Depressive Neurosis Treated by Acupuncture for Regulating the Liver -A Report of 176 Cases

Objective： To observe therapeutic effect of acupuncture for regulating the liver on depressive neurosis. Methods： In a multi-center randomized controlled trial, 440 patients were divided into 3 groups： Acupuncture group for regulating the liver （Acup., 176 cases） was treated by acupuncture at Siguan Points, i.e. bilateral Hegu （LI 4） and Taichong （LR 3）, Baihui （GV 20） and Yintang （EX-HN3） plus ear-acupuncture, Prozac group （P., 176 cases） by oral administration of Prozac, and Non-acupoint needling group （NAN, 88 cases） by acupuncture at non-acupoints as acupuncture placebo. Self-rating Depression Scale （SDS） was examined before treatment, and one month, two and three months after treatment respectively to evaluate therapeutic effect, and Rating Scale for Side Effects （SERS） was used to evaluate the safety. Results： After one month of treatment, SDS scores in Acup. Group were significantly lower than that in P. Group （P〈0.05） and than that in NAN Group （P〈0.01）, and SDS scores in P. Group were lower than that in NAN Group （P〈0.05）, showing the SDS scores in Acup. Group 〈P. Group 〈NAN Group. After 2 months of treatment, SDS scores in Acup. Group were also significantly lower than that in P. Group （P〈0.01） and than that in NAN Group （P〈0.01）, and SDS scores in P. Group were also lower than that in NAN Group （P〈0.05）, showing the SDS scores in Acup. Group 〈P. Group 〈NAN Group. After 3 months of treatment, SDS scores in Acup. Group were also significantly lower than that in P. Group （P〈0.01） and than that in NAN Group （P〈0.01）, and SDS scores in P. Group were also lower than that in NAN Group （P〈0.01）, showing the SDS score in Acup. Group 〈P. Group 〈NAN Group. After treatment, SERS scores were 0.16±0.95, 6.51±5.09 and 0.23±1.36 in Acup. Group, P. Group and NAN Group respectively. A significant difference existed between Acup. Group and P. Group （P〈0.05）, but no significant difference between Acup. Group and NAN Group （P〉0.05）, showing the SERS scores in Acup. Group 〈NAN Group 〈P. Group. No side effect was found in Acup. and NAN groups. Conclusion： The therapeutic effect of acupuncture on depressive neurosis is better than or similar to that of Prozac but with less side effect.     

针刺任脉经穴为主治疗脑梗塞临床观察

目的：观察针刺任脉经穴为主治疗脑梗塞的临床疗效。方法：60例脑梗塞患者随机分为治疗组和对照组,治疗组予任脉经穴为主针刺治疗,对照组用常规阳明经穴为主针刺治疗,并进行疗效比较。结果：治疗组患者神经功能损伤评分有明显改善并优于对照组,且治疗组在愈显率方面亦明显优于对照组,P〈0.01。结论：针刺任脉经穴为主治疗脑梗塞疗效明显。     

任脉电针对脑缺血大鼠侧脑室下区神经干细胞增殖与分化的影响

目的：观察任脉电针对脑缺血大鼠侧脑室下区神经干细胞增殖与分化的影响.方法：制备大脑中动脉闭塞模型（MCAO）,两小时后再灌注.实验大鼠随机分为手术对照组和任脉电针组,分别于造模成功7天、14天和28天后观察侧脑室下区神经干细胞增殖与分化的变化.结果：与手术对照7天组（C-7d）相比,任脉电针7天组（R-7d）的5-溴脱氧尿苷（Brdu）阳性细胞、5-溴脱氧尿苷/胶质纤维酸性蛋白双标细胞（Brdu/GFAP）、5-溴脱氧尿苷/巢蛋白双标细胞（Brdu/Nestin）、5-溴脱氧尿苷/神经元特异性烯醇化酶双标细胞（Brdu/Nse）数量差异无显著性（P＞0.05）;而在14天组及28天组中,任脉电针14天组（R-14d）、任脉电针28天组（R-28d）Brdu阳性细胞及Brdu/Nestin、Brdu/Nse双标细胞数量分别较手术对照14天组（C-14d）、手术对照28天组（C-28d）差异有显著性（P＜0.05）.在28天组,R-28d的Brdu/GFAP双标细胞明显多于C-28d（P＜0.01）.结论：任脉电针能促进脑缺血大鼠侧脑室下区神经干细胞的增殖与分化,适当促进增殖的神经干细胞向星形胶质细胞方向分化.     

