最新刊期
卷 43 ， 期 7 ， 2024
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- 摘要：ObjectiveTo explore the effects of transcutaneous electrical acupoint stimulation （TEAS） combined with multimodal analgesia on early active and resting pain after total knee arthroplasty （TKA）.MethodsA total of 68 patients with TKA were randomly divided into treatment group and control group， 34 cases in each one. The control group was treated with multimodal analgesia， and the treatment group was treated with TEAS based on multimodal analgesia. The clinical and blood test indexes of 2 groups were recorded and analyzed.ResultsOn the 3rd， 7th， 10th and 14th day after operation， the active pain scores of the treatment group were lower than those of the control group （P<0.01，P<0.05）. On the 1st day after operation， the active pain scores of the two groups were higher than those before operation （P<0.01）， and on the 3rd， 7th， 10th and 14th day after operation， the active pain scores of the two groups were lower than those before operation （P<0.01）. The rest pain scores of the treatment group were lower than those of the control group on 7th and 10th day after operation （P<0.05）. On the 1st and 3rd day after operation， the resting pain scores of the treatment group were higher than those before operation （P<0.05）， and on the 7th， 10th and 14th day after operation， there was no significant difference between preoperative and postoperative scores in the treatment group （P>0.05）. On the 1st， 3rd， 7th and 10th day after operation， the resting pain scores of the control group were higher than those before operation （P<0.05）， and on the 14th day after operation， there was no significant difference in the scores before and after operation of the control group （P>0.05）. The temperature of the operated knee in the treatment group was lower than that in the control group on the 14th day after operation （P<0.01）， and the diameter of suprapatellar circumference was smaller than that of the control group （P<0.01）. The level of serum CRP in the treatment group were lower than that in the control group on the 7th and 14th day after operation （P<0.01，P<0.05）.ConclusionTEAS combined with multimodal analgesia can reduce the temperature of the knee joint after TKA， accelerate limb swelling resolution， promote the resolution of inflammation. TEAS can relieve early active pain and resting pain after TKA， and the relief effect on active pain is more significant than that on resting pain.关键词：Transcutaneous electrical acupoint stimulation;total knee arthroplasty;postoperative pain;active pain;resting pain
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发布时间：2024-08-27 - 摘要：ObjectiveTo observe the effectiveness of acupuncture at the Yaotong dian（EX-UE7） in the treatment of acute renal colic caused by urinary tract stones and explore its mechanism of action from a metabolomics perspective.MethodsThis study was an exploratory prospective randomized controlled trial. 20 patients with acute renal colic due to urolithiasis were randomly divided into an experimental group（10 cases） and a control group（10 cases）. The experimental group received acupuncture at the bilateral Yaotongdian（EX-UE7）. The control group was treated with nonpoint shallow puncture. The outcome was the response rate at 10 minutes after needle manipulation. The nontargeted metabolomics method of chromatography-mass spectrometry was used to detect the metabolites in each group of samples before and after treatment. The detected metabolites were differentiated according to P value， difference multiple change and the projected importance value of calculated variables， and the Spearman correlation coefficient was used to combine with clinical indicators for further screening of differential metabolites. Functional pathway enrichment analysis was done based on the KEGG database.ResultsThe experimental group benefited from higher response rate of 80.0% at 10 minutes than the control group（95% CI，38.4%~94.3%，P<0.01）. In terms of metabolomics， 199 differential metabolites were screened before and after treatment in the experimental group； 54 differential metabolites were screened before and after treatment in the control group. Compared with the experimental group， 325 different metabolites were screened from the control group. Spearman level correlation analysis was performed on the changes in metabolites and NRS pain scores before and after treatment in the experimental group， the results showed that 4 different metabolites including guanosine were negatively correlated with NRS pain scores. 9 different metabolites including Albaflavenone were positively correlated with the NRS pain scores. Spearman correlation analysis was conducted between the changes in metabolites in the control group and those in the experimental group and the NRS pain scores. The results showed that 3 different metabolites including 3-aldehyde salicylic acid were negatively correlated with the NRS pain scores. 8 different metabolites including Cortisol were positively correlated with the NRS pain scores. Compared with the control group， the experimental group was enriched in 9 pathways， among which the pathways related to pain regulation were the tryptophan metabolism pathway and unsaturated fatty acid biosynthetic metabolism pathway.ConclusionAcupuncture at the bilateral Yaotongdian（EX-UE7） can be considered an effective therapy in relieving acute renal colic caused by urinary tract stones. Guanine， guanosine， cortisol different metabolites are associated with changes in pain， and tryptophan metabolic pathways and unsaturated fatty acid biosynthesis pathways also participates in the regulation of pain， which may be the potential mechanism of acupuncture in the treatment of renal colic.关键词：Yaotong dian（EX-UE7）;renal colic;acupuncture analgesia;metabolomics;mechanism of action
