目的 比较热敏灸在经期前介入与月经当天介入治疗原发性痛经的临床疗效差异,以优化临床治疗方案.方法 将纳入的60例原发性痛经患者随机分为预处理组和常规处理组,每组30例.所有患者仰卧位时选取双侧子宫穴与归来穴合围的区域,俯卧位时选择双侧肾俞穴与次髎穴合围的区域,分别施回旋灸2min,雀啄灸1 min,再循经往返灸激发灸感,找出所有热敏穴,最终选择2个灸感最好的热敏穴进行治疗.预处理组于月经来临前3～7天开始施灸,常规处理组于月经当天施灸,两组均每日1次,每个月经周期治疗7天,连续进行3个月经周期.治疗前后进行COX痛经症状评价量表(CMSS)评分、疼痛视觉模拟量表(VAS)评分,检测子宫动脉血流动力学指标[包括血液搏动指数(PI)和阻力指数(RI)],治疗后比较两组患者的中医临床疗效.结果 两组治疗后CMSS评分、VAS评分、PI、RI均低于本组治疗前,且治疗后预处理组VAS评分、CMSS评分、PI、RI低于常规处理组(P＜0.05或P＜0.01).预处理组治疗后中医临床疗效总有效率为93.3％(28/30),优于常规处理组的73.3％(22/30,P＜0.05).结论 热敏灸在经期前介入治疗原发性痛经的临床疗效优于月经当天介入治疗,能更好地改善患者痛经症状和子宫局部血液循环.

目的 研究基于现代工程技术热敏灸治疗仪与艾条热敏灸治疗颈肩肌筋膜炎的疗效.方法 研究对象为2020年9月—2021年4月收治的60例颈肩肌筋膜炎患者,按照就诊顺序分组,各30例.对照组给予常规的艾条热敏灸治疗,试验组给予热敏灸治疗仪治疗,2组患者均每天治疗1次,每周5次,每次20 min,连续治疗4周.比较患者颈部残障指数(NDI)、颈椎关节活动度(CROM)、体征和软组织症状积分;疼痛情况:视觉模拟疼痛评分(VAS)、疼痛分级指数(PRI)、现在疼痛状况(PPI)以及临床疗效.结果 疗程结束后,试验组NDI评分、症状总积分和PRI、VAS、PPI评分均低于对照组,CROM高于对照组,2组比较差异有统计学意义(P<0.05).试验组临床总有效率93.33％(28/30),对照组66.67％(20/30),差异有统计学意义(P<0.05).结论 热敏灸治疗仪治疗颈肩肌筋膜炎不仅有效缓解患者疼痛,改善颈部活动度,而且使用方便,临床疗效明确,值得在临床推广.

此项目为实现与热敏灸艾条光谱的拟合,采用加热体激发辐射体的方式,按照所测定的艾条燃烧温度和辐射光谱,通过理论研究和实验确定辐射体的受激辐射能量以及所需要的激发温度.利用仿艾治疗仪发光发热中心恒定的特点,始终保持腧穴定位和照射距离的准确,将专业医生或技师与患者的"一对一"操作变为"一对多"操作.通过近/远红外综合激发、定向传热、照射中心指示以及多轴调节等多项技术的研究和原始创新,高度拟合艾条光谱,实现热敏灸的治疗效果.

