最新刊期
卷 43 ， 期 5 ， 2018
- 摘要：According to the theory of traditional Chinese medicine,acupuncture points are very important in the treatment of various clinical conditions.This paper focuses on the correlation and connotation of two scientific propositions,i.e.,the primordial state and sensitized state of acupoints.We hold that the modern concept of acupuncture point may be not the same as the traditional one in the connotations.The current acupuncture points are probably referred to the spots for acupuncture stimulation,rather than simple acupoints,while the sensitized state is possibly one of its characteristics.The sensitized acupuncture point in fact may not be the main treatment locus for strengthening the body resistance to eliminate pathogenic factors.Contemporary research and establishment of theoretical framework should aim at developing a complete knowledge system pertaining to acupuncture-moxibustion medicine rather than deviating or separating it from the fundamental principles of the overall regulation of acupuncture or moxibustion treatment.关键词：Acupuncture points;Traditional concept;Modern concept;Primordial state;Sensitized state676|909|7更新时间：2023-08-11
- 摘要：Objective To observe the correlation between the referred pain regions of stable angina pectoris(SAP)and the acupoints in coronary heart disease(CHD)patients and to investigate the rule of regional sensitized point distribution in rats.Methods A total of 1 046 CHD patients with SAP from 8 hospitals in China were recruited in the present study.The tenderness was palpated along the left and right chest,back,shoulder,upper limb,etc.by a specially-assigned researcher in each hospital.Among them,77 patients accepted pain threshold(PT)measurement by using a hand-held esthesiometer.In animal experiments,14 SD rats were subjected to occlusion of the left anterior descending branch of the left coronary artery for 4 hfor establishing myocardial ischemia(MI)model,and other 4 normal rats were used as the sham-operation control group.Four hours after MI,all the rats accepted tail venous injection of 5% Evans blue(50 mg/kg)for examining the distribution of the blue dye exudation spots at the body surface where the mechanical PT was also detected by a von Frey.Results In 1 046 CHD patients,987(94.36%)were found to have at least one tenderness spot.The tenderness spots were found at the left chest(87.47%),right chest(13.67%),left arm(ulnar side,41.30%),right upper limb(4.68%),left shoulder back(30.21%),right shoulder back(7.07%),etc.,accompanied with rash or pigmentation,subcutaneous induration,cord-like tissue contracture,skin sag,etc.The mechanical PT level was significantly lower at the tenderness spots of the left upper limb than at non-tender points of the right upper limb in CHD patients(P<0.001).Tenderness and cutaneous abnormal changes in angor pectoris patients distributed mostly on the left chest,back,shoulder and upper limb,and some also on the right.Tender points scattered on,near or outside acupoints.A similar distribution of the blue exudation spots and lower mechanical PT spots were found in MI rats,but not in shamMI rats.Conclusion In the case of MI,a regular"referred sensitization"response frequently occurs in the dermatomere area innervated by the corresponding segments(T 1-T 5)in both CHD patients and MI rats,which may be closely associated with the formation of acupoints in ancient China.关键词：Angina pectoris;Referred pain;Acupoint sensitization;Mechanical pain threshold741|1309|30更新时间：2023-08-11
- 摘要：The anatomical structure of acupuncture points is the carrier for needling stimulation induced neurobiological effects.Although researchers have never stopped investigating its structure and experienced different stages from macroscopic to microcosmic morphological material basis,our understanding still largely lags behind the requirements of the times.In the present paper,we review development of researches on acupuncture points in recent decades from 1)macroscopic anatomical structure including skin,bones,muscles,nerves,blood vessels,etc.;2)macro-microcosmic structure as the thickness of skin and muscles,distribution of blood vessels and nerve fibers,and innervation;3)microstructure including cell categories(mast cells,fibroblasts,macrophages,etc.),peptidergic nerve fibers,various receptors,chemical substances,and their relationship with the brain and immune-endocrine system(cutaneous-neuro-immune-endocrine-mental biological communication),etc.These research outcomes will not only help us demonstrate the acupoint's structure better at the level of the body surface and regional anatomy,but also,at the microstructural level,reveal different kinds of cells and their chemical compositions in its structure as well as their relationship with the regulatory system of the whole body.From the perspective of the cutaneous and systemic neuro-immuno-endocrine networks,it undoubtedly prompts us to profoundly explore the underlying biological mechanisms of acupuncture.To observe the regional mutual connection and interaction of different kinds of cells and their chemical mediators and molecules in the acupuncture point will improve our understanding about the nature of acupuncture points from the static to the dynamic point of view.This might be a new approach for us to further reveal the functional roles of acupuncture points.关键词：Acupuncture point;Morphological structure;Acupuncture effects;Cutaneous-neuro-immune-endocrine network598|899|14更新时间：2023-08-11