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发布时间：2024-08-27 - 摘要：Cervicogenic shoulder pain is a common clinical disease，and its symptoms are similar to those of shoulder periarthritis，making it prone to misdiagnosis and mistreatment in clinical practice.Professor ZHANG Zhenyu started with the pathological mechanism of shoulder discomfort caused by stimulation of the dorsal root ganglion of the fifth cervical nerve to treat this disease. The combination of four-step precise point manipulation with rehabilitation training programs can fundamentally solve cervicogenic shoulder pain and limited mobility caused by degeneration of cervical vertibra and surrounding structure with satisfactory clinical efficacy.关键词：Precise point manipulation;cervicogenic shoulder pain;dorsal root ganglion;clinical experience
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发布时间：2024-08-27 -
- 摘要：ObjectiveTo observe the effects of acupuncture therapy on hyperarousal state， sleep quality， fatigue state and heart rate variability （HRV） in patients with chronic insomnia due to deficiency of heart and spleen.MethodsA total of 120 patients with chronic insomnia were randomly divided into treatment group and control group of 60 in each one.The treatment group was applied to bilateral Xinshu（BL 15）， Pishu（BL 20）， Shenmen（HT 7）， Zhaohai（KI 6）， Shenmai（BL 62）， Anmian， Sanyinjiao（SP 6）， Zusanli（ST 36） and unilateral Baihui（DU 20）；the control group was given shallow acupuncture but not along the channel. Both groups were treated with acupuncture once every other day for 4 weeks， with a total of 14 treatments. The patients' Hyperarousal Scale score （HAS）， Pittsburgh Sleep Quality Index （PSQI） and Fatigue Scale score （FS-14） were recorded before treatment and at the end of 4 weeks of treatment；ECGs of 24h 12 leads and Kubios HRV version software were used to analyze different parameters of HRV.ResultsPost-treatment HAS scale scores were highly significantly lower than pre-treatment in the treatment group（P<0.01）；Post-treatment HAS scale scores were highly significantly lower than pre-treatment in the control group（P<0.01）；Post-treatment HAS scale scores were highly significantly lower in the treatment group than in the control group（P<0.01）；Post-treatment PSQI scores on all dimensions and total scores were highly significantly lower than pre-treatment in the treatment group（P<0.01）；Sleep quality， daytime dysfunction and total PSQI scores were lower in the control group after treatment than before treatment（P<0.05）；Post-treatment sleep quality， time to sleep， sleep duration， daytime dysfunction， and total PSQI scores were significantly lower in the treatment group than in the control group（P<0.01）；Post-treatment FS-14 scale scores were highly significantly lower in the treatment group than pre-treatment（P<0.01）；Post-treatment FS-14 scale scores were lower than pre-treatment in the control group（P<0.05）；Post-treatment FS-14 scale scores were significantly lower in the treatment group than in the control group（P<0.01）；After treatment， PNN50， RMSSD， HRV triangle index， VLF and LF/HF showed an increasing trend（P<0.05）， while HF and LF showed a decreasing trend compared with before treatment（P<0.05）；SDNN and VLF in the control group showed a decreasing trend after treatment compared to before treatment（P<0.05）；PNN50 and LF/HF in the treatment group was higher than that（P<0.05） in the control group， and LF was lower than that（P<0.05） in the control group after treatment.ConclusionAcupuncture stimulation can improve hyperarousal and fatigue as a way to improve sleep quality in chronic insomnia patients. By adjusting heart rate variability， it is reflected in the ability to downregulate sympathetic excitability and upregulate parasympathetic regulation. Further， it can balance the autonomic nervous system and improve the body's adaptability. Its action is related to meridian point specificity.关键词：acupuncture;chronic insomnia;hyperarousal;heart rate variability
