BackgroundAcupuncture is a widely practiced, convenient, and safe treatment modality within complementary and integrative medicine. Increasing studies have revealed the efficacy of acupuncture for the treatment of osteoporosis in both human and non-human subjects. The aim of the present study was to assess the improvement of osteoporosis after overall adjustment acupuncture (OA) as well as its endocrine-modulating effect in an ovariectomized rat model.MethodsIn total, 32 female Sprague–Dawley (SD) rats were randomly divided into the sham, model, ovariectomy+estrogen (OVX+E), and OVX+OA (OVX+A) groups with eight rats in each group. The postmenopausal osteoporosis (PMOP) rat model was induced by bilateral ovariectomy. At 12 weeks after surgery, rats in the OVX+E group received estradiol (0.2 mg/kg/i.g./qod) for 12 weeks, and rats in the OVX+A group were treated with acupuncture at Zusanli (ST36), Shenshu (BL23), and Dazhu (BL11) points (qod) for 12 weeks. At the end of the treatment, all rats were sacrificed, and the body weight, uterus index, bone mineral density (BMD), bone mineral content (BMC), bone trabeculae structural parameters, femoral biomechanical properties, femoral histomorphology, and several hormone levels were examined.ResultsIn OVX rats, OA abrogated the body weight gain and improved osteoporosis in terms of BMD, BMC, bone trabeculae structural parameters, bone strength, and bone tissue histomorphology. Moreover, OA modulated the serum levels of estradiol, corticotropin releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and corticosterone (CORT).ConclusionsOA improves osteoporosis and exerts an endocrine-modulating effect in ovariectomized rats.

目的:观察整体调节针法联合唑来膦酸治疗老年骨质疏松性椎体压缩骨折(osteoporotic ver-tebral compression fracture,OVCF)的临床疗效.方法:将72例老年OVCF患者分为两组各36例,对照组在接受经皮椎体后凸成形治疗基础上加用唑来膦酸,治疗组在对照组基础上加用整体调节针法.分别在治疗前和治疗3个月及治疗后随访6个月评定两组患者视觉模拟疼痛评分(visual analog scale,VAS)和Qswestry功能障碍指数评分(Oswestry disability index,ODI)、患者生活质量评分(quality of life assessment,QOL)、骨密度及不良反应.结果:治疗后两组患者VAS、ODI及QOL评分均低于治疗前(P<0.05),治疗组低于对照组(P<0.05);治疗3个月,两组患者骨密度与治疗前比较差异无统计学意义(P>0.05),治疗后随访6个月,两组患者骨密度高于治疗前(P<0.05),治疗组高于对照组(P<0.05).不良反应治疗组低于对照组,差异有统计学意义(P<0.05).结论:整体调节针法联合唑来膦酸能够减轻老年OVCF患者症状,改善生活质量,提高骨密度,降低药品不良反应,效果优于单用唑来膦酸.

目的 基于文献分析我国针灸治疗绝经后骨质疏松症(post menopausal osteoporosis,PMOP)的选穴规律和作用机制,为进一步开展针灸治疗PMOP的研究提供参考依据.方法 通过CNKI检索自2015年以来公开发表于国内期刊的与针灸治疗PMOP相关的文献,对针灸治疗PMOP的选穴规律、作用机制等特点进行总结.结果 ①文献共检索到63篇,最终纳入41篇.②关于针灸治疗PMOP的选穴频次,使用频次较高的穴位是足三里、肾俞、脾俞.③使用频次最多的腧穴主要分布于膀胱经、督脉、脾经和肾经.④针灸可以通过调整PMOP患者的骨代谢,调节性激素水平,调控信号通路,改善瘦素等途径来治疗骨质疏松.结论 近年来在PMOP的研究领域中,科研学者们经过不懈努力取得了硕果,关于针灸治疗PMOP的机制也越来越多,治疗也创新出了很多方法与途径,但同时也存在一些问题,希望未来的研究者继续努力,深入探索,推动PMOP向进一步发展.