Effects of Electroacupuncture at the Conception Vessel on Proliferation and Differentiation of Nerve Stem Cells in the Inferior Zone of the Lateral Ventricle in Cerebral Ischemia Rats

Objective: To observe the effects of electroacupuncture (EA) at the Conception Vessel on proliferation and differentiation of the nerve stem cells in the inferior zone of the lateral ventricle in cerebral ischemia rats. Methods: The model rats were prepared by occlusion of the middle cerebral artery for 2 hours and then by reperfusion. They were randomly divided into two groups: a control group and an EA group. Changes in differentiation and proliferation of the nerve stem cells were observed 7, 14 and 28 days after successful modeling. Results: As compared with the 7-day control group (C-7d group), there was no significant difference (P>0.05) in the numbers of 5-bromodeoxyuridine (Brdu) positive cells, Brdu/GFAP, Brdu/Nestin and Brdu/Nse double-labeled cells in the inferior zone of the lateral ventricle in the EA group 7 days after modeling. However, in the 14-day EA group (R-14d group) and the 28-day EA group (R-28d group), the numbers of Brdu positive cells and Brdu/GFAP, Brdu/Nestin, Brdu/Nse double-labeled cells significantly increased as compared respectively with the 14-day control (C-14d group) and the 28-day control (C-28d) group (P<0.05 or P<0.01). Conclusions: EA at the Conception Vessel promotes differentiation and proliferation of the nerve stem cells in the inferior zone of the lateral ventricle in the cerebral ischemia rats, and may stimulate differentiation of the proliferous nerve stem cells towards the astrocytes.     

论中医学的意象体系

在目前中西医并存的医学现状下,中医工作者要继承和发展中医学,必须准确把握中医学的本质,学习中医的切入点。本文提出中医学的意象概念,并阐述中医意象体系,认为其是中医学的实质内涵,指出深入理解、把握该体系、形成中医意象思维是继承与发展中医学的重要途径。     

调任通督针法治疗脑梗塞恢复期患者的临床观察

目的:探讨调任通督针刺法治疗脑梗塞恢复期的临床疗效。方法:63例脑梗塞恢复期患者随机分为调任通督针刺组(调任通督组)和传统针刺组(传统对照组)。调任通督组32例接受调任通督针刺和常规基础治疗,传统对照组31例接受传统针刺和常规基础治疗。治疗4周后,进行两组神经功能评估。结果:治疗后,神经功能缺损评分(NIHSS)、卒中量表(css)的改善调任通督组优于传统组(P<0.01)。结论:调任通督针刺在改善神经功能缺损评分方面明显优于传统针刺法。     

调任通督针法治疗中风假性球麻痹临床研究

目的观察调任通督针法治疗中风假性球麻痹临床疗效。方法将60例中风假性球麻痹的患者随机分为调任通督针法组与康复训练组,每组30例,治疗组采用调任通督针法治疗;对照组按LogemannJA训练法施以康复训练治疗法,治疗前后分别对两组患者进行床边吞咽功能评价与洼田氏饮水试验评价。结果治疗组总有效率93.3%,对照组总有效率73.3%,治疗组临床疗效明显优于对照组(P<0.01)。结论调任通督针法治疗中风后假性球麻痹吞咽障碍具有显著的疗效。     

调任通督针法治疗假性球麻痹吞咽障碍临床研究

目的观察调任通督针法治疗卒中后假性球麻痹吞咽障碍的临床疗效。方法将60例假性球麻痹吞咽障碍患者随机分为治疗组与对照组各30例,治疗组采用调任通督针法,对照组按Logemann JA训练法施以康复训练。应用电视荧光放射录像术(VFG)评价吞咽障碍的改善状况。结果治疗组方法的临床疗效明显优于对照组,并能显著降低患者误吸、肺感染的机率。结论调任通督针法治疗卒中后假性球麻痹吞咽障碍具有显著疗效。     