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发布时间：2024-08-27 - 摘要：ObjectiveTo analyze the clinical manifestations， syndromes and location characteristics of cryptogenic organizing pneumonia （COP） in TCM.MethodsFour TCM diagnostic information and syndrome differentiation data of the patients diagnosed with COP were collected from April 2015 to March 2022 and a retrospective study was made on them.ResultsAmong 56 patients， 2 cases were found during routine physical examination， and the rest had 7 first symptoms， with cough and suffocation as the most common symptoms；then the sputum， shortness of breath and fever. There were 21 symptoms in 56 patients， including wheezing，cough，sweating，expectoration，chest tightness and shortness of breath with the frequency of occurrence more than 50%. The percentage of chest tightness was significantly lower in patients with fibrosis than in patients without fibrosis （P<0.05）；The percentage of sweating，thirst and polydipsia， weakness of lower back and knees was significantly higher in patients who took glucocorticoids than in patients who didn’t take glucocorticoids （P<0.05，P<0.01）. Among 56 patients， pale tongue is the most common， white coating is the most important， and string-taut pulse and rolling pulse are the most important， with the frequency exceeding 50%. Compared with the patients without fibrosis， the proportion of middle chords in patients with fibrosis was lower （P< 0.05）. Compared with patients who did not take glucocorticoid， the proportion of pulse string， pulse slip and pulse number in patients who took glucocorticoid was higher （P<0.05，P<0.01）. Among 56 cases， 48 belong to mixed deficiency and excess syndrome， 5 deficiency syndrome， 3 excess syndrome. Deficiency syndrome is mainly qi deficiency， followed by yin deficiency and yang deficiency. Combined with syndrome differentiation of zang-fu， the highest frequency of syndrome types is lung qi deficiency， followed by kidney yin deficiency and spleen qi deficiency， with the frequency exceeding 30%. Deficiency syndrome occurred in two or three syndromes at the same time， mainly for lung and spleen deficiency with kidney yin deficiency and spleen qi deficiency. The excess syndrome were mainly retention of cold fluid in the lung，phlegm dampness blocking lung， damage of lung by qi stagnation and obstruction of stagnation in lung collaterals with the frequency exceeding 25%. The combination of syndrome types was mainly phlegm-dampness blocking lung and qi stagnation damaging lung， and cold fluid obstructing lung and blood stasis blocking lung collaterals. The percentage of kidney yang deficiency and blood stasis obstructing pulmonary collaterals in patients with fibrosis was significantly higher than in patients without fibrosis （P<0.05，P<0.01），and the percentage of qi stagnation hurting the lung was significantly lower than in patients without fibrosis （P<0.01）；the percentage of kidney yin deficiency was significantly higher in patients who took glucocorticoids than in patients who didn’t take glucocorticoids （P<0.01）， and the percentage of lung Yang deficiency and blood stasis obstructing pulmonary collaterals was significantly lower than in patients who didn’t take glucocorticoids （P<0.05）. In 56 patients， most of the lesions were located in lung， followed by kidney， spleen and stomach. Among them， compared with patients who did not take glucocorticoids， the proportion of patients who took glucocorticoids was higher in kidney and spleen （P<0.05，P<0.01）.ConclusionThe clinical TCM symptoms of COP are mainly pulmonary symptoms， combination of deficiency and excess is the main syndrome type and location of disease is lung. Patients taking glucocorticoids are prone to symptoms of deficiency of kidney yin such as sweating， thirst and polydipsia， soreness and weakness of lumber and knees， and the proportion of diseases is high in kidney and spleen. Chest tightness and string-taut pulse are more common in patients without fibrosis， and more common syndrome type is excess syndrome.关键词：Cryptogenic organizing pneumonia;symptom;syndrome;location of disease;glucocorticoid;pulmonary fibrosis
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发布时间：2024-08-27 -
- 摘要：ObjectiveTo discuss the effect of acupuncture combined with orthopedic formentation on the gait characteristics of patients with knee osteoarthritis of cold-dampness obstruction syndrome.MethodsA total of 126 cases with knee osteoarthritis who were admitted by the Department of Acupuncture and Moxibustion and Department of Orthopedics， Huguosi Hospital of Traditional Chinese Medicine Affiliated to the Beijing University of Chinese Medicine from January 2021 to May 2023 were collected as the research subjects， and divided into three groups by using random numbers generated by block randomization method （block length is 9）. After excluding the lost patients， 36 cases were included in acupuncture group， 35 cases in orthopedic formentation group and 38 cases in combined treatment group. The acupuncture group was treated with a combination of local Yang needling and conventional acupoint selection acupuncture scheme， the orthopedic formentation group was treated with external orthopedic formentation， and the acupuncture combined with orthopedic formentation group was treated with a combination of local Yang needling and conventional acupoint selection acupuncture and orthopedic formentation. The three groups were treated once every 1 or 2 d and three times a week for 8 weeks. The gait characteristics before treatment， at the end of treatment and at the 16th week in follow up was evaluated by adopting IDEEA3 portable gait analyzer. Observation indicators included single leg support time， double leg support time， cycle time， ratio of single leg support time to double leg support time （SLS/DLS）， limb swing time， stride speed， stride length， stride length and leg lifting strength， leg