目的:总结重症肌无力的发病特点,中医辨证,诊疗经验。方法:选择天津中医药大学第一附属医院重症肌无力患者1例给与服用补中益气汤加减并与针灸治疗。结果:经治疗12周后患者基本痊愈,未见副作用。结论:对于重症肌无力,中医药早期参与治疗有重要意义。

<正>病历摘要患者男,62岁,因"双眼间断一过性黑蒙5 d"于2012年8月15日收入天津市南开医院神经内科。患者入院前5 d,因情绪波动出现头晕、头沉、双眼黑蒙、视物不能,并伴有轻度恶心,无呕吐,无头疼,无肢体运动障碍,无抽搐及肢体感觉异常,发作10 min后头晕、黑蒙症状缓解,并自觉全身乏力。入院前1d再次出现头晕、黑蒙,症状同前,数分钟后缓解。

Objective To investigate the clinical efficacy of acupuncture plus Chinese herbal medicine hot compress in treating restless leg syndrome.Methods One hundred and twelve patients with restless leg syndrome were randomly allocated to treatment and control groups,56 cases each.The treatment group received acupuncture plus Chinese herbal medicine hot compress and the control group,medication.The improving effects on restless leg syndrome and sleep quality were evaluated using the Restless Leg Syndrome Rating Scale(RLSRS) and the Pittsburgh Sleep Quality Index(PSQI),respectively,in the two groups after three courses of treatment.Results There was a statistically significant post-treatment difference in the RLSRS score between the treatment and control groups(P<0.05).There were statistically significant post-treatment differences in PSQI sleep quality,sleep time,sleep drug and daytime dysfunction subscores,and the PSQI total score between the treatment and control groups(P<0.01).There were statistically significant post-treatment differences in the RLSRS and PSQI scores between the two groups(P<0.01,P<0.05). Conclusion Acupuncture plus Chinese herbal medicine hot compress is an effective way to treat restless leg syndrome.

From the pathogenesis,clinical medicine (diarrhea,constipation,traditional Chinese medicine, acupuncture and massage therapy) and other summarized in the treatment of irritable bowel syndrome medicine clinical research.That Chinese medicine in improving the symptoms and shorten the course of treatment and long - term effect has certain advantages,but less basic research,efficacy evaluation method is not uniform.

[Objective] To observe the effects of Ginkgo biloba extract EGB761 on serum SOD,MDA,GSH-PX in rabbits with cholesterol-copper induced Alzheimer dementia.[Methods] The cholesterol-copper induced Alzheimer dementia in rabbit was established by modi-fied D.Larry Sparks’ methods.EGB761 was used to treat the rabbits per oral at a dose of 50 mg(kg.d) for 3 weeks.Then serum MDA con-tent,SOD and GSH-PX activity of rabbit were observed and compared between groups.[Results] MDA content and SOD and GSH-PX activity was obviously increased in rabbit with cholesterol-copper induced Alzheimer dementia with significant difference compared to control group(P0.05).In EGB761 group MDA content and SOD and GSH-PX activity was obviously declined compared with model group(P0.05).Compared with control group SOD level in EGB761 group showed decreasing tendency,and GSH-PX levels showed in-creasing trend without any statistical significance.[Conclusion] Obviously peroxidation injury was existed in rabbit with cholesterol-cop-per induced Alzheimer dementia.EGB761 has a certain protective effect against it.

[Objective] To investigate the effects of Liuweidihuang pills and aerobic exercise on blood glucose,insulin and glucose transporter-4 (GLUT-4) in rats with diabetes mellitus (DM). [Methods] Alloxan was intravenously injected into rats' tails to establish DM rats' models. These rats were divided into four groups at random according to the level of blood glucose and body weight:DM group (model group),aerobic exercise group,Liuweidihuang pills group,aerobic exercise and Liuweidihuang pills group. They were given distilled water and Liuweidihuang pills by stomach infusion respectively. Meanwhile control group was set up. After six weeks we measured the rats' blood glucose,the blood insulin. The expressions of GLUT-4 gene in skeletal muscle were measured by RT-PCR. [Results] The GLUT-4 of rats in DM group decreased,the blood glucose increased obviously. The blood glucose of rats in Liuweidihuang pills group and aerobic exercise group declined markedly,GLUT-4 increased obviously. [Conclusion] The aerobic exercise and Liuweidihuang pills can improve the level of gly-cometabolism to a certain extent,and this protective mechanism may be related to the enhanced GLUT-4 gene expression in the skeletal muscles of diabetic rats.

