头穴久留针治疗血管性痴呆30例

目的观察头穴久留针治疗血管性痴呆(vascular dementia,VD)的临床疗效。方法将60例VD患者随机分为治疗组和对照组,每组各30例,治疗组运用头穴久留针法针刺治疗,对照组采用常规针刺法治疗,治疗8周后观察并比较两组患者简明精神状态量表(mini mental state examination,MMSE)评分、Blessed痴呆量表(Blessed dementia scale,BDS)评分、Barthel指数(Barthel index,BI)及临床疗效。结果治疗组临床疗效显著优于对照组(P0.05);两组治疗后MMSE、BDS评分及BI均较治疗前显著升高(P0.01),但治疗组治疗前后MMSE、BDS、BI差值均显著大于对照组(P0.01)。结论头穴久留针法治疗血管性痴呆疗效确切,优于常规针刺疗法。     

rTMS联合醒脑开窍针法对脑梗死后血管性痴呆患者MMSE评分及日常生活能力的影响

目的探讨重复经颅磁刺激(rTMS)联合醒脑开窍针法对脑梗死后血管性痴呆(VD)患者认知功能评分(MMSE)及日常生活能力的影响。方法选取2014年2月至2016年3月洛阳市第二中医院收治的116例脑梗死后VD患者,按随机数表法分组,各58例。对照组接受rTMS治疗,观察组接受rTMS+醒脑开窍针法治疗,均治疗4周。统计对比两组治疗前后MMSE评分及日常生活能力评分(ADL),比较两组临床疗效。结果经治疗,观察组MMSE评分较对照组升高,ADL评分较对照组降低,差异有统计学意义(P均<0.05);治疗后观察组总有效率为94.83%(55/58),高于对照组的81.03%(47/58),差异有统计学意义(P<0.05)。结论 rTMS联合醒脑开窍针法治疗脑梗死后VD可改善患者认知功能,提高其日常生活能力,疗效确切。     

醒脑开窍针法联合康复训练改善脑卒中后偏瘫的疗效分析

目的探讨醒脑开窍针法联合康复训练治疗脑卒中后偏瘫的临床疗效。方法将2015年3月—2016年8月本院收治的脑卒中后偏瘫患者90例,参照随机原则分为对照组和联合组,每组45例,对照组采用康复训练,联合组采用醒脑开窍针法联合康复训练,治疗1个月后比较2组的临床康复效果。结果治疗前,2组Fugl-Meyer上肢运动功能评定量表(FMA)评分和Barthel指数比较,差异均无统计学意义(P0.05)。治疗后,2组FMA评分和Barthel指数均较治疗前显著改善(P0.05),且联合组的FMA评分和Barthel指数均较对照组更高,组间比较,差异均有统计学意义(P0.05)。结论对脑卒中后偏瘫患者予以醒脑开窍针法联合康复训练,有利于患者的运动功能和日常生活能力的恢复,具有临床推广意义。     

柿叶提取物治疗血管性痴呆的疗效观察

目的 观察柿叶提取物治疗血管性痴呆的临床疗效.方法 85例血管性痴呆患者,按随机数字表法分为观察组42例与对照组43例.两组均给予常规治疗及基础疾病治疗,观察组再给予柿叶提取物治疗,对照组再给予尼膜同片治疗,疗程均为6个月.观察两组治疗前后简易精神状态量表(MMSE)评分及Barthel指数评分.结果 治疗前两组MMSE、Barthel指数评分比较,差异无统计学意义(P＞0.05);治疗6个月后两组MMSE、Barthel指数评分均明显高于治疗前(P＜0.05),并且观察组MMSE、Barthel指数评分明显高于对照组(P＜0.05).结论 柿叶提取物能够显著改善血管性痴呆患者认知功能,提高患者生存质量.     

醒脑开窍针法联合腹针治疗中风偏瘫的临床疗效观察

目的应用随机对照的方法客观评价醒脑开窍针法联合腹针疗法治疗中风后偏瘫的临床疗效,比较醒脑开窍针法联合腹针和单纯醒脑开窍的疗效优势,提出针刺优化方案。方法将72例合格受试患者随机分为醒脑开窍针法联合腹针组(试验组36例)和单纯醒脑开窍组(对照组36例),分别给予不同方法治疗4周,于治疗前后使用统一相关量表进行疗效评价。结果治疗后2组Fugl-Meyer、BI指数评分均有改善,2组自身对照差异均有统计学意义(P<0.01);2组间比较,差异有显著性(P<0.05),试验组疗效优于对照组。结论醒脑开窍针法联合腹针治疗中风后偏瘫疗效确切,优于单纯醒脑开针法。     