swinging strength， ground pushing strength， and plantar flexion strength. The adverse reactions of the three groups during the treatment were counted.ResultsAfter treatment and at 16 weeks follow-up， the three groups showed improvements in single leg support time， double leg support time， SLS/DLS， stride speed， stride length， stride length and leg lifting strength， leg swinging strength， ground pushing strength， and plantar flexion strength compared to those before treatment （P<0.05）. Compared with the acupuncture group and orthopedic formentation group， the acupuncture combined with orthopedic formentation group showed significant improvement in single leg support time， double leg support time， SLS/DLS， stride speed， stride length， stride length， leg lifting strength， leg swinging strength， ground pushing strength， and plantar bending strength after treatment and 16 weeks of follow-up （P<0.05）， while the orthopedic formentation group showed no significant improvement （P>0.05）. There were no adverse reactions such as needle fainting， needle stagnation， needle breakage， aggravated pain， severe needle allergy， scald or allergic reaction in the three groups. Throughout the experiment， 8 subjects experienced mild subcutaneous hematoma （3 cases in acupuncture group and 5 cases in combined treatment group）， which subsided spontaneously within a few hours.ConclusionAcupuncture combined with orthopedic drugs can significantly improve the gait stability of patients with cold-dampness obstruction syndrome of knee osteoarthritis， enhance the strength of various flexors and extensors， prolong the walking distance and increase the gait frequency， and the effect is better than acupuncture and orthopedic drugs alone.关键词：knee osteoarthritis;acupuncture;orthopedic formentation;gait characteristics;cold-dampness obstruction syndrome
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发布时间：2024-08-27 -
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- 摘要：ObjectiveTo explore the rules of acupuncture point selection in treating neurodermatitis and postherpetic neuralgia with acupuncture from the perspective of “treating different diseases with same method” in the past 5 years based on multi-software collaborative data mining technology.MethodsCross-searching Chinese and English databases （CNKI， Wanfang， VIP， Medline， Embase， Web of Science）， the articles published from January 1， 2018， to December 31， 2022， in journal literature related to acupuncture treating neurodermatitis and postherpetic neuralgia. The literature was screened according to the inclusion and exclusion criteria， Zotero 6.0.26 was used to manage the original literature， Microsoft Excel 16.54 was used to create a database of acupuncture prescriptions and to clean the data entered， and various software was used to perform statistical analysis and to visualize the data.ResultsIn this study， 31 acupuncture prescriptions for neurodermatitis and 34 acupuncture prescriptions for postherpetic neuralgia were included， respectively. Both disease acupoints were topped by the frequency of using Ashi， and both disease acupoints were concentrated on the bladder meridian of foot-taiyang except Ashi and the five-shu points had the highest percentage of specific acupoints. Both diseases shared the core acupuncture point “Ashi- Xuehai （SP10）- Sanyinjiao （SP6）” and the core paired acupoint was “Xuehai （SP10） -Ashi”. Clustering analysis of high-frequency acupoints in both diseases was performed and each was clustered into three categories， with Ashi clustered into a single category in both diseases.ConclusionHigh consistency of acupoints selected in the acupuncture treatment of neurodermatitis and postherpetic neuralgia was consistent with the theory of “treating different diseases with same treatment”， but there are some differences in the compatibility of acupoints， indicating that the two diseases have their own special emphasis in pathogenesis， and the clinically it should be considered with the actual situation to add or reduce the selection of acupoints.关键词：Treating different diseases with same method;neurodermatitis;postherpetic neuralgia;data mining;acupoint selection rules
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发布时间：2024-08-27 -
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- 摘要：Non-specific low back pain， characterized by lumbar pain not attributed to specific pathological changes， usually arises from decreased lumbar vertebral stability， the root cause being inadequate control of the lumbar spine by the lumboabdominal core muscle group. Ultimately， low back pain manifests as weakened muscle reaction speed and strength of the core muscle group， or stiffness and shortening due to the appearance of trigger points. The trigger points of antagonistic muscle groups and related muscle groups in different moving directions of multifidus， transverse abdominis and waist can be treated by acupuncture to improve lumboabdominal core muscle function so as to treat low back pain.关键词：Non-specific low back pain;acupuncture;lumboabdominal core muscle;acupoint selection based on syndrome differentiation
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发布时间：2024-08-27 -
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