[目的]观察透刺法联合麦粒灸治疗周围性难治性面瘫患者的临床疗效.[方法]将64例周围性难治性面瘫患者随机分为治疗组和对照组,每组各32例.对照组给予电针联合红外线治疗,治疗组给予透刺法联合麦粒灸治疗,1周为1个疗程,连续治疗2个疗程.治疗2周后,评价2组患者的临床疗效,观察2组患者治疗前后House-Brackmann(H-B)面神经功能评分的变化情况,以及Sunnybrook面神经评分的情况.比较2组患者治疗前后汉密尔顿焦虑量表(HAMA)评分的变化情况.[结果](1)治疗后,2组患者的Sunnybrook面神经评分明显改善(P<0.05),且治疗组在改善Sunnybrook面神经评分方面明显优于对照组,差异有统计学意义(P<0.05).(2)治疗后,2组患者的HAMA评分明显改善(P<0.05),且治疗组在改善HAMA评分方面明显优于对照组,差异有统计学意义(P<0.05).(3)治疗组总有效率为87.50％(28/32),对照组为68.75％(22/32).治疗组疗效优于对照组,差异有统计学意义(P<0.05).[结论]透刺法联合麦粒灸治疗周围性难治性面瘫能明显改善患者的临床症状,改善患者面部的肌肉活动和感觉功能,改善患者焦虑与抑郁的状态,临床疗效显著.

[目的]基于数据挖掘技术探讨针刺治疗原发性不宁腿综合征的选穴和配伍规律.[方法]检索中文期刊网全文数据库(CNKI)、万方科技信息数据库(Wanfang Data)、中文维普科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)自建库至2020年11月1日针刺治疗原发性不宁腿综合征的相关文献,运用数据挖掘技术进行描述性分析、关联规则分析和聚类分析.[结果]共纳入文献15篇,涉及46个腧穴.选用频次前2位的腧穴为三阴交、足三里.涉及腧穴以足太阳膀胱经、足少阳胆经、足太阴脾经经穴为主.下肢腧穴应用频次最高.常用的腧穴配伍为三阴交+足三里、三阴交+阳陵泉.聚类分析中体现出上下配穴、交会穴配穴等取穴原则.[结论]针刺治疗原发性不宁腿综合征疗效确切,有一定规律可循,常选用三阴交、足三里为主穴,运用远近配穴及局部取穴发挥疗效.

[目的]运用数据挖掘技术探析针刺治疗突发性耳聋的腧穴配伍规律,为临床治疗提供参考方案及新思路.[方法]通过计算机检索中国知网(CNKI)、万方数据库(Wanfang)近20年收录的针刺治疗突发性耳聋的临床研究文献,应用Excel建立数据库,运用SPSS统计软件分析及数据挖掘,分析腧穴配伍的规律.[结果]共收集到139首处方,腧穴总频次由高到低依次为翳风、听会、听宫、耳门、中渚等;腧穴出现频次最高的归经为手少阳三焦经,其次是足少阳胆经;关联度较高的腧穴组合有"翳风-听宫,翳风-听会,听会-听宫"等.通过聚类分析,以23为标度,得到8个聚类群.[结论]针刺治疗突发性耳聋,具有重视耳部穴位的运用,并与远端配穴相结合的特点.

在经络腧穴学实验课中,教师通过指导学生用软陶制作临床常用腧穴周围组织的立体解剖模型,提高学生对腧穴周围结构的深层认识及针刺的安全性.课后对比实验组和对照组的测试成绩,结果 表明实验组的成绩显著高于对照组(P<0.01),说明学生通过自制腧穴立体模型,取得了良好的教学效果,学生能够快速掌握腧穴解剖相关理论知识,可以有效避免针刺意外的发生,对指导学生针灸临床实践有重要意义.