目的:观察热敏灸对膝骨关节炎(KOA)兔背根神经节NGF/p38 MAPK/TRPV1信号通路的影响,探讨其治疗KOA的作用机制.方法:36只普通级雄性新西兰兔,采用随机数表法随机分为空白组(6只)、假手术组(6只)、造模组(24只).采用木瓜蛋白酶溶液注射膝关节腔法造模15 d,假手术组关节腔内注射等量的0.9％氯化钠溶液.造模成功后,选取6只为模型组,其余艾灸犊鼻穴,每日1次,每次40 min,共7d,根据兔艾灸过程中温度变化分为热敏灸组和非热敏灸组,各6只;空白组、假手术组、模型组不予干预措施.干预结束后,观察各组兔行为学变化;采用ELISA法检测血清神经生长因子(NGF)含量;Western blot法检测各组大鼠背根神经节p-p38 MAPK、TRPV1蛋白的表达.结果:造模后,与空白组比较,假手术组、模型组、非热敏灸组、热敏灸组兔Lequesne MG评分均显著升高(P＜0.01).干预后,与模型组比较,非热敏灸组及热敏灸组Lequesne MG评分显著下降(P＜0.05,P＜0.01).与空白组比较,模型组血清NGF含量显著上升(P＜0.01);与模型组比较,非热敏灸组、热敏灸组血清NGF含量显著下降(P＜0.01);与非热敏灸组比较,热敏灸组血清NGF含量显著下降(P＜0.05).与空白组比较,模型组p-p38 MAPK、TRPV1蛋白含量显著升高(P＜0.01);与模型组比较,非热敏灸组及热敏灸组p-p38 MAPK、TRPV1蛋白表达显著下降(P＜0.01);与非热敏灸组比较,热敏灸组p-p38 MAPK、TRPV1蛋白表达显著下降(P＜0.01).结论:热敏灸可能通过减少局部NGF的产生,从而抑制NGF/p38 MAPK/TRPV1通路的激活,降低炎性局部的痛敏反应而发挥其改善KOA的作用.

OBJECTIVE To observe the effect of moxibustion on the expression of phosphorylated calcium/calmodulin-dependent protein kinase Ⅱα(pCaMKⅡα) and neuronal nuclei (NeuN) and the ability of learning and memory in the neonatal mice model of hypoxic-ischemia encephalopathy(HIE), so as to explore its mechanism underlying improvement of learning and memory. METHODS ICR mice (aged 7 days) were randomly divided into sham operation, model and moxibustion groups. HIE model was induced by ligation of the right common carotid artery combined with hypoxia in a closed transparent chamber. Mice in the moxibustion group were treated with gentle moxibustion at "Dazhui"(GV14) for 35 min，once daily for 3 consecutive days. The pathological changes of brain tissues were observed with the naked eyes and under microscope after H.E. staining, respectively. The expressions of pCaMKⅡα and NeuN in the ischemic penumbra were examined by immunofluorescent staining, and the learning and memory ablility was tested with Morris maze. RESULTS No infarcts were found in the brain tissue of the mice in the sham operation group. Compared with the sham operation group, mice in the model group had infarcts and the expression of pCaMKⅡα and NeuN in the ischemic penumbra was significantly reduced (P<0.01), and the latency to find a platform was significantly prolonged in Morris maze test (P<0.01). After moxibustion, in comparison with the model group showed that, small areas of infarction were seen in the right hemisphere of the moxibustion group, and the expressions of pCaMKⅡα, NeuN increased significantly (P<0.01), and the latency to find a platform was significantly shortened (P<0.01). CONCLUSION Moxibustion can improve the ability of learning and memory in the neonatal mice with HIE, which might be related to alleviating brain injury and increasing the expression of pCaMKⅡα in neurons of ischemic brain tissues.

