目的:观察"心脑同调"法电针对焦虑模型大鼠行为学及血清心房利钠肽(ANP)、促肾上腺皮质激素释放激素(CRH)、皮质酮(CORT)含量的影响,探讨针刺治疗焦虑障碍的效应及部分作用机制.方法:32只SD大鼠随机分为正常组、模型组、电针组和假针组,每组8只,制备焦虑大鼠模型.15 d后,采用高架十字迷宫实验与自发活动开场实验测试大鼠行为学变化,酶联免疫吸附试验法检测血清ANP、CRH、CORT的含量.结果:与正常组比较,模型组大鼠进入开臂次数百分比(OE％)、开臂停留时间百分比(OT％)明显降低(均P<0.01),水平得分、垂直得分明显下降(均P<0.05),血清ANP、CRH、CORT含量显著升高(均P<0.01);与模型组比较,电针组OE％、OT％值明显升高(均P<0.01),水平得分、垂直得分明显升高(均P<0.05),血清ANP、CRH、CORT含量显著降低(均P<0.01).结论:焦虑模型大鼠血清中ANP、CRH、CORT含量异常可能是导致其发病的机制之一;"心脑同调"法电针可能通过调节三者之间的紊乱状态而达到对焦虑障碍的治疗作用.

目的 系统评价针药并用治疗老年抑郁症的有效性和安全性.方法 利用计算机全面检索中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方学术期刊全文数据库(WF)、PubMed、荷兰医学文献数据库(EMbase)和Cochrane图书馆(Cochrane Library),自建库至2020年12月的有关针药并用治疗老年抑郁症的相关文献.筛选随机对照试验(RCT试验),采用Cochrane偏倚风险评估工具RoB2进行证据质量评价,采用RevMan5.3.0进行Meta分析.结果 共纳入16篇文献,病例数1238例,针药组620例,单纯药物组618例.Meta分析结果显示针药组有效率明显高于单纯药物组[RR=1.12,95％CI(1.07,1.17),P<0.01],汉密尔顿抑郁(HAMD)量表评分明显低于单纯药物组[SMD=﹣1.20,95％CI(﹣1.64,﹣0.77),P<0.01],简易精神状态检查表(MMSE)评分明显高于单纯药物组[SMD=1.90,95％CI(1.60,2.20),P<0.01],匹兹堡睡眠质量指数(PSQI)评分明显低于单纯药物组[SMD=﹣1.43,95％CI(﹣1.77,﹣1.10),P<0.01].而针药组不良反应显著低于单纯药物组[SMD=﹣0.60,95％CI(﹣0.85,﹣0.36),P<0.01].结论 针药并用治疗老年抑郁症可以显著改善患者抑郁程度、认知水平和睡眠状态,并减少不良反应的发生.

目的:观察"心脑同调"法电针对焦虑模型大鼠行为学及脑源性神经营养因子-酪氨酸激酶受体B(BDNF-TrkB)信号通路的影响,探讨针刺治疗焦虑障碍的疗效及相关作用机制.方法:将32只SD大鼠随机分为正常组、模型组、电针组和假针组,每组8只,制备焦虑大鼠模型.电针组电针"百会""风府""神门""内关"穴,假针组浅刺上述腧穴旁1 mm处,隔日1次,20 min/次,造模与治疗共计15 d.治疗结束后,采用高架十字迷宫实验与旷场实验测试大鼠行为学变化,酶联免疫吸附试验法检测血清BDNF水平,免疫组织化学法检测大鼠前额叶皮质BDNF、TrkB的表达水平.结果:与正常组比较,模型组大鼠进入开臂次数百分比(OE％)、开臂停留时间百分比(OT％)明显降低(P<0.01,P<0.05);与模型组比较,电针组OE％、OT％值明显升高(P<0.01);与电针组比较,假针组OT％值明显降低(P<0.05),OE％值有降低趋势,但差异无统计学意义(P>0.05).与正常组比较,模型组水平得分、垂直得分明显下降(P<0.05,P<0.01);与模型组比较,电针组水平得分、垂直得分显著上升(均P<0.01);与电针组比较,假针组水平得分、垂直得分显著降低(均P<0.05).模型组大鼠血清BDNF水平较正常组明显降低(P<0.01);电针组大鼠血清BDNF水平较模型组明显升高(P<0.05);假针组大鼠血清BDNF水平较电针组明显降低(P<0.05).与正常组比较,模型组大鼠前额叶皮质BDNF、TrkB表达水平明显降低(均P<0.01);与模型组比较,电针组大鼠前额叶皮质BDNF、TrkB表达水平明显升高(P<0.01,P<0.05);与电针组比较,假针组大鼠前额叶皮质BDNF、TrkB表达水平明显降低(均P<0.05).结论:焦虑模型大鼠BDNF-TrkB信号通路的异常表达可能是其焦虑的发病机制之一."心脑同调"法电针可能通过调控BDNF-TrkB信号通路而发挥抗焦虑作用.