针刺治疗肩关节周围炎选穴方式繁多,传统针刺取穴包括局部取穴、辨经取穴、循本经远端取穴、循同名经远端取穴、巨刺取穴法;现代针刺取穴包括肌筋膜触发点理论取穴、肌肉起止点取穴、全息理论取穴、耳针理论取穴、腹针取穴;经验取穴包括条口透承山穴、阳陵泉穴、肩痛穴、肾关穴;综合取穴包括远近配穴法、对应取穴法.遵循分期施治原则采用远近配穴的方式,构成目前穴位优选的大致方向,而具体的穴位方案需综合考量多种因素.由于影响因素众多,临床上并不存在一成不变的穴位优选方案,综合考量众多因素后的选择,才是针刺治疗肩关节周围炎穴位的优选方案.

目的:观察刺络拔罐联合苯甲酸利扎曲普坦口服治疗急性发作期偏头痛的临床疗效及对5-羟色胺(5-HT)、P物质(SP)、同型半胱氨酸(HCY)水平的影响.方法:选取2017年1月至2018年9月在深圳市宝安区中医院针灸科门诊就诊的急性发作期偏头痛患者130例为研究对象,按照随机数字表法分为对照组与观察组,每组65例.对照组予以苯甲酸利扎曲普坦片10 mg口服,日1次;观察组在对照组基础上予刺络拔罐法治疗,5d1次,4次为1个疗程;两组均观察20d.两组治疗前进行24h生活质量问卷(24 hMQOLQ)评分和疼痛视觉模拟量表(VAS)评分,并于治疗后2h及24 h进行VAS评分,治疗24 h后进行24 hMQOLQ评分;检测两组治疗前后血清5-HT、SP、HCY的水平.结果:观察组即时疗效有效率87.7％,高于对照组63.1％,差异具有统计学意义(P＜0.05);与对照组比较,观察组治疗后24 hMQOLQ评分显著升高,差异有统计学意义(P＜0.05);观察组治疗后2h、24 h的VAS评分均显著低于对照组,差异有统计学意义(P＜0.05);观察组SP、HCY水平明显低于对照组,5-HT水平明显高于对照组,差异有统计学意义(P＜0.05).结论:急性发作期偏头痛患者应用刺络拔罐联合苯甲酸利扎曲普坦口服治疗,能快速止痛,减少疼痛发作,显著改善患者生活质量;其作用机制可能与提高血浆5-HT、降低SP及HCY而调节神经-内分泌-炎症因子有关.

目的:采用Meta分析对穴位注射治疗膝骨关节炎的临床疗效进行评价.方法:电脑检索中国知网(CNKI)、维普(VIP)、万方(WANFANG)、中国生物医学文献数据库(CBM)、Cochrane Library、PubMed、Embase相关文献,采用Cochrane 5.1.0系统评价文献质量,统计学分析采用Revman 5.3及Stata 13.0软件进行分析.结果:纳入18篇文献共1432例患者.结果 显示:治疗组在总有效率(OR=3.23,95％CI[2.24,4.65])、改善患者VAS评分(SMD=0.96,95％CI[0.26,1.66])和Lysholm膝关节评分(SMD=-1.85,95％CI[-2.74,-0.96])方面均优于对照组,差异具有统计学意义(P<0.01).结论:穴位注射治疗KOA具有较好的疗效,但鉴于纳入研究文献的方法学质量较低,仍需更多高质量的对照试验来支持本研究结果.

目的 观察十二井穴刺络放血疗法治疗糖尿病周围神经病变(DPN)的临床疗效.方法 将符合诊断标准的60例DPN病人随机分为治疗组和对照组,各30例.两组均进行糖尿病基础治疗.治疗组选取十二井穴行刺络放血疗法,对照组口服甲钴胺片(弥可保).观察两组治疗前后密歇根糖尿病周围神经病筛查表(MNSI)总积分,腓总神经、正中神经的感觉神经传导速度(SNCV)与运动神经传导速度(MNCV)的变化.结果 治疗后两组MNSI积分均较治疗前降低(P＜0.05),且治疗组MNSI积分降低幅度优于对照组(P＜0.05).治疗后两组正中神经、腓总神经SNCV和MNCV均较治疗前明显提高(P＜0.05);且治疗组改善幅度优于对照组,差异有统计学意义(P＜0.05).治疗组总有效率为86.7％,高于对照组的66.7％,差异有统计学意义(P＜0.05).结论 十二井刺络放血疗法治疗DPN能缓解肢体感觉异常、麻木及灼热感等神经症状,还能够有效改善病人神经传导速度.