早期醒脑开窍针法联合通心络胶囊治疗急性脑梗死合并心衰患者的临床疗效研究

目的探讨早期醒脑开窍针法联合通心络胶囊治疗急性脑梗死合并心衰患者的临床疗效。方法选取2016年1月至2018年6月期间我院收治的脑梗死急性期合并心衰患者102例,根据治疗方法不同分为治疗组和对照组,每组51例,对照组给予通心络胶囊和常规治疗,治疗组在对照组基础上给予醒脑开窍针法治疗。比较两组治疗前后心功能指标和神经功能评分情况。结果治疗后两组心功能指标LVEF明显升高(P0.05),LVESD、LVEDD指标明显降低(P0.05),且治疗后治疗组LVEF指标明显高于对照组(P0.05),LVESD、LVEDD指标明显低于对照组(P0.05)。治疗后两组NIHSS评分明显降低(P0.05),Barthel指数评分明显升高(P0.05),治疗组NIHSS、Barthel指数评分改善情况优于对照组(P0.05)。结论早期醒脑开窍针法联合通心络胶囊可有效改善急性脑梗死合并心衰患者的心功能和神经功能,疗效显著。     

醒脑开窍针刺法对血管性痴呆患者IGF-1、MMP-2、MMP-9表达的影响

目的:探讨醒脑开窍针刺法对血管性痴呆患者胰岛素样生长因子-1(insulin-like growth factors,IGF-1)以及基质金属蛋白酶2(matrix metalloproteinase-2,MMP-2)、MMP-9表达的影响。方法:收集140例血管性痴呆患者,随机分为观察组和对照组,每组各70例。观察组患者采用基础治疗联合醒脑开窍针法,对照组患者采用基础治疗,并针刺观察组所取穴位的旁开0.5 cm非经非穴点。观察并比较两组患者治疗前后简易智能状态量表(mini-mantal state examination,MMSE)评分、IGF-1、MMP-2、MMP-9水平。结果:与治疗前相比,治疗后两组患者的MMSE评分、IGF-1水平均升高,MMP-2、MMP-9水平均下降,差异具有统计学意义(P0.05);与对照组相比,观察组患者的MMSE评分、IGF-1水平较高,MMP-2、MMP-9水平较低,差异具有统计学意义(P0.05)。结论:醒脑开窍针刺法能够明显改善血管性痴呆患者血清IGF-1、MMP-2、MMP-9水平,并可显著改善患者的认知功能,其作用机制可能与下调血清MMP-2、MMP-9水平,提高IGF-1的水平有关,具体作用机制有待于进一步论证研究。     

醒脑静注射液联合尼莫地平治疗血管性痴呆临床观察

目的:探讨醒脑静注射液联合尼莫地平治疗血管性痴呆的临床疗效。方法:选择血管性痴呆患者83例,随机分为治疗组和对照组。治疗组给予尼莫地平联合醒脑静注射液治疗,对照组给予尼莫地平治疗。两组疗程均为4周。对两组患者治疗前后进行MMSE和ADL评分,并评定两组患者的治疗效果。结果:①两组总有效率比较,差异有统计学意义(P<0.05);②两组患者治疗后MMSE及ADL评分分别和治疗前比较,差异有统计学意义(P<0.05);治疗组治疗后MMSE和ADL评分与对照组治疗后比较,差异有统计学意义(P<0.05)。结论:醒脑静注射液联合尼莫地平治疗血管性痴呆,能够显著改善患者智力和生活活动能力,治疗效果显著,值得临床借鉴。     

醒脑开窍针法联合体外冲击波治疗对脑卒中后肩手综合征的康复效果

目的 观察醒脑开窍针法联合体外冲击波治疗对脑卒中后肩手综合征的康复效果。方法 选择2017年7月至2019年6月于浙江省舟山医院康复医学科脑卒中存在肩手综合征功能障碍的56例患者,采用随机对照法以入院先后顺序随机分为对照组和治疗组。每组各28例。在常规药物、康复治疗基础上,对照组给予单纯醒脑开窍针刺法治疗,治疗组给予醒脑开窍针刺法结合体外冲击波治疗。根据上肢Fugl-Meyer运动功能评分法(FMA)、视觉模拟评分法(VAS)、疗效标准等指标评价两组患者临床疗效,观察治疗4周后患者肩手综合征功能障碍的改善情况。结果 治疗后治疗组FMA评分较治疗前明显升高(P0.05),对照组治疗前后FMA评分比较,差异无统计学意义(P0.05);治疗前两组患者FMA评分比较,差异无统计学意义(P0.05),治疗后治疗组FMA评分明显高于对照组,差异有统计学意义(P0.05)。治疗后两组VAS评分均较治疗前明显降低(P0.05),治疗组VAS评分显著低于对照组,差异有统计学意义(P0.05)。治疗组总有效率为89.29%,明显高于对照组的64.29%,差异有统计学意义(P0.05)。结论 醒脑开窍针法联合体外冲击波治疗对脑卒中后肩手综合征的临床疗效优于单纯给予醒脑开窍针刺治疗。     