目的 观察热敏灸对膝骨性关节炎(Knee Osteoarthritis,KOA)兔软骨病理及p53、Caspase-3的影响,探讨热敏灸治疗KOA的作用机制.方法 36只雄性新西兰兔按随机数字表随机分为空白组(6只)、假手术组(6只)、模型组(6只)、艾灸组(18只).空白组正常饲养,模型组与艾灸组采用木瓜蛋白酶注射膝关节腔内建立KOA模型,并且每日强迫活动1小时,造模15天,假手术组关节腔内注射等量的0.9％ NaCl溶液.造模结束后,艾灸组艾灸"犊鼻"穴,每日1次,每次40min,共7天,根据家兔艾灸过程中温度变化分为热敏灸组和非热敏灸组,两组各随机抽取6只;空白组、模型组正常饲养,不予任何干预.干预结束后,光镜下观察膝关节软骨形态学改变;Real-time PCR法检测兔膝关节软骨p53、Caspase-3 mRNA的表达.结果 (1)与空白组比较,模型组软骨病理损害严重,软骨Markin's评分上升(P＜0.01);与模型组比较,非热敏灸组、热敏灸组软骨病理损害减轻,软骨Markin's评分下降(P＜0.01),其中热敏灸组优于非热敏灸组(P＜0.05).(2)与空白组比较,模型组兔关节软骨p53、Caspase-3含量均显著升高(P＜0.01);与模型组比较,非热敏灸组、热敏灸组兔关节软骨p53、Caspase-3含量显著降低(P＜0.01);与非热敏灸组比较,热敏灸组兔关节软骨p53、Caspase-3含量显著降低(P＜0.05).结论 热敏灸治疗KOA兔具有显著疗效,其作用途径可能是通过改善软骨损害,降低p53、Caspase-3的表达,抑制KOA模型兔软骨细胞的过度凋亡来实现的,这可能是热敏灸防治KOA的可能作用机制.

目的:研制热敏灸治疗仪代替人工热敏灸.方法:通过查阅大量文献,初步确定辐射体材料的可选范围,再通过对实验辐射体的温度变化与光谱的对应关系分析,与热敏灸艾条以及同类产品的光谱进行对比,不断优化,确定各种技术参数,研制出仿艾热敏灸治疗仪,并进行临床验证,选取2019年5月至2020年12月来江西中医药大学附属医院就诊的120例周围性面神经炎患者,随机分为三组,观察组使用热敏灸治疗仪,对照A组使用人工热敏灸,对照B组使用艾灸仪,一天一次,10天一疗程,治疗后,通过比较三组患者疗效评估各治疗方法的有效性.结果:观察组和对照A组在临床愈显率和周期性面神经炎治疗成绩(Portman)评分方面均无显著差异(P>0.05),但观察组临床愈显率和Portman评分均显著高于对照B组(P<0.05).结论:该热敏灸治疗仪替代人工热敏灸具有可行性.

OBJECTIVE To observe the effect of heat-sensitive moxibustion at "Zhongwan" (CV 12) on serum growth hormone (GH) and pepsinogen (PG) in chronic atrophic gastritis (CAG) rats, and to explore the potential mechanism of heat-sensitive moxibustion for CAG. METHODS A total of 66 male SD rats were randomized into a blank group (12 rats) and a model establishment group (54 rats). No intervention was given in the blank group. Rats in the model establishment group were intervented with compound pathogeny method for 12 weeks to establish CAG model, which were further divided into a model group (11 rats), a vitacoenzyme group (11 rats) and a moxibustion group (22 rats). In the moxibustion group, suspending moxibustion was applied at "Zhongwan" (CV 12) for 40 min. After the intervention of moxibustion, 0.9% sodium chloride solution was given by gavage (2 mL·kg-1·d-1). According to the changes of tail temperature, rats in the moxibustion group were divided into a heat-sensitive moxibustion group (11 rats) and a non-heat-sensitive moxibustion group (8 rats). The vitacoenzyme group was given vitacoenzyme as the same dose by gavage. The intervention was adopted once a day for 28 days. Changes of body weight were observed among the groups. Expressions of serum GH, PGⅠand PGⅡwere detected by ELISA, and the ratio of PGⅠand PGⅡ (PGR) was calculated. The morphological changes of gastric mucosa were observed by macroscopy and light microscope. RESULTS ①After modeling, the body weight of rats in the model establishment group was lower than the blank group (P<0.01). Compared with the model group, the body weight of rats in the vitacoenzyme group, the heat-sensitive moxibustion group and the non-heat-sensitive moxibustion group was increased after intervention (P<0.05), and there were no significant differences among the intervention groups (P>0.05). ②Under macroscopy and light microscope, gastric tissue of rats after modeling showed dark red and pale gastric mucosa, lower plica and mucosal congestion. The glands of lamina propria were atrophied or disappeared with sparse and disordered arrangement, in which, lymphoid follicles and inflammatory cells could be observed. After intervention, morphology of gastric mucosa was improved in the vitacoenzyme group, the heat-sensitive moxibustion group and the non-heat-sensitive moxibustion group. ③Compared with the blank group, the serum levels of GH, PGⅠ, PGⅡ and PGR were decreased in the model group (P<0.05, P<0.01). Compared with the model group, the serum levels of GH, PGⅠand PGⅡwere increased in the vitacoenzyme group, the heat-sensitive moxibustion group and the non-heat-sensitive moxibustion group (P<0.05, P<0.01), the levels of PGR were increased without statistical difference (P>0.05). Compared with the vitacoenzyme group and the non-heat-sensitive moxibustion group, the serum levels of GH and PGⅠwere increased in the heat-sensitive moxibustion group (P<0.05). CONCLUSION Heat-sensitive moxibustion at "Zhongwan" (CV 12) can improve the morphology of gastric mucosa in chronic atrophic gastritis rats, its mechanism may be related to the up-regulation of serum GH and PGⅠ.

