针灸对失眠焦虑的影响

针灸治疗头痛253例

针灸研究的复杂性与挑战性

With the growing popularity of acupuncture in western society in recent decades,many acupuncture researches and clinical studies have been conducted.These studies have significantly enhanced our understanding of acupuncture;neverthe-less,very few findings obtained from acupuncture research have been transferred to acupuncture clinical practice,which has sig-nificantly hampered the development of acupuncture treatment.In addition,some crucial information,such as correct dosage of acupuncture,remains unknown,which further limits the interpretation of clinical trials testing the efficacy of acupuncture treatment. Future acupuncture research should try to fill these gaps and explore new ways to increase the clinical effectiveness of acupuncture treatment.

电针对新生脑性麻痹大鼠单胺类神经递质的影响

objective to detect the content of monoamine neurotransmitters in hippocampus, cortex, basal nucleus and the brainstem of newborn rats with cerebral palsy, to observe the effects of acupuncture on monoamine neurotransmitters, and to explore the mechanism of acupuncture treatment to newborn rats with cerebral palsy. Methods using the method of hypoxic ischemic to make the model of newborn rats with cerebral palsy,decapitating brain after giving acupuncture treatment, separating the required brain regions, and detecting the content of monoamine neurotransmitters with speetrophotometer.Results Compared with the sham operation group, the content of dopamine (DA), 5-Hydroxytryptamine (5-HT) in basal nucleus area of newborn rats with cerebral palsy, and norepinephrine (NE) in Brainstem area decreased significantly(P<0.05), which elevated ignificantly(P<0.05)afler acupuncture treatment. Conclusion it indicated that to improve the ontent of monoamine neurotransmitters in related brain areas may be one of the mechanisms in the acupuncture treatment of newborn rats with cerebral paraly.

早期针刺及康复治疗中风偏瘫临床疗效观察

目的 观察早期应用针刺及康复治疗中风偏瘫临床疗效.方法 选择120例住院的中风偏瘫患者,随机分为治疗组60例和对照组60例.对照组单纯用药物治疗;治疗组在对照组药物治疗基础上,早期采用头针、体针、推拿及运动治疗.结果 治疗组总有效率85.0%与对照组总有效率63.8%比较,差异有显著性(P＜0.05).治疗组治疗后神经功能缺损积分(9.93±7.82)分明显少于治疗前(22.30±8.19)分(P＜0.01)及对照组治疗后(13.04±7.96)分(P＜0.05).结论 中风偏瘫患者早期应用头针、体针、推拿及运动治疗,能较大限度地恢复肢体功能,预防残疾,降低致残率,减轻残疾程度.

AIM To study the effect of acupuncture on the IL2-IFN-NKC immunoregulatory system and tumorinhibition of HAC grafting hepatocarcinoma mice models, and to provide the latest theoretical evidence ofcuring diseases immunologically with acupuncture.METHODS The 28 HAC-vaccinated BALB/C mice were randomly divided into a tumor-bearing controlledgroup and tumor-bearing group to be needed. For the latter group, the selected acupoints are Dazhui (DU,14) and Zusanli (St, 36) which are localized according to the corresponding positions indicated in thecomparative anatomy of animals. The mice in the group were needled once a day for 12 days with thesupplementing and reducing methods, the frequency being 60 times/minute and the needles being retained for2 minutes. The former group was treated in the same way as the latter except needling. Twenty-four hoursafter the last needling, the mice were killed and the spleen taken out to prepare a cell suspension at requiredconcentration, The IL-2 (MTT method) and NKC (colorimetric method) were determined respectively; theIFN (CPE micr-oplate staining) was determined by using the serum separated from the mice's orbit blood; thetumor mass was taken and weighed with an analytical balance (1/1000) to calculate the tumor inhibitationrate according to the formula.RESULTS In the tumor-bearing group after having been needled. the activity of IL-2 (OD value), the titerof IFN (U/mL), the soluble rate of NKC (%) and the tumor weight were respectively 1. 3542±0. 226, 50±0.12, 33.19±4.01 and 70.88±22.8, while those corresponding items in the controlled group were 1.1049±0.028, 3.1±0.22, 21.58±2.77 and 112.45±21.1, When all the concerned items were compared with, thedifference was obvious (P<0.01), showing the IL-2, NKC and IFN of the tumor-bearing group after beingneedled were greatly increased, and the tumor weight is much decresed (inhibitation rate 43.06%). Thedifference between groups was studied by Student's t test.CONCLUSION Acupuncture can strengthen the positive immunoregulatory function of the IL2-IFN-NKCsystem of the HAC bearing mice with hypoimmunity.

