论中医经筋学说与肌筋膜链理论的关联性

通过对肌筋膜链理论以及经络系统中经筋学说在实质、整体性、病理特点、治疗原则以及临床运用等方面进行比较,发现肌筋膜链理论在姿势评估和运动锻炼指导方面,更具有优势。以期将肌筋膜经线理论与经筋学说相结合,更好地指导临床针灸、运动康复、推拿等领域的治疗,为经筋的进一步研究提供新的思路。     

多法联用治疗泌尿系结石的临床体会

泌尿系结石在目前已成为一种常见病，好发于男性青壮年。其病包括的范围有：肾结石、输尿管结石、膀胱结石、前列腺结石、尿道结石。我院从2003年2月开始。采用体外碎石术与中医结合。多法联用治疗泌尿系结石。取得了一些疗效和体会。现介绍如下。     

眼眶肿瘤的CT诊断

目的：探讨眼眶肿瘤的CT诊断。方法：回顾性分析60例眼眶肿瘤的CT表现,所有病例均由手术、病理以及临床随访证实。结果：球内肿瘤23例,钙化是视网膜母细胞瘤的特征性表现（15／16）;眶内原发良性肿瘤18例;眶内原发恶性肿瘤3例及继发转移性病变3例,大多伴有骨质破（5／6）;炎性假瘤13例,表现多样,结论CT有助于眼眶肿块定位,对大大部分病变可以单独或结合临床作出定性诊断。     

电针足三里对胃黏膜损伤大鼠细胞凋亡及其调控基因Bcl-2、Fas蛋白表达的影响

目的:观察电针足三里对胃黏膜损伤大鼠的细胞保护作用与细胞凋亡及其调控基因Bcl-2、Fas 蛋白表达的关系。方法:将40只大鼠随机分为足三里组、非穴组、模型组和空白组,每组10只。用无水乙醇 灌胃,造成胃黏膜损伤模型。检测各组大鼠胃黏膜细胞凋亡指数、胃黏膜细胞Bcl-2、Fas蛋白表达水平。结 果:细胞凋亡指数模型组与空白比较,差异有非常显著性意义(P<0.01)。足三里组与模型组比较,差异有非 常显著性意义(P<0.01),细胞凋亡指数显著降低;足三里组与非穴组比较,差异有显著性意义(P<0.05); 足三里组与空白组比较,差异无显著性意义(P>0.05)。Bcl-2基因蛋白阳性表达:模型组与足三里组、空白 组比较,差异均有显著性意义(P<0.05)。Fas基因蛋白阳性表达:非穴组、模型组与足三里组、空白组比 较,差异有显著性或非常显著性意义(P<0.05,P<0.01)。结论:电针足三里对胃黏膜损伤后的细胞保护作 用可能的机理是由于降低胃黏膜细胞凋亡,促进了Bal-2基因蛋白表达,抑制了Fas基因蛋白表达,并具有腧 穴相对特异性。     

Observation on clinical effect of tuina plus Western medication for functional dyspepsia due to liver qi stagnation and spleen deficiency

Objective

To observe the clinical effects of tuina plus Western medication for functional dyspepsia (FD) due to liver qi stagnation and spleen deficiency.

Methods

total of 72 patients in conformity with the inclusion criteria of FD were randomly divided into an observation group and a control group based upon the random number table, 36 cases in each group. The control group was treated with mosapride citrate dispersible tablets, and the observation group was treated with the same tablets plus tuina. Before the treatment and 4 weeks after the treatment, the clinical symptoms, quality of life (QOL) and depression severity were observed by the scale, and were followed up two months later after the treatment for assessment of the clinical effects.

Results

After the treatment and at the follow-up, the symptom scores of FD and the sores of Hamilton depression rating scale (HAMD) in both groups decreased, and the scores in Chinese version of quality of life questionnaire for functional digestive disorders (Chin-FDDQL) increased, with statistically significant differences in comparison with the same group before the treatment (all P<0.05). In comparison between the two groups at the same time point after the treatment, the scores of FD symptoms, HAMD and Chin-FDDQL were improved better in the observation group than those in the control group, with statistically significant differences (all P<0.05). The total effective rates at the follow-up were 91.7% in the observation group and 75.0% in the control group, without statistical difference between the two groups (P>0.05). The rate of clinical cure and remarkable effect was 66.7% in the observation group, higher than 41.7% in the control group, it is higher in the observation group than that in the control group, with a statistically significant difference between the two groups (P<0.05).

Conclusion

Tuina plus Western medication is precise in the therapeutic effects for FD due to liver qi stagnation and spleen deficiency and can effectively relieve clinical symptoms, elevate the QOL and alleviate depression severity of the patients. Moreover, it’s better than the treatment by Western medication alone in the long-term therapeutic effects.

     

PET/MRI融合图像诊断妇科恶性肿瘤盆腔复发

目的 探讨PET/MRI融合图像诊断妇科肿瘤术后盆腔复发、转移的效能。方法 回顾性分析38例妇科恶性肿瘤患者术后PET/CT、盆腔MRI图像,并进行PET与MRI图像的融合,比较PET/CT、盆腔MRI及PET/MRI融合诊断盆腔局部复发、转移的价值。结果 38例患者中23例有肿瘤复发、转移,PET/MRI融合图像诊断盆腔复发、转移有较高的敏感度、特异度和准确率,且PET/MRI融合诊断盆腔局部复发的准确率高于MRI（94.73% vs 73.68%,P=0.025）。结论 PET/MRI融合结合了PET和MRI的优势,在诊断妇科肿瘤患者盆腔复发、转移中具有重要的价值。     

针刺胃扩张模型大鼠内关、足三里等穴位下丘脑室旁核相关神经元的反应

背景：既往有关针刺对胃功能调节的神经机制研究多以外周神经为主,涉及中枢,尤其是高位中枢的研究较少。目的：探讨针刺“内关”、“足三里”等穴位对下丘脑室旁核胃相关神经元作用的影响。方法：运用微电极细胞外记录技术,在大鼠胃扩张的基础上,找出室旁核胃相关神经元,予以手针刺激“内关”、“足三里”等穴位各30 s,观察其对室旁核胃相关神经元的影响。结果与结论：60只大鼠共记录到109个下丘脑室旁核神经元放电,109个下丘脑室旁核神经元中与胃扩张相关的神经元有56个,56个胃扩张相关神经元中,对针刺足三里、内关、脾俞、胃俞有反应的神经元个数分别是44,47,29,33,有反应的神经元出现的比例分别是78.57%,83.47%,51.79%,58.93%。结果表明下丘脑室旁核中存在同时对胃扩张刺激和针刺刺激起反应的躯体内脏汇聚神经元,且参与针刺对胃功能的调节作用。     

针刺内关、足三里等穴对大鼠孤束核神经元放电的影响

目的通过比较针刺内关、足三里等穴对正常大鼠孤束核(nucleus tractus solitarii,NTS)神经元放电的影响,阐明NTS在内关、足三里穴共同调节心、胃功能中的作用。方法运用细胞外记录神经电生理学方法,观察针刺内关、足三里等穴时NTS神经元放电频率的变化。结果NTS内神经元对针刺刺激主要以呈兴奋性反应为主;针刺内关、足三里穴组,NTS内兴奋性神经元出现率与针刺偏历、合阳穴组比较有显著性差异(P<0.01);针刺内关、足三里穴组兴奋性神经元频率变化率亦显著高于针刺偏历、合阳穴组(P<0.01)。结论NTS是针刺内关、足三里穴共同调节心胃功能的整合中枢之一;经穴具有相对特异性。