To evaluate the differences in the clinical effect and the safety in the treatment of post-stroke anxiety disorder (PSAD) between electroacupuncture (EA) and paroxetine on the base of the heart-brain theory. A total of 70 patients of PSAD were randomized into an EA group and a medication group, 35 cases in each one. In the EA group, four acupoints were selected and divided into two pairs. In the Pair A, there were Băihuì (百会 GV20) and Fēngfŭ (风府 GV16). In the Pair B, there were Xīnshū (心俞 BL15) and Shénmén (神门 HT7). After acupuncture, the electroacupuncture apparatus was applied. The duration of needle retention was 20 min. EA was given three times a week, totally for 4 weeks. In the medication group, paroxetine tablets were administered orally, 10 mg daily in the first 4 days and 20 mg afterwards, totally for 4 weeks. Before and after treatment, as well as in the follow-up period, Hamilton anxiety scale (HAMA), Barthel index (BI) for daily life ability, and clinical global impression (CGI) were observed and the clinical therapeutic effect was evaluated separately. A total of 3 cases were dropped-out in the medication group. Finally, 35 cases in the EA group and 32 cases in the medication group were included in the analysis. Compared with the scores before treatment, the scores of HAMA and CGI-SI (severity of illness) were lower and the scores of BI were higher after treatment and during the follow-up in either the EA group or the medication group (all P < 0.05). Compared with the scores after treatment, the differences were not significant in HAMA and CGI-SI scores during the follow-up in either the EA group or the medication group (all P > 0.05). Compared with the medication group, BI score in the EA group was higher in the follow-up, indicating the statistical significance (P < 0.05). After treatment, CGI-SI score was different statistically between the EA group and the medication group (P < 0.05). There were 5 cases with adverse reactions in the EA group and 9 cases in the medication group. The therapeutic effect of electroacupuncture on the base of heart-brain theory is similar to the oral administration of paroxetine in the treatment of post-stroke anxiety disorder. This therapy relieves anxious emotions, promotes the recovery of limb function and has less adverse reactions in the patients.

脐是人体腹部重要的解剖结构,脐痛属于腹痛范畴,腹腔内脏器病变引发肚脐痛.中医认为脐与五脏六腑、十二经脉等密切相关,脐痛既可能是内脏病症的临床症状,也可能是神阙穴作为腧穴对脏腑病症的病理反应.本文记录了1例脐痛患者针刺治疗的全过程,患者脐痛的部位恰处脾病在脐的病理反应点,辨证为寒邪中脾,脾阳不振,针刺取穴以足阳明经、足太阴经及任脉穴为主,收效圆满.笔者通过分析此脐中痛针灸有效临床案例,探讨作为临床症状及腧穴反应点的“脐中”与五脏中脾的相关性,与同道共享肚脐诊治五脏病症的个人体会.

谈“补泻”,咱们先得说说“虚实”.中医理论认为,疾病的发展与正邪的盛衰变化密切相关.《黄帝内经》记载:“邪气盛则实,精气夺则虚.”意思是说,邪气入侵人体,如果正气旺盛,能够奋起反抗,正邪抗争剧烈,就会表现为实证,如精神亢奋、语高气粗、面赤发热、烦躁易怒等;若正气不足,脏腑功能减退,则表现为虚证,如面色苍白、精神不振、身困乏力、心慌气短等.

张仲景在《素问·热论》六经分证分类法的基础上,创造性的把外感疾病错综复杂的证候及其演变过程加以归类而提出六经辨证体系.但笔者认为,《灵枢·经脉》中关于十二经脉及其病候的记载为张仲景六经病证的提出、六经体系的创立提供了非常有益的参考价值.张仲景沿用了十二经脉理论,提出了六经的概念,并对十二经脉病候总结发挥,结合伤寒病变特点,阐述了六经病候特点,从而形成了完整的六经辨证体系.

俗话说“看耳知寿命,摸耳治百病”.民间一向把耳大视作有福之相,认为耳朵厚而大的人更长寿.虽然这个理论不完全具有科学意义,但通过观察耳朵的外在形态、颜色、质地等情况,确实可以了解我们身体的健康状态.传统医学还可以据此来诊断和治疗疾病,例如耳穴疗法,对于内、外、妇、儿、皮肤、五官等各科疾病均适宜,而且见效快,疗效好,安全易操作.

从不寐的病因病机及辨证论治两个角度进行分析,并结合神阙穴中药贴敷的临床应用情况,探讨了神阙穴中药贴敷治疗不寐的机理.

To Analyze the significance and mechanism of soothing liver by acupuncture for treatment of al-lergic rhinitis from the theoretical level ,so as to lay a solid foundation for prevention and treatment of aller-gic rhinitis in clinic.

目的:提高针灸留学生的临床教学质量.方法:根据针灸留学生的背景和特点,有针对性的制定教学内容和进度,综合运用归纳式、互动式、故事式、类比式、案例式结合PBL教学等多种教学方法.结果:激发了学生学习的兴趣和热情,克服了学习困难,变被动灌输为主动求索和讨论,提高了临床教学质量.结论:针对针灸留学生的特点安排教学内容,创新教学方法,可提高教学质量.