AIM To observe the features of acupuncture and meridians by measuring transcutaneous CO2 emission(TCE).METHODS A high sensitive CO2 analyzer was used to measure the TCE. TCE on 31 levels of meridianpoints and control points along stomach meridian on leg, large intestine meridian on arm (30) andpericardium meridian on whole course (22) were measured. During needling Jianshi (P5), the changes ofTCE on distal side, proximal side and outside of the pericardium meridian were measured in 20 healthypeople. TCE on 24 source points of twelve meridians in 30 healthy people and some related source points inpatients were measured. TCE on source points, connecting points and sea points in 20 healthy cases weremeasured. Acupoints and reference points (no opening time) were measured on the opening time and nonopening time according to day-prescription in midnight-noon Ebb-flow law in 15 healthy people. The relationbetween TCE and skin temperature and TCE change after muscular exercise were also studied.RESULTS The mean TCE on the meridians was significantly higher (P<0.05, same below) than controlpoints. About 40% levers showed significantly higher TCE on meridian points than on control points amongwhich two third were acupoints, mostly were Jing point and He point where Oi were rich. TCE increasedsignificantly in both the meridian and control points during the needling, while moderately increased on themeridian line, particularly the proximal direction. The correlative coefficient (CC) between the points alongpericardium meridian was 0.65 between acupoi, nts which was significantly higher than 0.56 between nonacupoints. For the 24 source points, CC between the points on same meridian, exterior meridian and internalmeridian, same named hand and foot meridian and normal meridian were 0.81, 0.65, 0.51 and 0.38respectively with significant difference. The mean CC between connecting points was 0.67, significantlyhigher than 0.61 between source points and 0.56 between sea points. The imbalance degree (ID) betweenleft and right meridian points, Yin and Yang meridian points and same named hand and foot meridian pointswere 13.6%, 17.6% and 19.6% respectively, while ID was 30.2% in patients, significantly higher than inhealthy people. For midnight-noon law, TCE relative to the reference points on the opening time was 1.25which was significantly higher than 1.08 before the opening time. The certain correlation (r = 0. 19,P < 0.01) between TCE and skin temperature and the increase after muscular exercise illustrate that TCE canindicate the energy metabolism level on meridians.CONCLUSION TCE is an ideal index to show the feature of acupuncture and meridians and may widely beused in the study and practice of traditional Chinese medicine.

Acupuncture at Baihui (GV20) and Dazhui (GV14) reduces neuronal loss and attenuates ultra-structural damage in cerebral ischemic rats. However, whether acupuncture can treat addiction and prevent readdiction through changes to brain cell ultrastructure remains unknown. In this study, cell apoptosis was observed in the hippocampus and frontal lobe of heroin readdicted rats by electron microscopy. Immunohistochemical staining displayed a reduction in Bcl-2 ex-pression and an increase in Bax expression in the hippocampus and frontal lobe. After rats were given acupuncture at Baihui and Dazhui, the pathological damage in the hippocampus and frontal lobe was signiifcantly reduced, Bcl-2 expression was upregulated and Bax expression was downregulated. Acupuncture exerted a similar effect with methadone, a commonly used drug for clinical treatment of drug addiction. Experimental ifndings suggest that acupuncture at Dazhui and Baihui can prevent brain cell apoptosis in heroin readdicted rats.