针灸治疗68例血管性痴呆患者的临床疗效观察

目的评价针灸在血管性痴呆治疗上的临床治疗效果。方法68例轻、中度血管性痴呆患者随机分成针灸组和对照组,两组均口服欣络舒;针灸组在口服欣络舒同时针刺百会、风池、内关、神门、三阴交、足三里穴,艾灸神阙穴。应用简易智力状态检查量表（MMSE）和日常生活活动能力量表（Barthel指数）评定疗效。结果12周末针灸组和对照组患者MMSE和Barthel指数评分较入组时差异均有统计学意义（P〈0．05）,与对照组比较,12周末针灸组患者MMSE和Barthel指数评分较对照组差异有统计学意义（P〈0．05）。结论针刺百会、风池、内关、神门、三阴交、足三里穴和艾灸神阙穴可明显提高血管性痴呆患者的MMSE和Barthel指数评分,改善认知功能,提高日常生活活动能力。     

Acupuncture

NIN Consensus Development Panel on Acupuncture

JAMA. 1998;280:1518-1524.

Objective.— To provide clinicians, patients, and the general public with a responsible assessment of the use and effectiveness of acupuncture to treat a variety of conditions.

Participants.— A nonfederal, nonadvocate, 12-member panel representing the fields of acupuncture, pain, psychology, psychiatry, physical medicine and rehabilitation, drug abuse, family practice, internal medicine, health policy, epidemiology, statistics, physiology, biophysics, and the representatives of the public. In addition, 25 experts from these same fields presented data to the panel and a conference audience of 1200. Presentations and discussions were divided into 3 phases over 2 days: (1) presentations by investigators working in areas relevant to the consensus questions during a 2-day public session; (2) questions and statements from conference attendees during open discussion periods that were part of the public session; and (3) closed deliberations by the panel during the remainder of the second day and morning of the third. The conference was organized and supported by the Office of Alternative Medicine and the Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md.

Evidence.— The literature, produced from January 1970 to October 1997, was searched through MEDLINE, Allied and Alternative Medicine, EMBASE, and MANTIS, as well as through a hand search of 9 journals that were not indexed by the National Library of Medicine. An extensive bibliography of 2302 references was provided to the panel and the conference audience. Expert speakers prepared abstracts of their own conference presentations with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience.

Consensus Process.— The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in the open forum and scientific literature. The panel composed a draft statement, which was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately following its release at the conference and was updated with the panel's final revisions within a few weeks of the conference. The statement is available at http://consensus.nih.gov.

Conclusions.— Acupuncture as a therapeutic intervention is widely practiced in the United States. Although there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations, such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.

     

试论针刺反应与针刺效应的关系

针刺反应与针刺效应密切相关,针刺反应可在穴位局部及全身形成相互联系的网络,其中被证实有关键响应介质的参与,使在穴区的神经细胞、肥大细胞以及相关化学物质形成良性循环的小网络,其中一些介质激活全身性的神经-免疫-内分泌大网络循环,若阻断关键响应介质可明显减低局部小网络的反应程度以及相应的针刺效应。因此,关键响应介质是维持针刺反应网络中各单元相互联系的枢纽,是针刺反应中不可缺少的一部分,并且支撑着反应网络内部的脆弱联系,但从反应到效应的具体路径和机制尚不明确。     

耳针、体针、耳体针结合治疗单纯性肥胖病临床疗效比较

目的：观察耳针、体针、耳体针结合单纯性肥胖病的疗效。方法：将195例单纯性肥胖病人分为耳针组，体针组，耳体针结合组分别施治，并视不同证型施以相应补泻手法。结果：体针组与耳体针结合组疗效明显优于耳针组，体针组证型与疗效无明显关系，而耳针组胃肠实热型疗效高于脾虚湿阻型，肾气不足型和肝郁气滞型。结论：耳体针结合治疗单纯性肥胖疗效较好。     

岭南针灸名医曾天治《科学针灸治疗学》学术探析

[目的]探讨岭南针灸名医曾天治《科学针灸治疗学》的学术成就。[方法]采用传统文献学的研究方法,认真研读原文,对全书进行总结、概括。[结果]《科学针灸治疗学》的学术思想可概括为：针灸治疗具有科学性;确定穴位正确位置的标准;分析各病证的治疗原理;中西汇通治疗疾病;针灸治疗成功的内外因素。[结论]本书汇通中西医学,开中西医学汇通之先河;其丰富的针灸学知识,留给后世的宝贵财富。在一定意义上推广了针灸医学的发展。曾氏的治学经历及临床经验,值得我们借鉴与学习。