目的:探索偏头痛复合敏化腧穴适宜的刺激方式.方法:将60例偏头痛患者随机分为A、B、C三组.A组给予力敏针刺治疗,B组给予热敏灸治疗,C组给予力敏针刺联合热敏灸治疗.三组均每日治疗1次,共治疗10次.比较三组患者治疗前后简化McGill量表评分、观察三组疗效差异.结果:C组的愈显率为95％,显著优于B组的65％、A组的30％(P<0.05,P<0.01).三组治疗前后的简化McGill量表评分比较有极显著差异(P均<0.01).在降低VAS、PPI评分方面,C组与B组均优于A组(P<0.05),C组与B组相比较无显著性差异(P>0.05);在降低PRI和McGill总分方面,C组最佳,B组次之,二者均优于A组(P<0.05).结论:力敏针刺、热敏灸、力敏针刺联合热敏灸三种治疗方式对偏头痛均有较好疗效;热敏灸与力敏针刺联合热敏灸治疗偏头痛疗效优于力敏针刺;力敏针刺联合热敏灸是偏头痛复合敏化腧穴最适宜的刺激方式.

目的:观察热敏灸对肠易激综合征(IBS)模型大鼠CRH、ACTH与CORT的影响.方法:64只SD雄性大鼠随机分为空白组(8只)、模型组(8只)、艾灸组(32只)、假手术组(8只)、NMDA组(8只),空白组不予干预,其余各组通过慢性不可预见性刺激法复制IBS模型.造模完成,艾灸组以悬灸命门穴出现尾温变化为依据,分为热敏灸组和非热敏灸组.实验第21、28、35天,NMDA组套管植入海马微量注射5μg/μL NMDA 1 μL,假手术组、艾灸组注射生理盐水.观察各组大鼠行为学变化.应用Real-time PCR检测下丘脑CRH mRNA表达,放射免疫法检测血清ACTH、CORT水平.结果:(1)与空白组相比,各组大鼠下丘脑CRH mRNA表达均升高(P＜0.01,P＜0.05).与模型组相比,假手术组CRH mRNA表达无明显差异,NMDA组CRH mRNA表达升高(P＜0.01),热敏灸组、非热敏灸组CRH mRNA表达均明显降低(均P＜0.01).与非热敏灸组相比,热敏灸组CRHmRNA表达降低,差异有统计学意义(P＜0.05);(2)与空白组相比,各组大鼠血清ACTH含量均升高(均P＜0.01).与模型组相比,假手术组ACTH含量无明显差异,NMDA组ACTH含量升高(P＜0.01),热敏灸组、非热敏灸组ACTH含量均明显降低(P＜0.01,P＜0.05).与非热敏灸组相比,热敏灸组ACTH含量降低(P＜0.05);(3)与空白组相比,各组大鼠血清CORT含量均升高(P＜0.01,P＜0.05).与模型组相比,假手术组、NMDA组CORT含量无明显差异;热敏灸组、非热敏灸组CORT含量均明显降低(均P＜0.01).与非热敏灸组相比,热敏灸组CORT含量降低(P＜0.05).结论:热敏灸可有效改善IBS模型大鼠相关症状,可能是通过调节NR的表达,降低下丘脑CRHmRNA表达及血清ACTH、CORT含量,恢复HPAA负反馈调节功能实现的.

