药新冠肺炎救治效果、推进中医药抗疫科学机制研究提供线索和依据.

目的:观察揿针联合小剂量镇静剂治疗老年失眠患者的临床疗效.方法:将61例老年失眠患者随机分为揿针组(31例)和对照组(30例),前者采用揿针联合小剂量镇静剂治疗,后者采用中等剂量镇静剂治疗,疗程均为4周,观察临床疗效和匹兹堡睡眠质量指数(PSQI).结果:揿针组总有效率83.33％,对照组总有效率80.00％,两组比较,无显著性差异(P＞0.05);两组治疗后PSQI均有不同程度的下降,与治疗前相比有显著性差异(P＜0.05),两组治疗后PSQI相比无显著性差异(P＞0.05);揿针组副作用少于对照组.结论:揿针联合小剂量镇静剂与中等剂量镇静剂疗效相当,其副作用少于对照组,揿针治疗的减毒增效作用可有效控制镇静剂的耐药性和成瘾性.

OBJECTIVE:To observe the effect of warm-needle-moxibustion on behavior changes and the levels of tumor necrosis factor-α (TNF-α) and matrix metalloproteinase-3 (MMP-3) in the knee cartilage tissue of rabbits with knee osteoarthritis (KOA) so as to explore its mechanisms in relieving KOA.METHODS:Thirty male Japanese white rabbits were randomly divided into normal, model and treatment groups (n=10 in each group). The KOA model was established by using immobilization me-thod. The internal and external "Dubi" (ST 35), "Xuehai" (SP 10) and "Yanglingquan "(GB 34) were punctured with filiform needles first, followed by attaching an ignited moxa column to the handle of each inserted needles. The treatment was conducted for 20 min every time, once daily for 4 weeks. The behavioral scores were assessed according to the pain severity, gait, joint motion range and articular swelling severity in reference to the modified Lequesne's methods. The TNF-α and MMP-3 contents in the knee joint cartilage tissue were assayed by radioimmunoassay, and pathological changes of the articular cartilage tissue were observed under microscope after sectioning and H.E. staining.RESULTS:The Lequesne total score, and the cartilage TNF-α and MMP-3 contents were significantly increased in the model group than in the normal group (P<0.05), and obviously down-regulated after warm-needle-moxibustion intervention (P<0.05). Under light microscope, the inflammatory infiltration of the articular cartilage and the disordered arrangement of chondrocytes in KOA rabbits were improved in the treatment group.CONCLUSIONS:Warm-needle-moxibustion intervention can improve the motor function of rabbits with KOA, which may be related to its effects in reducing the level of TNF-α and MMP-3 in articular cartilage tissue.

OBJECTIVE:To observe the effect of warm-needle moxibustion on transfer growth factor-β1 (TGF-β1) and insulin-like growth factor I (IGF-I) expression in knee cartilage of knee osteoarthritis (KOA) rabbits so as to explore its underlying mechanism in improving osteoarthritis. METHODS:Thirty Japanese white rabbits were randomly and equally divided into control, model and warm-needle moxibustion(treatment) groups (n = 10 in each group). The KOA model was made by immobilization of the rabbit knee. Warm-needle moxibustion was applied to internal and external Dubi (ST 35), Yanglingquan (GB 34) and Xuehai (SP 10) on the affected side for 30 min in each session and for consecutive 4 weeks. The expression levels of TGF-P 1 and IGF-I in the knee cartilage tissue were assessed by means of radioimmunoassay. HE staining was carried out to examine the morphological changes of knee cartilage. RESULTS:In comparison with the control group, the expression levels of both TGF-β1 and IGF-I were up-regulated in the model group(P<0. 05) and then down-regulated after the warm-needle moxibustion treatment(P<0. 05). In addition, after the treatment the surface of the knee cartilage of rabbits became smoother and less cell proliferations and clusters were found in the cartilage in the warm-needle moxibustion group compared to those of the model group. CONCLUSION:Warm-needle moxibustion therapy can inhibit the overexpression of TGF-β1 and IGF-I in the knee cartilage of rabbits with KOA, which may be responsible for its effect in improving pathological changes of the cartilage.

Objective To investigate the effects of warming-needle acupuncture on the levels of matrix metalloproteinase-1 (MMP-1) and interleukin-1β (IL-1β) in the articular cartilage in knee osteoarthritis induced by immobilization in rabbits.MethodsA total of 30 adult male Japanese white rabbits were randomly assigned into three groups by random number table method: a normal group, a model group and a treatment group, with 10 rabbits in each group. Knee osteoarthritis was induced by 6 weeks of immobilization. The rabbits in the treatment group received warming-needle acupuncture after modeling at points of “Neixiyan” (EX-LE4), “Dubi” (ST35), “Zusanli” (ST36) and “Yanglingquan” (GB34) for 4 weeks. The level of MMP-1 and IL-1β in the articular cartilage of the knee were determined with radioimmunological assay.ResultsThere were significant difference in the levels of MMP-1(0.16 ± 0.02 ng/mg, 0.37 ± 0.02 ng/mg, and 0.28 ± 0.03 ng/mg;F=258.251) and IL-1β (0.21 ± 0.01 pg/mg, 0.34 ± 0.02pg/mg, and 0.31 ± 0.04 pg/mg;F=127.112) among the normal group, model group and treatment group. The levels of MMP-1 and IL-1β both in the model group and treatment group were significant higher than those in the normal group (allP<0.01), while the levels of MMP-1 and IL-1β in the treatment group were significant lower than those in the model group (allP<0.01).ConclusionWarming-needle acupuncture can effectively reduced the levels of MMP-1 and IL-1β in the articular cartilage in knee osteoarthritis induced by immobilization in rabbits.

[目的]了解北京地区医学本科生亚健康的特点.[方法]采用流行病学调查横断面研究方法,通过问卷对北京地区4所医学院校在读本科生的亚健康特征进行调查,根据问卷结果分析亚健康发生率,使用SPSS 18.0软件中的非参数检验对表现特征进行统计分析.[结果]收回问卷657份,回收率为73％,其中判定为亚健康者259例(39.4％).不同院校、不同性别的亚健康发生率没有统计学差异.健康组、亚健康组与疾病组的能力因子分别为8.801、9.681和9.656,躯体不适因子分别为17.524、21.869和20.892,睡眠因子分别为5.168、7.331和6.661,情绪因子分别为6.485、7.924和7.629,二便因子分别为7.653、9.669和8.886.上述5个因子3组间有统计学差异(P＜0.05).[结论]调查人群中亚健康的发生概率为39.4％.其发生率在中西医院校、性别之间差异无显著性.亚健康主要表现为躯体不适、精力下降、二便异常、负性情绪增加、睡眠质量下降等特点.