Our previous ifndings have demonstrated that acupuncture at the Taixi (KI3) acupoint in healthy youths can activate neurons in cognitive-related cerebral cortex. Here, we investigated whether acupuncture at this acupoint in elderly patients with mild cognitive impairment can also activate neurons in these regions. Resting state and task-related functional magnetic resonance imaging showed that the pinprick senstation of acupuncture at the Taixi acupoint differed signiifcantly between elderly patients with mild cognitive impairment and healthy elderly controls. Results showed that 20 brain regions were activated in both groups of participants, including the bi-lateral anterior cingulate gyrus (Brodmann areas [BA] 32, 24), left medial frontal cortex (BA 9, 10, 11), left cuneus (BA 19), left middle frontal gyrus (BA 11), left lingual gyrus (BA 18), right medial frontal gyrus (BA 11), bilateral inferior frontal gyrus (BA 47), left superior frontal gyrus (BA11), right cuneus (BA 19, 18), right superior temporal gyrus (BA 38), left subcallosal gyrus (BA 47), bilateral precuneus (BA 19), right medial frontal gyrus (BA 10), right superior frontal (BA 11), left cingulate gyrus (BA 32), left precentral gyrus (BA 6), and right fusiform gyrus (BA 19). These results suggest that acupuncture at the Taixi acupoint in elderly patients with mild cogni-tive impairment can also activate some brain regions.

Most studies addressing the speciifcity of meridians and acupuncture points have focused mainly on the different neural effects of acupuncture at different points in healthy individuals. This study examined the effects of acupuncture on brain function in a pathological context. Sixteen patients with ischemic stroke were randomly assigned to true point group (true acupuncture at right Waiguan (SJ5)) and sham point group (sham acupuncture). Results of functional magnetic resonance imaging revealed activation in right parietal lobe (Brodmann areas 7 and 19), the right temporal lobe (Brodmann area 39), the right limbic lobe (Brodmann area 23) and bilateral oc-cipital lobes (Brodmann area 18). Furthermore, inhibition of bilateral frontal lobes (Brodmann area 4, 6, and 45), right parietal lobe (Brodmann areas 1 and 5) and left temporal lobe (Brodmann area 21) were observed in the true point group. Activation in the precuneus of right parietal lobe (Brodmann area 7) and inhibition of the left superior frontal gyrus (Brodmann area 10) was observed in the sham group. Compared with sham acupuncture, acupuncture at Waiguan in stroke patients inhibited Brodmann area 5 on the healthy side. Results indicated that the altered speciifcity of sensation-associated cortex (Brodmann area 5) is possibly associated with a central mechanism of acupuncture at Waiguan for stroke patients.

Drugs can cause obvious damage to the brain. To verify the relationship between acupuncture, neurotrophic factor expression and brain cell structural changes, this study established a rat model of heroin relapse using intramuscular injection of increasing amounts of heroin. During the detoxiifcation period, rat models received acupuncture at Baihui (DU20) and Dazhui (DU14). Electron microscopy demonstrated that the structure of the ventral tegmental area in heroin relapse rats gradually became normalized after acupuncture treatment. Immunohistochem-ical staining exhibited that the expression of brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor increased in the ventral tegmental area following acupuncture. Moreover, the effects were similar to that of methadone, a type of medicine called an opioid. Results suggested that acupuncture at Baihui and Dazhui protected brain neurons against injury in rats with heroin relapse by promoting brain-derived neurotrophic factor and glial cell line-de-rived neurotrophic factor expression.

Preliminary basic research and clinical ifndings have demonstrated that electroacupuncture ther-apy exhibits positive effects in ameliorating depression. However, most studies of the underlying mechanism are at the single gene level;there are few reports regarding the mechanism at the whole-genome level. Using a rat genomic gene-chip, we proifled hippocampal gene expression changes in rats after electroacupuncture therapy. Electroacupuncture therapy alleviated depres-sion-related manifestations in the model rats. Using gene-chip analysis, we demonstrated that electroacupuncture at Baihui (DU20) and Yintang (EX-HN3) regulates the expression of 21 genes. Real-time PCR showed that the genes Vg f, Ig f2, Tmp32, Loc500373, Hif1a, Folr1, Nmb, and Rtn were upregulated or downregulated in depression and that their expression tended to nor-malize after electroacupuncture therapy. These results indicate that electroacupuncture at Baihui and Yintang modulates depression by regulating the expression of particular genes.

