电针治疗神经病理性疼痛机制研究进展

神经病理性疼痛是一种临床常见的顽固性慢性疼痛。电针可有效缓解神经病理性疼痛引起的不适,其作用机制可能涉及外周敏化、中枢敏化、下行抑制性调控,其中中枢敏化机制又可细分为脊髓背角神经元相关机制、胶质细胞活化抑制机制、信号通路相关机制以及突触可塑机制。但当前大多数研究的结论尚未得到明确证实,今后可借助基因推敲或相关抑制剂来开展进一步研究以验证作用机制。参考文献34篇。     

针刺对偏头痛患者疼痛及脑血流动力学的影响:随机对照研究

目的:观察针刺结合药物与单纯药物治疗偏头痛的临床疗效差异及其对脑血流动力学的影响。方法:将120例偏头痛患者随机分为针药组(60例,脱落3例)和药物组(60例,脱落6例)。药物组口服盐酸氟桂利嗪胶囊,每日10 mg,每晚睡前服;针药组在药物组基础上结合针刺治疗,穴取丝竹空、率谷、太阳、风池等,每次30 min,每天1次,两组均连续治疗4周。观察两组治疗前后疼痛视觉模拟量表(VAS)评分、脑血流动力学指标[大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)、椎动脉(VA)、基底动脉(BA)血流速度]、中医证候总积分变化,并比较两组临床疗效及不良反应发生率。结果:与治疗前比较,治疗后两组VAS评分,ACA、MCA、PCA、VA、BA血流速度,中医证候总积分均下降(P<0.05);治疗后针药组VAS评分,ACA、MCA、PCA、VA、BA血流速度及中医证候总积分均较药物组低(P<0.05)。针药组总有效率为96.5%(55/57),高于药物组的90.7%(49/54,P<0.05)。两组的不良事件发生率比较差异无统计学意义(P>0.05)。结论:针刺结合盐酸氟桂利嗪可显著改善偏头痛患者疼痛程度,降低颅内血流速度,效果优于单纯口服盐酸氟桂利嗪。     

探讨艾灸在新型冠状病毒肺炎防疫中的应用价值

摘要：针对新型冠状病毒肺炎拐点尚未到来的现状，探讨艾灸在新型冠状病毒肺炎疫情防控中的应用价值，并从治未病的核心思想“未病先防、既病防变、愈后防复”三个方面进行辨证施灸，提出三期防治方案，以尽可能阻断病源、降低新增病例和新增医学隔离观察人员数、减少复发，充分发挥艾灸在新型冠状病毒肺炎防疫工作中的特色和优势。     

火针对比西药治疗痛风性关节炎血尿酸及关节功能影响Meta分析及试验序贯分析

Objective:To conduct the meta-analysis and trial sequential analysis(TSA) on clinical trials of fire needling therapy in treatment of gouty arthritis and review systematically the clinical therapeutic effect of fire needling therapy on gouty arthritis so as to provide the medical evidences of the extensive application of this therapy in treatment of gouty arthritis.Methods:The relevant clinical trials of fire needling therapy for treatment of gouty arthritis were searched from China National knowledge Infrastructure,Wanfang Data Knowledge Service Platform,Chinese Science and Technology Journal Database,American Medical Online,Dutch Medical Literature Database and International Evidence-Based Medical library.Using Review Manager 5.3 software,the quality of the included trials was assessed and meta-analysis was performed.With TSA v0.9 software,the trial sequential analysis was conduced on the appropriate outcomes.Results:A total of 10 trials were included with 775 patients involved.The analysis results showed that compared with the western medication,the total effective rate(RR=1.14’95%CI [1.09,1.20]),the curative rate(RR=1.59’95%CI [1.33,1.89]),the reduced VAS score(MD=-1.44’ 95%CI [-1.93,-0.951]) and the reduced incidence of adverse reaction(RR=0.27’ 95% CI [0.09,0.76]) of the fire needling therapy were different significantly(all P <0.05).Regarding the reduction of blood uric acid(MD=-40.47’ 95%CI [-80.21,-0.72]) and the score of symptoms and physical signs(MD=-1.38’95% CI [-3.71,0.95]),the effect of fire needling therapy was similar to that of western medication group(both P≥0.05).The trial sequential analysis suggested that the result was reliable,in which,the total effective rate of fire needling therapy was much higher than the western medication.But,it was potentially a false-positive finding,in which,fire needling therapy was much more advantageous at reducing blood uric acid as compared with the western medication.Conclusion:Based on the analytic results,it can be determined that fire needling therapy,as an effective approach to the treatment of gouty arthritis,has a certain advantage as compared with western medication.Given the low overall quality of trials,it still needs high-quality clinical trial to verify the findings of this study results.     

耳穴贴压联合温和灸治疗肝郁脾虚型经前期综合征的临床观察

目的 观察耳穴贴压联合温和灸疗法治疗肝郁脾虚型经前期综合征的临床效果。方法 将60例经前期综合征患者随机分为两组，每组30例，观察组给予耳穴贴压联合温和灸疗法治疗，对照组给予盐酸氟西汀片治疗，两组均治疗3个月经周期。观察两组患者治疗前后12项中医症候积分、总分和疗效。结果 治疗后，观察组除腹部胀满外，其他中医症候(情绪低落或郁闷不乐、乳房胀痛、心烦、失眠、头痛、疲乏、食欲不振、肢体水肿、大便烂、思想不集中、工作效率低)积分和总分均较治疗前降低，且乳房胀痛、失眠、头痛、疲乏、食欲不振、大便烂、工作效率低积分和总分均低于对照组(均P<0.05)。观察组疗效优于对照组(P<0.05)。结论 耳穴贴压联合温和灸疗法可以有效地改善肝郁脾虚型经前期综合征中医症候，临床疗效优于盐酸氟西汀片。