目的:观察热敏灸对肠易激综合征(irritable bowel syndrome,IBS)大鼠下丘脑促肾上腺皮质释放激素(corticotropin releasing hormone,CRH)、促肾上腺皮质激素释放因子(corticotropin releasing factor,CRF)和肾上腺糖皮质激素受体(glucocorticoid reccptor,GR)的影响,探讨热敏灸治疗IBS的可能作用机制.方法:50只SD雄性大鼠按随机数字表随机分为空白组(6只)、模型组(6只)、艾灸组(32只),米非司酮(Mifepristone,RU-486)组(6只),空白组正常饲养,模型组、RU-486组与艾灸组采用慢性不可预见性刺激法建立IBS模型,造模21 d.造模结束后,艾灸组灸命门穴,每日1次,每次40 min,共14天,每隔10 min检测大鼠尾温并记录,根据大鼠尾温变化分热敏灸组和非热敏灸组,两组各随机抽取6只;RU-486组RU-486灌胃处理,空白组与艾灸组灌服同等换算体积生理盐水14 d.观察各组大鼠行为学变化.治疗结束后取下丘脑、肾上腺,-80℃保存待检.结果:(1)与空白组相比,模型组、热敏灸组、非热敏灸组、RU-486组CRF、CRH表达差异均明显升高(P＜0.05,P＜0.01);与模型组相比,热敏灸组、非热敏灸组表达均明显偏低(P ＜0.05,P＜0.01),RU-486组表达升高(P ＜0.05,P＜0.01);与热敏灸组相比,非热敏灸组、RU-486组表达明显均升高(P＜0.05,P＜0.01).(2)与空白组相比,模型组、非热敏灸组、RU-486组GR表达均下降,差异均有统计学意义(均P＜0.01),热敏灸组表达无明显差异;与模型组相比,热敏灸组表达偏高,差异有统计学意义(P＜0.05),RU-486组表达偏低(P＜0.01),非热敏灸组无明显差异;与热敏灸组相比,非热敏灸组、RU-486组表达均偏低(P ＜0.05,P＜0.01).结论:热敏灸可能通过改善GR表达,恢复对HPA轴的负反馈作用,从而达到治疗IBS的目的.

目的:观察热敏灸对肠易激综合征(IBS)模型大鼠海马iGR及CORT的影响,探讨热敏灸治疗IBS的可能作用机制.方法:64只SD雄性大鼠按随机数字表随机分为空白组(8只)、模型组(8只)、艾灸组(32只)、假手术组(8只)、NMDA组(8只),空白组正常饲养,模型组、艾灸组、假手术组、NMDA组采用慢性不可预见性刺激法建立IBS模型.假手术组、艾灸组和NMDA组大鼠于造模第15天进行脑立体定位,海马处植入套管.造模结束后,艾灸组灸“命门”穴,根据大鼠尾温变化分为热敏灸组和非热敏灸组.造模完成当天、第8、15天,NMDA组海马微量注射NMDA,假手术组、艾灸组注射等量生理盐水.观察各组大鼠行为学变化.治疗结束后采用PCR方法检测海马iGR mRNA表达,放免法检测血清CORT含量.结果:(1)与空白组比较,模型组、热敏灸组、非热敏灸组、假手术组、NMDA组iGR mRNA表达降低(P＜0.01),与模型组比较,热敏灸组、非热敏灸组iGR mRNA表达增加(均P＜0.01).与非热敏灸组相比,热敏灸组在改善iGR mRNA表达方面优于非热敏灸组(均P＜0.05).(2)与空白组相比,模型组、热敏灸组、非热敏灸组、假手术组、NMDA组CORT含量均升高(均P＜0.01).与假手术组比较,热敏灸组、非热敏灸组CORT含量均明显降低(均P＜0.01).与非热敏灸组相比,热敏灸组CORT含量降低(均P ＜0.05).结论:热敏灸能改善iGR mRNA表达,降低CORT含量,改善HPAA负反馈调节,这可能是热敏灸通过HPAA途径治疗IBS的可能机制.