[Objective] To observe the bone metabolism-related biochemical changes in urine in castrated rats and explore the therapeutic mechanism of acupuncture and moxibustion in treating osteoporosis. [Methods] Forty Wistar rats were divided into 5 groups: sham operation group, model group, acupuncture group and moxibustion group. After the model was established, the rats in acupuncture and moxibustion were given acupuncture and moxibustion at the point of shenshu, sanyinjiao once a day for altogether 60 days. After that in the next day, blood and urine were obtained for determination of ALP and DPD. [Results] In both treatment groups blood ALP was increased when compared with that of model group. Simultaneously, their DPD concentration in urine was significantly lower than that in control group. [Conclusions] Acupuncture and moxibustion possesses a benign regulatory effect on bone metabolism in castrated rats.

Objective:To investigate the effects of Liuwei Dihuang Pills on blood glucose,insulinand glucosu transporter-4(GLUT-4) of diabetes mellitus(DM) rats. Method:Alloxan was intravenous injected(in rats' tails) to establish DM rats' models. The rat models of DM were divided into two groups at random according to the blood glucose and weight,they were diabetes mellitus(DM) group(model group) ,Liuwei Dihuang Pills group(treatment group) ,and they were given distilled water and Liuwei Dihuang Pills by stomach lavaging respectively. Meanwhile control group was set up. After six weeks we measured the rats' general condition,the blood glucose,the blood insulin. Expressions of GLUT-4 gene in skeletal muscle were measured by RT-PCR. Results:The weight and GLUT-4 of rats in DM group decreased,the blood glucose increased obviously;The weight of rats in Liuwei Dihuang Pills group gained gradually,the blood glucose declined markedly,GLUT-4 increased obviously.Conclusion:Liuwei Dihuang Pills can gain weight of diabetes mellitus(DM) rats,and improve the level of glycometabolism to a certain extent,and this protective mechanism may be relative to the enhanced GLUT-4 gene expression in the skeletal muscles of diabetic rats.

No matter in the past or now, scholars are always having different ideas on classification methods of needling fundamental manipulation, but the unified standardization is not yet formed.In the article, the author refers to both ancient literature and modern literature with his prehension as an addition to analyze and sum up the summarize in order to propose a suggestion of the standardization in classification methods of needling fundamental manipulation.

目的探讨力量训练对2型糖尿病的治疗作用。方法对2型糖尿病患者(运动组)8w力量训练前、后血糖、糖化血红蛋白(HbA1C)、胰岛素敏感性、血脂、体重指数(BMI)进行分析,并与同等条件的对照组进行对比。结果运动组训练后血糖、胰岛素、HbA1C、BMI明显降低,与对照组相比差异有统计学意义(P<0.05或P<0.01),胰岛素敏感性显著增加,与对照组相比差异有统计学意义(P<0.01);对照组无明显变化(P>0.05)。结论8w力量训练对2型糖尿病患者糖代谢具有明显改善作用。

为探讨中医对颈椎病的诊断和治疗的认识,对近3年来部分有代表性的文献进行了研究,认为颈椎病根据其不同的病因病机和临床表现以及损伤部位可分为不同的类型。对颈椎病的治疗有针灸、穴位贴敷、中药热透、穴位注射、刮痧、手法推拿等等,均有较好的临床疗效。

《内经》中"经脉"实际包含两套完全不同的脉道系统,即行气之脉--十二经脉,和行血之脉--血脉.气血是分离的,气即卫气,血即营血,二者各自运行于这两套不同的脉道之中.古人误将"内视"所见的行气之脉与解剖所见的行血之脉及各自脉中的气血视为一体,导致了气脉与血脉、气与血相互混淆的错误.

吸烟危害人体健康,已为世人所公认.烟在燃烧时会产生3000多种有害物质,诸如尼古丁(烟碱)、烟焦油、一氧化碳、醛类和胺类等,是导致人类慢性支气管炎、肺气肿、高血压、冠心病、糖尿病、多种癌症、男性不育症、胎儿畸形等多种系统多种疾病的危险因素之一.针灸戒烟作为一种操作简便、疗效确切、副作用少的绿色疗法,越来越受到人们的重视.现将近年来国内针灸戒烟的研究概况综述如下.