电针任脉和肌肉注射碱性成纤维细胞生长因子对脑缺血模型大鼠侧脑室下区原位神经干细胞增殖的影响***☆

目的：近来的研究认为，针刺任脉治疗脑卒中的机制在于针刺任脉可能产生与干细胞增殖分化有一些联系的生长因子。脑缺血损伤后调动内源性神经干细胞试图自我修复的途径应是多元化的,针刺及外源性生成因子的给予为其不同的途径。实验拟观察电针任脉和肌肉注射碱性成纤维细胞生长因子对脑缺血模型大鼠缺血侧脑室下区5-溴-2’-脱氧尿苷和5-溴-2’-脱氧尿苷/巢蛋白阳性细胞的表达的影响。 方法：实验于2004-09/2005-07在中山大学医学院解剖学实验室完成。①材料：选用成年健康雄性Wistar大鼠83只。将实验动物按随机抽签法分为5组：空白对照组6只、假手术组6只、模型组26只、电针任脉组23只、碱性成纤维细胞生长因子组22只。后3组又分为缺血后7，14和28 d 3个时间点进行观察。②干预：除空白对照组和假手术组外，其余大鼠采用线栓法制作局灶性脑缺血模型。再灌注后参考Longa神经病学评分标准，1~4分为造模成功。空白对照组不作任何处理；假手术组仅分离右侧颈总动脉并离断右颈外动脉，不予栓塞。电针任脉组大鼠于造模后第2天采用上海华谊医用仪器厂生产的G6805Ⅱ型电针仪针刺承浆、气海、关元3穴，针刺后加电，疏密波刺激（疏波30 Hz，密波100 Hz），强度6~15 V，以身体相应部位出现轻微颤动为准，持续时间为20 min。碱性成纤维细胞生长因子组：再灌后立即给药，肌注碱性成纤维细胞生长因子4 000 U/d，此后每天肌注碱性成纤维细胞生长因子，1次/d。模型组、假手术组大鼠于造模后第2天固定于针刺操作台上20 min，不予针刺。空白对照组大鼠不作任何处理。③观察指标：通过免疫荧光方法测定侧脑室下区5-溴-2’-脱氧尿苷和5-溴-2’-脱氧尿苷/巢蛋白阳性细胞的表达。用Olympus FV 500激光共聚焦显微镜系统，在200倍镜下，计数平均5个视野阳性细胞数。 结果：造模成功大鼠54只及空白对照组和模型组各6只进入结果分析。侧脑室5-溴-2’-脱氧尿苷阳性细胞数和5-溴-2’-脱氧尿苷/巢蛋白双标细胞：空白对照组与假手术组比较，差异无显著性意义（P > 0.05）。模型组与空白对照组相比，均有不同程度的增加，其中造模后7和14 d差异有显著性意义（P < 0.01）。电针任脉组和碱性成纤维细胞生长因子组造模后3个时间点与模型组比较，均有较大程度的增加，差异有显著性意义（P < 0.05~0.01）。碱性成纤维细胞生长因子组与电针任脉组相比,差异无显著性意义（P > 0.05）。 结论：电针任脉和肌肉注射碱性成纤维细胞生长因子均可促进局灶性缺血模型大鼠原位神经干细胞增殖，且两者作用相当。     

醒脑开窍法对卒中后抑郁及神经功能康复的影响

目的:观察醒脑开窍法治疗脑卒中后抑郁(PSD)患者的临床疗效.方法:将90例PsD患者随机分为两组,治疗组45例给予醒脑开窍法针刺结合静脉点滴醒脑静注射液,对照组45例给予常规针刺治疗.采用汉密尔顿抑郁量表(}tAM[))、日常生活自理能力量表(ADL,Barthel指数记分法)和神经功能缺损程度评定两组患者治疗前后抑郁症状及神经功能康复的情况.结果:治疗组患者无论HAMD量表、ADL评分变化及神经功能缺损程度评分均优于对照组(P＜0.01),并且治疗组抑郁症状及神经功能康复的总有效率均明显高于对照组.结论:醒脑开窍法治疗不仅有利于卒中后抑郁症状的改善,也有利于患者神经功能康复.