目的:运用系统评价与Meta分析评价灸法治疗肠易激综合征的临床有效性和安全性.方法:采用计算机检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普数据库(VIP)和万方数字化期刊群(WF)中的相关文献,经过严格地筛选后,运用Cochrane协作网提供的RevMan5.3进行Meta分析.结果:共纳入的文献有15篇,1151例患者,纳入研究普遍质量不高.Meta分析结果示:(1)灸法VS西药总有效率,RR=1.46,95%CI(1.12,1.90),Z=2.83,P=0.005,差异具有统计学意义.(2)中药汤剂配合灸法VS西药总有效率,RR=1.30,95%CI(1.12,1.51),Z=3.40,P=0.0007,差异具有统计学意义.(3)针刺配合灸法VS单纯针刺总有效率,RR=1.16,95%CI(1.05,1.29),Z=2.87,P=0.004,差异具有统计学意义.(4)针刺配合灸法VS西药总有效率,RR=1.20,95%CI(1.08,1.33),Z=3.52,P=0.0004,差异具有统计学意义.结论:灸法治疗肠易激综合征具有一定的疗效优势,但还需进一步高质量、多中心的研究.

Objective:To observe whether there was difference efficacy of moxibustion interval of unit moxibustion time X in the treatment of knee osteoarthritis.Method:80 knee osteoarthritis patients with heat-sensitized moxibustion sensation on yaoyangkuan (Du 3) were included,random number table method was used to divide patients into four groups.The four groups all used moxibustion on yaoyangkuan (Du 3).Group A received moxibustion for 15min,qd;group B received moxibustion for 15min,qod;group C received moxibustion for 40min,qod;group D received moxibustion for 40min,qd.7 times as a course of treatment,and there were two courses.Japanese orthopedic association low back pain score (M-JOA) and visual analogue scale (VAS).Results:After the two courses of treatment,there were significant differences in M-JOA and VAS among four groups (P＜0.01).There was no significant difference in M-JOA and VAS between group A and B.There was no significant difference in M-JOA and VAS between group C and D.There were significant differences in M-JOA and VAS between group A and group C and D (P＜0.05,P＜0.01,respectively).There were significant differences in M-JOA and VAS between group B and group C and D (P＜0.05,P＜0.01,respectively).Conclusion:The efficacy of moxibustion in the same heat-sensitive acupoints and saturate moxibustion was better than traditional moxibustion,and there was no significant difference in the efficacy of moxibustion at different intervals when the cumulative treatment was the same.