[Objective] To research the mechanism of acupuncture for relifing lobour pain.[Methods] To evaluate the effect for relifing lobour pain,we used Keele staff diagram grade-evaluating method and VRS pain-classifying method as the observation.To observe the effect of acupuncture on mother and infant,such as the stages of labor of the parturient were recorded.To research the mechanism of relifing lobour pain,we observed the concentration changes of β-EP and 5-HT in the blood of parturient before and after acupunctured.[Result] The acupuncture can effectively relieve lobour pain in the first stage of labor.And compared with the comparing group,it differed significantly(P0.05) and had no harmful effects on the mother and infant.This method can obviously improve the concentration of β-EP and 5-HT in the blood of parturient.[Conclusion] Taking the acupuncture as the means of relifing lobour pain has the merits of convenient manipulation,safety,reliable effect on analgesia and without side effect and so on.The effect of acupuncture for relifing lobour pain may be produced by the joint-work of CNS and directly effect on the uteri.

大动脉炎是发生在主动脉及其分支的慢性非特异性炎性改变.其中头臂动脉型以脑部及上肢缺血为主症,属中医"无脉症"范畴.多年来我们采用针灸治疗本病取得满意效果,并从经颅超声多普勒角度探讨其疗效机制,现报告如下.

[目的]观察针刺对多发梗死性痴呆(MID)模型大鼠大脑皮层bcl-2和bax mRNA及蛋白表达的影响.[方法]通过向颈内动脉注入自体血栓的方法建立大鼠MID模型.将大鼠随机分为模型组、针刺组、非穴组和假手术组.针刺组取人中、内关、风池穴,非穴组取双侧胁下两固定非穴点,针刺1次/d.模型组与假手术组进行与针刺组和非穴组相同时间、相同程度的捉抓.连续针刺2周后断头处死,取左侧大脑.原位杂交和免疫组化法观察皮层bcl-2和baxmRNA及蛋白的表达.[结果]模型组bcl-2和bax mRNA和蛋白的表达均增加;针刺后,bcl-2mRNA和蛋白的表达进一步增加,bax mRNA和蛋白的表达减少.[结论]针刺可促进MID模型大鼠大脑皮层bcl-2的表达,抑制bax的表达,从而保护脑组织,且这种作用具有穴位特异性.

目的:采用客观、严格的诊断及疗效评定标准开展针灸治疗本病的临床研究,以确定其疗效.方法:选取80例患者(头臂动脉型),随机分为针灸组和药物组各40例,比较两组的疗效.结果:针灸组临床治愈率15%,显效率62.6%,总有效率95%;药物组显效率12.5%,总有效率75%.两组比较有显著性差异(P＜0.01).结论:提示针灸治疗多发性大动脉(头臂动脉型)疗效确切,明显优于目前常规药物疗法.

目的:观察针刺"水沟"、"内关"、"太冲"穴对快速老化脑萎缩模型小鼠(SAM-P/10)脑丙二醛含量(MDA)、超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)活性的影响.结果:针刺可降低模型动物MDA含量,提高抗氧化酶活性.结论:抗氧化酶活性降低可能是脑老化的重要因素,针刺可从整个抗氧化体系水平提高机体抗氧化能力,减少自由基代谢产物,从而起到延缓脑老化的作用.

本研究以热凝法阻断大鼠一侧大脑中动脉造成实验性脑梗塞模型,观察了实验性脑梗塞模型大鼠脑缺血后不同时段皮质、纹状体、海马早期快反应基因c-fos、HSP70基因表达水平及针刺的干预作用,从基因水平探讨了针刺治疗脑梗塞的作用机制,结果表明: 1用免疫组化法观察缺血区脑组织c-fos、HSP70蛋白的动态变化及针刺的干预作用,结果提示:脑缺血能诱导c-fos、HSP70蛋白的表达,并随时间的延长(1～48 h)逐渐增加.针刺能增强各时段c-fos、HSP70蛋白的表达,提高神经细胞的应激能力,促进神经细胞对脑缺血损伤产生适应性变化,增强脑组织的修复能力."醒脑开窍"针法作用优于常规针刺法.