目的 观察评价腹针联合十二井穴放血疗法治疗糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的临床疗效.方法 将符合诊断标准的60例DPN患者随机分为两组各30例.两组患者在糖尿病常规治疗的基础上,治疗组DPN患者采用腹针联合十二井穴放血疗法,对照组DPN患者口服弥可保,两组患者均连续治疗4周.观察两组患者治疗前后血生化指标(血清半胱氨酸Hcy含量、血浆黏度),密歇根糖尿病神经病变评分(michigan diabetic neuropathy score,MDNS),腓总神经、正中神经的感觉传导速度(sensory nerve conduction velocity,SNCV)与运动传导速度(motion conduction velocity,MNCV)及临床疗效.结果 治疗后两组患者血生化指标、MDNS积分均较前明显降低,腓总神经、正中神经的SNCV与MNCV较前明显增快,且治疗组DPN患者各项指标改善程度均优于对照组,差异具有统计学意义(P<0.05);治疗组患者的总有效率为86.7％,显著优于对照组的60％,差异具有统计学意义(P<0.05).结论 腹针联合十二井穴放血治疗DPN疗效确切,值得进一步推广及运用.

[目的]观察悬挂针联合麦粒灸治疗面肌痉挛(hemifacial spasm,HFS)的临床疗效.[方法]选取符合面肌痉挛纳入诊断的68例病例,随机分成治疗组(34例)和对照组(34例).治疗组予悬挂针联合麦粒灸法,对照组予常规普通针刺法.两组隔日治疗1次,5次为1个疗程,共3个疗程.分别对两组在试验前后进行Cohen Albert面肌痉挛强度评级、面肌痉挛频度评级、面部残疾指数量表(Facial Disability Index,FDI)判定,观察分析治疗后的疗效.[结果]经3个疗程治疗后,治疗组有效率为91.18％,对照组为76.47％,差异具有统计学意义(P﹤0.05);治疗后,治疗组在上述疗效指标的改善幅度方面均明显优于对照组,差异具有统计学意义(P<0.05).[结论]悬挂针联合麦粒灸方法治疗面肌痉挛可以提高临床疗效,改善症状,促进神经肌肉功能恢复.

病例 患者,男性,61 岁,2017 年 9 月 13日初诊.主诉:二便障碍半年余.患者于 2017 年3 月感冒后出现双下肢麻木乏力,不能行走,伴二便障碍.到某医院就诊,诊断为"急性脊髓炎"对症治疗好转后出院.出院后尚有二便障碍后遗症状,曾多方治疗疗效欠佳.患者深受折磨,曾因痛苦难忍欲轻生,被家属发现后及时阻止.刻下症:精神萎靡,语声低微,双下肢轻度麻木、乏力,可站立及行走,纳一般,眠差,小便困难、频数,大便难解.舌质紫黯、有瘀斑、舌肌痿软、苔薄,脉细涩.