OBJECTIVE:To observe the effects of heat-sensitive moxibustion on corticotropin releasing hormone (CRH), adrenocorticotrophic hormone (ACTH) and corticosterone (CORT) in rats with irritable bowel syndrome (IBS), and to explore the possible mechanism of heat-sensitive moxibustion on IBS. METHODS:According to random number table, 56 SD male rats were randomly divided into a blank group (n=8), a model group (n=8), a moxibustion group (n=32), and a mifepristone group (RU-486 group, n=8). The rats in the blank group were treated with normal feeding; the rats in the model group, RU-486 group and moxibustion group were treated with chronic non-predictable stimulation for 21 days to establish IBS model. After model establishment, the rats in the moxibustion group were treated with moxibustion at "Mingmen" (GV 4) for 40 min, once a day for 14 days; the tail temperature was recorded every 5 min; according to the change of tail temperature, the rats were divided into a heat-sensitive moxibustion group and a non-heat-sensitive moxibustion group, and 8 rats were randomly selected in the two groups. The rats in the RU-486 group were treated with gastric administration of RU-486 for 14 days, while the rats in the blank group, model group and moxibustion groups were treated with identical volume of 0.9% NaCl. The rat general condition, body mass, behavioristics, intestinal propulsive rate and visceral sensitivity were observed in each group; ELISA method was used to detect serum CRH, ACTH and CORT; optical microscope was applied to observe the morphological changes of colon. RESULTS:(1) After model establishment, rats were in rest state, fatigued, with withered hair and dim ear; the stool was dry or watery; the body mass were slowly increased; the number of crossed grid and standing frequency were significantly reduced; visceral sensitivity was increased and intestinal propulsion rate was decreased; no obvious inflammatory cell infiltration was observed under microscope. (2) After intervention, compared with the blank group, the body mass and visceral sensitivity in the RU-486 group were not significantly different (both P>0.05), but the intestinal propulsion rate was decreased significantly (P<0.01). Compared with the blank group, the body mass of heat-sensitive moxibustion group and non-heat-sensitive moxibustion group was lower (both P<0.01), but the visceral sensitivity and intestinal propulsion rate were similar (both P>0.05). Compared with the model group, the body mass and visceral sensitivity were improved in the RU-486 group (P<0.05, P<0.01), but the intestinal propulsion rate was similar (P>0.05). The body mass, visceral sensitivity and intestinal propulsion rate of the heat-sensitive moxibustion group and the non-heat-sensitive moxibustion group were superior to those of the model group (P<0.05, P<0.01), and the body mass and intestinal propulsion rate of heat-sensitive moxibustion group were superior to those of non-heat-sensitive moxibustion group (both P<0.05). (3) After intervention, compared with the blank group, the contents of CRH, ACTH and CORT in the model group were significantly increased (P<0.05, P<0.01). Compared with the model group, the contents of CRH, ACTH and CORT of the heat-sensitive moxibustion group were statistically reduced (P<0.05, P<0.01), and the contents of CRH and ACTH in the non-heat-sensitive moxibustion group were statistically reduced (P<0.05, P<0.01); the content of CRH in the RU-486 group was reduced (P<0.05), but the contents of ACTH and CORT were increased (P<0.05, P<0.01). Compared with the non-heat-sensitive moxibustion group, the heat-sensitive moxibustion group was better in the improvement of CRH (P<0.05), but there was no significant difference of ACTH and CORT between the two groups (both P>0.05). CONCLUSION:Heat-sensitive moxibustion could reduce the contents of CRH, ACTH and CORT through the HPA axis, and improve the function of gastrointestinal motility to treat IBS.

Objective:To observe the clinically therapeutic effect of moxibustion on heat-sensitive moxibustion and acupoint moxibustion according to syndrome differentiation on back myofascitis.Methods:A total of 50 eligible patients were randomly divided into a treatment group (acupuncture at Ashi point plus moxibustion at heat-sensitive points,n =25) and a control group (acupuncture at Ashipoint plus acupoint moxibustion according to syndrome differentiation,n =25),one time a day,ten times as a course.The therapeutic effects were assessed according to changes of the score of the short-form of McGill pain questionnaire composing of pain rating index (PRI),visual analogue scale (VAS) and present pain intensity (PPI) before and after treatment.Results:92％ of all back myofascitis patients had heat-sensitive acupoints.Coincidence rate of heatsensitive acupoints and Ashi points was higher.Before treatment,no significant differences were found between the treatment group and the control group according to PRI,VAS and PPI.After treatment,PRI,VAS and PPI were all significantly lower in the treatment group than those in the control group (P ＜ 0.01).PRI,VAS and PPI were all lower in the treatment group than those in the control group before and after the treatment (P ＜0.01).The curative rate of the treatment group was significantly higher than that of the control group (P ＜0.05).Conclusion:Back myofascitis patients are easier to show up heat-sensitive phenomena.Heat-sensitive points have a high coincidence with Ashi points.Moxibustion at heat-sensitive acupoint is significantly superior to moxibustion according to syndrome differentiation for treating back myofascitis.