Here, we administered repeated-pulse transcranial magnetic stimulation to healthy people at the left Guangming (GB37) and a mock point, and calculated the sample entropy of electroencephalo-gram signals using nonlinear dynamics. Additionally, we compared electroencephalogram sample entropy of signals in response to visual stimulation before, during, and after repeated-pulse tran-scranial magnetic stimulation at the Guangming. Results showed that electroencephalogram sample entropy at left (F3) and right (FP2) frontal electrodes were significantly different depending on where the magnetic stimulation was administered. Additionally, compared with the mock point, electroencephalogram sample entropy was higher after stimulating the Guangming point. When visual stimulation at Guangming was given before repeated-pulse transcranial magnetic stimula-tion, signiifcant differences in sample entropy were found at ifve electrodes (C3, Cz, C4, P3, T8) in parietal cortex, the central gyrus, and the right temporal region compared with when it was given after repeated-pulse transcranial magnetic stimulation, indicating that repeated-pulse transcranial magnetic stimulation at Guangming can affect visual function. Analysis of electroencephalogram revealed that when visual stimulation preceded repeated pulse transcranial magnetic stimulation, sample entropy values were higher at the C3, C4, and P3 electrodes and lower at the Cz and T8 electrodes than visual stimulation followed preceded repeated pulse transcranial magnetic stimula-tion. The ifndings indicate that repeated-pulse transcranial magnetic stimulation at the Guangming evokes different patterns of electroencephalogram signals than repeated-pulse transcranial mag-netic stimulation at other nearby points on the body surface, and that repeated-pulse transcranial magnetic stimulation at the Guangming is associated with changes in the complexity of visually evoked electroencephalogram signals in parietal regions, central gyrus, and temporal regions.

Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs, namely col ateral shock in the brain. Contralateral needling is the insertion of needles into acupoints on the relative healthy side of the body to treat diseases such as apoplexy. However, there is little wel-designed and control ed clinical evidence for this practice. This study investigated whether contralateral needling could treat hemiplegia after acute ischemic stroke in 106 randomly selected patients with acute ischemic stroke. These patients were randomly assigned to three groups:45 in the contralateral needling group, receiving acupuncture on the unaffected limbs; 45 in the tional acupuncture group, receiving acupuncture on the hemiplegic limbs; and 16 in the control group, receiving routine treatments without acupuncture. Acupuncture at acupoints Chize (LU5) in the upper limb and Jianliao (TE14) in the lower limb was performed for 45 minutes daily for 30 consecutive days. The therapeutic effective rate, Neurological Deficit Score, Modified Barthel Index and Fugl-Meyer Assessment were evaluated. The therapeutic effective rate of contralateral needl-ing was higher than that of conventional acupuncture (46.67% vs. 31.11%, P < 0.05). The neuro-logical deficit score of contralateral needling was significantly decreased compared with conven-tional acupuncture (P < 0.01). The Modified Barthel Index and Fugl-Meyer Assessment score of contralateral needling increased more significantly than those of conventional acupuncture (both P<0.01). The present findings suggest that contralateral needling unblocks col aterals and might be more effective than conventional acupuncture in the treatment of hemiplegia fol owing acute ischemic stroke.

Acupuncture has been used to treat neuropathic pain for a long time, but its mechanisms of action remain unknown. In this study, we observed the effects of electroacupuncture and manual acu-puncture on neuropathic pain and on ephrin-B/EphB signaling in rats models of chronic constriction injury-induced neuropathic pain. The results showed that manual acupuncture and elec-puncture significantly reduced mechanical hypersensitivity fol owing chronic constriction injury, es-pecial y electroacupuncture treatment. Real-time PCR results revealed that ephrin-B1/B3 and EphB1/B2 mRNA expression levels were significantly increased in the spinal dorsal horns of chronic constriction injury rats. Electroacupuncture and manual acupuncture suppressed the high sion of ephrin-B1 mRNA, and elevated EphB3/B4 mRNA expression. Electroacupuncture signifi-cantly enhanced the mRNA expression of ephrin-B3 and EphB3/B6 in the dorsal horns of neuro-pathic pain rats. Western blot results revealed that electroacupuncture in particular, and manual acupuncture, significantly up-regulated ephrin-B3 protein levels in rat spinal dorsal horns. The re-sults of this study suggest that acupuncture could activate ephrin-B/EphB signaling in neuropathic pain rats and improve neurological function.

