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.

目的 探究千年草提取物的抗氧化活性及对人成纤维细胞胶原蛋白合成的影响及其抗衰老作用.方法 分别采用热水和乙醇提取千年草的籽、皮和茎,获得提取物冻干粉末.检测千年草的籽、皮和茎的热水提取物、乙醇提取物的1,1二苯基-2三硝基苯肼(DPPH)清除活性、2,2'-联氮-双-3-乙基苯并噻唑啉-6-磺酸(ABTS)清除活性.采用千年草提取物与人皮肤成纤维细胞共培养,采用2',7'-二氯二氢荧光素二乙酸酯(DCFHDA)荧光探针试剂盒检测千年草提取物对人皮肤成纤维细胞内活性氧(ROS)清除活性,检测千年草提取物对人皮肤成纤维细胞的增殖作用及对Ⅰ型胶原蛋白合成的影响.结果 千年草籽、皮、茎的热水提取物和乙醇提取物均具有DPPH、ABTS和细胞内ROS清除活性,随着浓度增加,清除率升高,千年草籽乙醇提取物的DPPH和ABTS清除能力最强,其IC50分别为(47.96±5.18)μg/ml、(33.48±3.25)μg/ml.10μg/ml以上浓度的千年草提取物对人皮肤成纤维细胞增殖均有一定的促进作用,千年草籽的乙醇提取物和热水提取物的促进作用最强.千年草提取物对人皮肤成纤维细胞Ⅰ型胶原蛋白的合成具有促进作用,随浓度增加促进作用增强,其中,浓度为50μg/ml的千年草籽热水提取物促进作用越强.结论 千年草热水提取物和乙醇提取物均具有抗氧化活性、促进人皮肤成纤维细胞Ⅰ型胶原蛋白的合成作用,其中千年草籽的活性最强,能促进细胞增殖,无明显细胞毒性.

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 观察针刺配合刺络放血和常规西药治疗心脾积热型复发性口腔溃疡的疗效差异.方法 将70例符合纳入标准的复发性口腔溃疡患者随机分成治疗组和对照组,治疗组脱落2例,最终治疗组33例、对照组35例纳入统计.治疗组采用针刺配合背腧穴刺络拔罐放血治疗,对照组采用口服维生素B2、维生素C、左旋咪唑片治疗.2组均以7d为一个疗程,若溃疡在一个疗程内愈合,则无须继续治疗,若一个疗程未愈合,则继续治疗一个疗程.观察2组患者治疗前后症状体征积分、VAS疼痛评分、平均溃疡期,评定2组近期疗效,并观察2组半年内的复发率.结果 (2组患者治疗后症状体征积分、VAS疼痛评分、平均溃疡期均较治疗前降低,差异有统计学意义(P＜0.05);②治疗后治疗组的症状体征积分、VAS疼痛评分、平均溃疡期与对照组比较差异有统计学意义(P＜0.05);③治疗组总有效率为90.9％优于对照组的77.1％,差异有统计学意义(P＜0.05);④半年内复发率,治疗组为23.3％,对照组为53.1％,差异有统计学意义(P＜0.05).结论 针刺配合刺络放血可有效治疗心脾积热型复发性口腔溃疡,具有较好的近期疗效,在改善患者的症状和体征、止痛、缩短平均溃疡期等方面优于西药治疗,并且在控制复发率上也更有优势.

目的:通过观察穴位埋线配合梅花针叩刺治疗面瘫后遗症的临床疗效,为面瘫后遗症的临床治疗提供依据.方法:将符合标准的60例周围性面瘫后遗症患者随机分为观察组与对照组,观察组脱落2例,对照组脱落3例,最终观察组28例,对照组27例纳入统计.观察组采用穴位埋线配合梅花针叩刺治疗,对照组给予常规针刺治疗,观察2组治疗前、治疗1疗程、2疗程、3疗程后的治疗效果.结果:治疗2、3疗程后,观察组面神经功能House-Brackman(H-B)评分明显低于对照组,差异有统计学意义(P＜0.05);治疗3疗程后,观察组总有效率85.7％,显著高于对照组的66.7％,差异有统计学意义(P＜0.05).结论:穴位埋线配合梅花针叩刺治疗面瘫后遗症显效快,疗效确切,值得临床推广.