目的:分析针灸治疗绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)的研究特点.方法:通过检索中国知网数据库自2015年以来公开发表的相关文献资料,对针灸治疗PMOP的文献类型、诊断标准、治疗方法、对照用药、治疗周期等特点进行分析和总结.结果:1)共检索到相关文献60篇,最终纳入48篇.2)根据文献类型,可将文献分为临床研究、动物实验研究、综述.其中,临床研究24篇,占50％;动物实验研究14篇,占29％;综述10篇,占21％.3)针灸治疗PMOP的治疗方法众多,包括针灸治疗、艾灸治疗、穴位注射治疗、穴位埋线治疗、针灸联合药物治疗等,其中针灸联合药物治疗较多,约占38％.4)PMOP的相关临床研究诊断标准以《中国人骨质疏松症建议诊断标准》《中药新药临床研究指导原则》居多,均占29％.5)针灸治疗PMOP临床研究的文献中,常规治疗体穴有31个,分别分布于足太阳膀胱经、足阳明胃经、足少阳胆经、足太阴脾经、足少阴肾经、任脉、督脉、手少阳三焦经、经外奇穴.6)针灸治疗PMOP的临床研究周期普遍偏短.7)关于PMOP临床研究的疗效评价指标以骨密度、骨代谢生化指标为主,还有较大比例的文献研究以观察临床症状为主,约占46％;而动物实验研究的疗效评价指标主要以骨密度为主,约占79％.结论:近年来针灸治疗PMOP的临床研究及动物实验研究均取得了一定进展,相关研究还在不断深入,但同时也存在不少问题,针灸治疗PMOP的研究有待于进一步完善并向更深领域发展.

Review question / Objective: Which external treatment combined with Acupuncture and moxibustion is the most e ff ective treatment for osteoporosis patients? The aim of this systematic review and Network Meta-Analysis is to compare the e ff ect of acupuncture and acupuncture combined with various external treatments of traditional Chinese medicine, to improve the existing treatment of acupuncture and moxibustion, to scientifically evaluate the e ffi cacy of acupuncture and moxibustion in the treatment of osteoporosis and to provide the basis for clinical selection of acupuncture and moxibustion therapy in the treatment of osteoporosis, based on evidence-based medicine for systematic review and Network Meta-Analysis. Participant ： Patients with primary osteoporosis Intervention ： Acupuncture and moxibustion combined with various external treatments of TCM Comparison: Acupuncture, Traditional Chinese Medicine Decoction, Conventional Western Medicine Outcome: To improving

Background. Acupoint embedding treatment on obesity has been applied in clinical practice for many years and has achieved obvious efficacy. However, animal experimental studies on acupoint embedding are relatively few, and its mechanism remains unclear. Methods. We established a simple obese rat model using a high-fat diet for 8 weeks. Acupoint embedding therapy was performed once a week for 4 weeks. After the treatment, serum leptin, triglyceride (TG), cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels were detected by radioimmunoassay, HE staining was used for fat morphology analysis, and immunohistochemical method was used to detect the expression of leptin receptor in hypothalamus. Results. Compared with model group, acupoint embedding treatment can reduce body weight and Lee's index, reduce serum leptin, TG, TC, and LDL level, increase HDL level, change the morphology and number of adipocytes, and increase the expression of leptin receptor in hypothalamus. Conclusion. Acupoint embedding therapy can reduce the level of leptin in blood, increase the number of leptin receptors in hypothalamus, enhance the biological effect of leptin, alleviate the leptin resistance in obese body, change the shape of fat, and regulate the level of blood lipid, so as to achieve the goal of weight loss.

目的 探讨针灸疗法治疗原发性骨质疏松症骨代谢的研究特点.方法 翻阅在2008-2018年发表的有关针灸治疗对原发性骨质疏松症骨代谢影响的相关文献,并对针灸治疗的文献类型、疗效性、指导原则、骨代谢指标应用规律进行深度分析.结果 发现在文献中以临床研究为主,机制研究和综述较少;针灸疗法对原发性骨质疏松症骨代谢具有改善作用,主要是针灸通过促进骨形成、抑制骨吸收的途径;指导原则以补肾健骨、健脾补肾调肝、活血化瘀为主;代谢指标中首推血清Ⅰ型前胶原氨基端前肽和骨吸收标志物中β-Ⅰ型胶原羧基端肽.结论 针灸疗法对原发性骨质疏松症骨代谢的影响上,现在还处于初起阶段,临床研究逐渐增多,机制探索渐趋完善;在临床中疗效显著;指导原则基本确立;骨代谢指标中血清Ⅰ型前胶原氨基端前肽和骨吸收标志物中β-Ⅰ型胶原羧基端肽因其敏感性、动态监测性等今后将成为研究者的首选指标.

文章通过回顾中国知网数据库自2014年以来公开发表的相关文献资料,对针灸治疗多囊卵巢综合征排卵障碍的文献类型、诊断标准、治疗方法、对照用药、研究周期等规律和特点进行分析总结.