To observe the clinical efficacy of acupuncture by enriching renal essence and improving intelligence in group acupoints tor vascular cognitive impairment (deficiency of kidney essence).Methods:sixty eligible patients were allocated and divided randomly into control group and treatment group,with 30 cases each.control group received Donepezil Hydrochloride Tablets,and the treatment group,acupuncture by enriching renal essence and improving intelligence in group acupoints in addition.Before the treatment,4 weeks after that,and 8 weeks after treatment,the simplified Montreal Cognitive Assessment (MoCA) score,Mini-mental State Examination (MMSE) and The Scale for differentiation of syndromes of vascular dementia (SDSVD) (deficiency of kidney essence) results of the two groups will be compared and assessed.Results:(1) Two groups after treatment by scale (MoCA,MMSE s,SDSVD) to assess efficacy:compared with the situation before treatment,the treatment group was better than the control group (P ＜ 0.05),total efficiency of the treatment group were 96.6％,93.3％,96.7％ respectively and the control group were 76.7％,60％,60％ respectively.by rank sum test of the two groups,treatment group was significantly better than the control group (P ＜ 0.05).(2) The treatment group was dramatically better than the control group on the deficency of kidney essence of TCM symptoms,the prominent change was about the soreness and weakness of waist and knees,tinnitus,nocturia (P ＜0.01).Conclusion:Acupuncture by enriching renal essence and improving intelligence in group acupoints can significantly improve cognitive function and clinical symptoms in patients with VCI,and improve the quality of life

目的:强直性脊柱炎属祖国医学"痹证"范畴,临床上以腰背、骶髂关节处疼痛、肌肉僵硬、活动受限等为主要表现.笔者临床综合运用毫火针、拔罐、电针、TDP以及中药内服等方法,固护先后天之本,扶正而祛邪,平调阴阳,形神同治,治疗强直性脊柱炎一例,取得满意疗效,现报道如下.

Objective:To evaluate the efficacy and safety of fire needle therapy in treating eczema.Methods:The clinical articles involved in PubMed,Medline,CNKI,CBM,Wanfang and VIP databases were searched by electronic and manual retrieval.The researching quality was evaluated by Cochrane handbook 5.1.0 and data were analyzed by Review Manager (RevMan) 5.3.Results:A total of 12 trials involving 785 patients were included.Meta analysis showed that the difference in total effective rate between fire needle group and western medicine group was significant (RR =1.23,95％ CI [1.12,1.36]);the difference between fire needle combined with moxibustion group and western medicine group was significant (RR =1.17,95％ CI[1.03,1.33]);the differences between fire needle combined with western medicine group and western medicine alone group,and between combination of fire needle with acupuncture therapy and acupuncture therapy were significant.The difference EASI score between fire needle therapy and western medicine group was significant (MD =-2.06,95％ CI[-2.91,-1.21]);the difference between fire needle combined with pricking blood therapy and western medicine group was significant (MD =-1.89,95 ％ CI [-3.17,-0.61]);the difference between fire needle combined with moxibustion therapy and western medicine group was significant (MD =-1.16,95％ CI [-2.09,-0.22]).The difference of VAS score between fire needle therapy and western medicine group,and combination of fire needle with pricking blood therapy and western medicine group were significant.Conclusion:Fire needle therapy has certain superiority and are safe in treating eczema.The quality of medical literatures included is not so high,so the conclusion needs to be further verified by enlarged sample from multicenter with double-blind controlled clinical trials.

目的:观察针刺联合乳果糖治疗肿瘤患者口服盐酸羟考酮缓释片所致肿瘤患者便秘的临床疗效.方法:选取60例患者随机分为治疗组和对照组各30例,对照组给予乳果糖治疗,治疗组在此基础上予以针刺治疗.观察两组治疗前、治疗后4周、治疗后8周的CCS、KPS评分的改善情况及临床疗效.结果:两组治疗后4周、治疗后8周便秘评分较同组治疗前均明显降低(P＜0.05),且治疗组的降低程度大于对照组(P＜0.05);治疗组治疗后8周KPS评分较同组治疗前明显改善(P＜0.05);对照组治疗后4周、治疗后8周KPS评分较本组治疗前均无明显改善(P＞0.05);治疗组治疗后4周、治疗后8周总有效率均优于对照组,差异有统计学意义(P＜0.05).结论:针药结合能明显改善肿瘤患者口服盐酸羟考酮缓释片所致便秘,提高患者生活质量,临床疗效较好,值得临床推广运用.

纤维肌痛综合征(fibromyalgia syndrome,FMS)是一种非关节性弥漫性软组织疼痛疾病,其临床表现为肌肉骨骼系统广泛的疼痛与发僵,在特殊部位有敏感的压痛点,并伴有疲劳、焦虑、睡眠障碍等.