规范试验设计是进行临床研究的基础.笔者通过循证医学理念和流行病学方法,从科研设计的重复性、随机性、对照性、盲法等方面入手,具体细化阐述力敏推拿治疗腰椎间盘突出症的试验设计思路,完善力敏推拿治疗的临床试验方案,减少试验研究的偏倚因素,更真实、客观评价研究结果和结论,为临床针灸试验设计提供思路.

目的 观察热敏灸疗法对不同症型膝骨关节炎(KOA)的临床疗效,筛选热敏灸疗法对KOA的适应证.方法 将60例KOA患者按照就诊时是否肿胀分为2组,肿胀组31例,非肿胀组29例,2组均在膝关节压痛明显、皮下结节部位附近探查热敏化腧穴.治疗选取1~2个热敏化腧穴,或传统经穴施以温和灸,施灸时间以达到饱和灸量为度.比较2组治疗前后膝关节功能评分表评分变化,并统计临床疗效.结果 肿胀组治疗后疼痛、步行、关节屈曲动度、不稳定感、肿胀、上下楼梯评分及总分均较本组治疗前下降(P<0.05),且治疗前后差值大于非肿胀组(P<0.05).非肿胀组治疗后疼痛、步行、不稳定感、肿胀、上下楼梯评分及总分均较本组治疗前下降(P<0.05).2组临床疗效比较差异有统计学意义(P<0.01),肿胀组疗效优于非肿胀组.结论 热敏灸对肿胀型KOA的治疗作用明显优于非肿胀型.

Objective:To compare different moxibustion stimulation (heat-sensitive moxibustion stimulation vs non-heat-sensitive moxibustion stimulation) on Shangyintang acupoint in the treatment of allergic rhinitis.Methods:A total of 60 patients with allergic rhinitis were divided into heat-sensitive moxibustion and non-heat-sensitive moxibustion groups in accordance with their reactions to moxa-heat stimulation.Mild-warm moxibustion was distanced from skin 2-3cm and applied to bilateral Shangyintang acupoint for 45 minutes.The degree was warm but not hot.Moxibustion treatment was conducted once daily for 20 days.Patients with occurrence of heat-sensitivity being equal to and more than 3 times during the treatment were assigned to heat-sensitive group and those with occurrence of heat-sensitivity less than 3 times assigned to non-heat-sensitive group.The changes of clinical symptoms before and after treatment in two groups were observed.Results:The nasal symptoms scores of the two groups were lower than those before the treatment (P＜0.05),and the heat-sensitive group was better than the non-heatsensitive group (P＜0.05);the effective rate of the heat-sensitive group was 73.53％,compared with the non-heat-sensitive group,the difference was statistically significant (P＜0.05).Conclusion:Heat-sensitive moxibustion is significantly better than nonheat-sensitive moxibustion in the treatment of allergic rhinitis.The emergence of the heat-sensitivity to moxibustion is the key to improve the curative effect of moxibustion therapy.

微透析采样技术(microdialysis sampling)是一种常用于科学实验的活体生物微量采样技术, 1972年首次应用于神经生化实验.该技术以小分子物质顺浓度梯度扩散特性作为理论基础,将一种具有透析作用的探针埋置于实验预采样的活体组织中,灌流液在透析探针导管中通过微量进样泵和控制器以特定速率进行推进,经过部分配有半透膜的探针和精密灌流体系对半透膜两边的物质进行互换(透析),通过灌流液收集系统来收集透析样本,微透析收集到的样品能够直接使用电化学、紫外、质谱等检测技术进行物质含量检测分析,可实现对灌流液中可溶性物质变化的连续监测.