Angong Niuhuang pill, a Chinese materia medica preparation, can improve neurological func-tions after acute ischemic stroke. Because of its inconvenient application and toxic components (Cinnabaris andRealgar), we used transdermal enhancers to deliverAngong Niuhuang pill by modern technology, which expanded the safe dose range and clinical indications. In this study, Angong Niuhuang stickers administered at different point application doses (1.35, 2.7, and 5.4 g/kg) were administered to theDazhui (DU14), Qihai(RN6) andMingmen (DU4) of rats with chronic cerebral ischemia, for 4 weeks. The Morris water maze was used to determine the learning and memory ability of rats. Hematoxylin-eosin staining and Nissl staining were used to observe neuronal damage of the cortex and hippocampal CA1 region in rats with chronic cerebral ischemia. The middle- and high-dose point application ofAngong Niuhuangstickers attenuated neuronal damage in the cortex and hippocampal CA1 region, and improved the memory of rats with chronic cerebral ischemia with an efifcacy similar to interventions by electroacupuncture at Dazhui (DU14),Qihai (RN6) andMingmen (DU4). Our experimental ifndings indicate that point application withAngong Niuhuang stickers can improve cognitive function after chronic cerebral ischemia in rats and is neuroprotective with an equivalent efifcacy to acupuncture.

The Alzheimer’s disease model in Wistar rats was established by injection of amyloid β-peptide (Aβ1-42 ) into the hippocampal CA1 region. Rats were treated with suspended moxibustion on Baihui (GV20) and Shenshu (BL23) acupoints. Prior to and post Aβ1-42 exposure. Results showed no evidence of apoptosis in hippocampal neurons, a significantly reduced apoptosis rate of neurons and improved learning and memory abilities were observed in the Alzheimer’s disease model. In particular, moxibustion prior to Aβ1-42 exposure was more effective than moxibustion after Aβ1-42 exposure in protecting the neuronal structure and lowering the apoptosis rate. Our findings indicate that a combination of preventive and therapeutic moxibustion has a beneficial effect for the tion of Alzheimer’s disease development.

Shaoyang acupoints are the most frequently used in migraine treatment. However, the central anal-gesic mechanism remains poorly understood. Studies have demonstrated that single stimulus of the verum acupuncture in healthy subjects can induce significant connectivity or activity changes in pain-related central networks compared with sham acupuncture. However, these findings are not indicative of the central analgesic mechanism of acupuncture at Shaoyang acupoints. Thus, we recruited 100 migraine sufferers and randomly assigned them into five groups: Shaoyang uncommon acupoint, Shaoyang common acupoint, Yangming uncommon acupoint, non-acupoint control, and blank control groups. Subjects were subjected to evaluation of curative effects and functional MRI prior to and after 10 and 20 acupuncture treatments. Al subjects were diagnosed by physicians and enrol ed fol owing clinical physical examination. Subjects were observed during 1-4 weeks after inclusion. At the fifth week, the first clinical evaluation and resting functional MRI were conducted. The Shaoyang uncom-mon acupoint, Shaoyang common acupoint, Yangming uncommon acupoint, and non-acupoint control grousp then were treated with acupuncture, five times per week, 20 times in total over 4 weeks. The second and third clinical evaluations and resting functional MRI screenings were conducted fol owing 10 and 20 acupuncture treatments. The blank control group was observed during the 5 to 8 week pe-riod, fol owed by clinical evaluation and resting functional MRI. The aim of this study was to examine changes in brain functional activity and central networks in subjects with migraine undergoing acu-puncture at Shaoyang uncommon acupoints. This study provides a further explanation of the central analgesic mechanism by which acupuncture at Shaoyang acupoints treats migraine.

Intracerebral hemorrhage(ICH)is one of the cerebrovascular disease which occurs frequently in China with the high rate of occurance,disability and death.Through the acupuncture in treating cerebral hemorrhage related literature study in recent 5 years,we found that acupuncture compared with the simple western medicine has certain advantages in the treatment of cerebral hemorrhage,the help of acupuncture treatment can improve the patients neurological function score and increase the effective rate.Through these datas research,we hope to provide references for further study.