Objective To observe the effect of acupoints external application (AEA) of herbal drug on peripheral eosinophil (EOS) count and serum IgE level of the experimental murine model of allergic rhinitis induced by ovalbumin (OVA). Methods Sixty BALB/C mice were randomized into 5 groups: normal group, model group, AEA group, hormone positive group and phosphate buffer solution (PBS) negative group. Murine models of allergic rhinitis were induced by sensitization and activation of OVA. AEA group received external application of powder of Semen Sinapis, Rhizoma Corydalis, Herba Asari, Radix Kansui and Fructus Xanthii on acupoint of Dazhui;hormone group received intraperitoneal injection of dexamethasone (100mg/L);PBS group received pseudo-acupoints external application and intraperitoneal injection of PBS. Hematoxylin-eosin staining was used to detect the EOS count and percentage in peripheral blood of different groups, and enzyme-linked immunosorbent assay (ELISA) was applied to detect the serum level of specific IgE(SIgE).Results EOS count and percentage in peripheral blood and serum SIgE level were increased in the model group (P0.05 or P0.01 compared with the normal group), and AEA and hormone treatment decreased the above indexes (P0.05 compared with the model group). The effect in AEA group was similar to that in hormone group (P0.05). Conclusion The therapeutic mechanism of AEA of herbal drug for OVA-induced allergic rhinitis may be related with the decrease of peripheral eosinophil count and serum IgE level.

【Objective】To observe the effect of acupoint external application of herbal drugs on pathological changes of nasal mucosa of allergic rhinitis mice. 【Methods】 Sixty BALB/c mice were divided into 5 groups: A(normal),B(model),C(treated with external application of herbal drugs on acupoints),D(treated with dexamethasone) and E(treated with PBS).Except group A,the mice in other groups were sensitized by ovalbumin(OVA).On the 15~(th) of the first sensitization,group C received external application of medicinal disc(mainly composed of Semen Sinapis, Rhizoma Corydalis,Herba Asari,Radix Kansui,Fructus Xanthii,etc.) on Dazhui (GV14)point,group D received intraperitoneal injection of 0.1?g/L dexamethasone(0.5?mL for each mouse) one hour before nasal dripping of OVA solution,and group E received external application of paper disc on Dazhui point and intraperitoneal injection of(0.1?g/L) PBS(0.5 mL for each mouse) one hour before nasal dripping of OVA solution,qd,for 4 weeks.After treatment,the mice were executed and the nasal mucosa was fixed in 4% paraformaldehyde.Routine paraffin slices were prepared and stained by haematoxylin and eosin.The pathological features of nasal mucosa were observed under light microscope,and eosinophil(EOS),neutrophil and lymphocyte count was performed in different groups.【Results】Compared to group A,the infiltration of EOS and neutrophil in nasal mucosa was obvious in group B(P0.05 or P0.01);the infiltration of EOS decreased in group C,and the difference was significant(P0.05 compared with group B) but the difference of neutrophil and lymphocyte was insignificant(P0.05).【Conclusion】The infiltration of EOS in nasal mucosa plays an important role in the pathogenesis of allergic rhinitis and the decrease of EOS infiltration may be one of the therapeutic mechanism of external application of herbal drugs on acupoints for allergic rhinitis.

The development of acu-moxibustion in treating allergic rhinitis(AR)in recent years was reviewed.It is indicated that the experimental research of acu-moxibustion for allergic rhinitis is relative deficiency and the mechanism study can be carried out by applying morden medical scientific methods and by detecting cellular factors,thus to supply scientific evidence for acu-moxibustion for allergic rhinitis.

单纯性肥胖症是一种需要较长时间连续治疗才能奏效的疾患,长期的药物治疗有较多潜在的不良反应.针灸治疗单纯性肥胖是一种安全、健康、有效的方法,值得推广应用.本文就近年来针灸对单纯性肥胖症的临床与机理研究作简要综述.