Nitric oxide( NO) is an important substance of Qi. Qi in the human body,Qi of Zangfu organs and Qi of meridians are all originated from primordial Qi. Qi of Zangfu organs,such as: heart dominating blood circulation and vessels,spleen and stomach ascending and descending; kidney governing growth and development; lung governing Qi; liver controlling conveyance and dispersion. Qi of meridians includes stimulation of channel-Qi,acupuncture treatment of diseases and health care. Besides,there are also Tai Chi and Chi gong. All these have close relationship with NO.

According to the comparative analysis on the basic concepts in biology and medicine and main physiological function of nitric oxide(NO) and Qi in TCM,NO is a kind of specific material belongs to the Qi of Chinese Medicine in the human body.The study on essence of this king of Qi and Chinese medicine as well as integrated traditional Chinese and Western medicine research associated with the NO has the vital significance.

支气管哮喘(Bronchial asthma)是由多种细胞和细胞组分参与的气道慢性炎症性疾病[1].属中医"哮病"范畴. 建国以米,一大批名老针灸医家为针灸事业做出了重要贡献.名老中医的学术传承是培养新一代名中医的重要途径[2].总结名老中医的经验不仅能丰富中医学的理论体系,还能为中医药学术进步产生推动作用. 为总结当代名老中医针刺治疗支气管哮喘的证治思想,我们在参考《针灸学报》1986年第1期发表的《中国当代针灸名家》名单基础上,选取1949年以来在针灸理论及临床方面有较大贡献的名老中医,通过研读其论著、医案,总结针刺治疗支气管哮喘的重要经验.

Objective: This study analyzes the law of JORRP relevant factors with the clinical investigation of the large sample.Methods: This study investigated 116 cases of children with a variety of factors(Age,gender,geography,time to recurrence).Results: Gender differences in children is not very obvious,the first age peak age of 1 year and 3-year-old children with an average incidence of the number of days is mostly concentrated in 1-3 months,the incidence of geographical mostly concentrated in the economically underdeveloped provinces,counties and rural areas.Conclusion: The disease is starting at early age,with an average recurrence of the number of days shorter.The level of the national economy more developed countries lag behind as well as poor awareness of preventing and curing diseases caused by this situation.

赵吉平教授立足于中医针灸经典理论,深入研究产后身痛,指出本病以气血亏虚为本,瘀血留滞、风寒湿邪侵袭为标；不荣则痛和不通则痛为基本病机；针灸治疗以固本为要,兼顾祛邪；选穴上辨证取穴、辨经取穴、局部取穴相结合；操作上针刺与艾灸相结合,并配合拔罐、红外线照射等治疗.针对具体患者,结合具体情况,随病机变化而灵活调整方案.

目的 观察电针治疗特发性睑痉挛的临床疗效.方法 利用电针对17例特发性眼睑痉挛患者进行治疗,随访1年,采用Cohen强度分级对痉挛程度进行对比观察.结果 完全缓解7例(41.18%),明显缓解8例(47.06%),部分缓解1例(5.9%),无效1例(5.9%),总有效率94.1%,随访1年1例复发.结论 电针对特发性眼睑痉挛具有较好疗效,值得临床推广应用.

Bell面瘫是临床上较为常见的疾病之一.临床观察与科学研究认为,面瘫的最佳治疗时机为急性期,急性期的治疗是提高疗效、降低后遗症发病率的关键,故寻找面瘫急性期最佳治疗方法有较大的临床意义.本课题对头穴电刺激联合体针治疗急性期重度Bell麻痹的疗效及安全性进行了综合评价,报道如下.

目的 通过检索近30年国内体针治疗支气管哮喘随机对照临床试验(RCT)文献,归纳分析其选穴及疗程设定规律.方法 电子检索1979-2009年<中国学术文献网络出版总库/中国学术文献总库>、1979-2009年<中国期刊全文数据库>及1989-2009年<中文科技期刊数据库>.把逐一阅读检索到的20篇文献,用自制的<文献质量、治疗手段、选穴及疗程信息表>提取相关信息,建立数据库.将收集的相关数据,通过Excell软件进行统计分析.结果 1.体针治疗支气管哮喘RCT文献,哮喘分期认识不足,文献质量尚待提高.2.选穴及疗程规律:(1)选穴:肺俞、定喘、丰隆、曲池、足三里是急性发作期使用频次较高的腧穴;肾俞、肺俞、脾俞是临床缓解期使用频次较高的腧穴.(2)疗程:急性发作期每天针刺1次(83.3%),7～10天1个疗程,治疗1个疗程;临床缓解期每天针刺1次(33.3%),或隔日针刺1次(33.3%),12～21天1个疗程,治疗1～4个疗程.结论 国内体针治疗支气管哮喘RCT研究质量有待提高.本次研究结果对急性发作期、临床缓解期体针选穴及疗程设定有一定的参考价值.