- 关键词：Classical concept about acupoints;Signs and structure of acupoints;A-B Classic of Acupuncture and Moxibus tion;Literature research627|596|3更新时间：2023-08-11
- 摘要：The"superficial fascia"is often interpreted as"tendon-membrane like structure"in acupuncture field and it is speculated that acupuncture stimulation-induced structural alteration of the superficial fascia may contribute to the alleviation of many medical conditions.The fact is that the superficial fascia mainly consists of subcutaneous adipose tissue and fibrotic network(which function in storing,supporting and buffering external pressure and are not responsible for producing "Deqi"or"needling sensations"),and has no typical tendon or membrane structure in hypodermis.In the present paper,the author tries to clarify its incorrect translation,misinterpretation,and misunderstanding in acupuncture and propose that the target of acupuncture stimulation is probably not only the subcutaneous soft tissue per se,but also the contents in subcutaneous soft tissue network as the nerves,blood vessels,lymph-vessels,cutaneous accessory structures,mast cells,multiple movable cells,related receptors,etc.关键词：Superficial fascia;Acupuncture;Skin tissue;Subcutaneous tissues690|366|0更新时间：2023-08-11
- 摘要：Objective To observe whether the transient receptor potential vanilloid 1(TRPV 1)plays a role in moxibustion(Moxi)-induced regulation of local immune inflammatory response.Methods Fifteen C 57 BL/6 Jand 15 TRPV1(-/-)mice were randomly and respectively divided into blank control,Moxi-30 min and Moxi-72 hgroups(5 mice/group).The Moxi intervention([46±1]℃)was applied to the left"Zusanli"(ST 36)for 30 min.The local tissue of the left ST 36 region was collected for observing the histological changes after H.E.staining,and for counting the number of tumor necrosis factor-α(TNF-α)immunereaction(IR)-positive cells after immunofluorescence staining.Results In both C 57 BL/6 Jand TRPV 1(-/-)mice were randomly and respectively divided into blank control,Moxi-30 min and Moxi-72 hgroups(5 mice/group).The Moxi intervention([46±1]℃)was applied to the left"Zusanli"(ST 36)for 30 min.The local tissue of the left ST 36 region was collected for observing the histological changes after H.E.staining,and for counting the number of tumor necrosis factor-α(TNF-α)immunereaction(IR)-positive cells after immunofluorescence staining.Results In both C 57 BL/6 Jand TRPV 1(-/-)mice,following Moxi,the local epidermis tissue was incomplete,with vague layers and arrangement of the stratum corneum(being thicker than control mice),and visible scar tissue.The corium layer was relatively looser in the structure,and the collagenous and elastic fibers were loosened in the arrangement or absence,with an abundant inflammatory cell infiltration,vascular dilation and congestion of blood vessels,and abnormal hyperplasia of hair follicles and sebaceous glands(but without marked structural changes of the subcutaneous tissue).In C 57 BL/6 Jmice,compared with the control group,the numbers of TNF-αIR-positive cells were significantly increased in the epidermis of the Moxi-30 min group(P<0.05),and in the dermis of the Moxi-30 min and-72 hgroups(P<0.01).In TRPV1(-/-)mice,following Moxi,the local epidermis tissue was incomplete,with vague layers and arrangement of the stratum corneum(being thicker than control mice),and visible scar tissue.The corium layer was relatively looser in the structure,and the collagenous and elastic fibers were loosened in the arrangement or absence,with an abundant inflammatory cell infiltration,vascular dilation and congestion of blood vessels,and abnormal hyperplasia of hair follicles and sebaceous glands(but without marked structural changes of the subcutaneous tissue).In C 57 BL/6 Jmice,compared with the control group,the numbers of TNF-αIR-positive cells were significantly increased in the epidermis of the Moxi-30 min group(P<0.05),and in the dermis of the Moxi-30 min and-72 hgroups(P<0.01).In TRPV1(-/-)mice,compared with the control group,the numbers of TNF-αIR-positive cells were also considerably increased in the epidermis of the Moxi-30 min group,and in the dermis of both Moxi-30 min and-72 hgroups(P<0.01).Comparison between the two Moxi groups showed that the number of TNF-αpositive cells was significantly lower in the dermis of the Moxi-72 hgroup than in that of the Moxi-30 min group in C 57 BL/6 Jmice(P<0.01),and significantly lower in both the epidermis and dermis of the Moxi-72 hgroup than in those of the Moxi-30 min group in TRPV1(-/-)mice,compared with the control group,the numbers of TNF-αIR-positive cells were also considerably increased in the epidermis of the Moxi-30 min group,and in the dermis of both Moxi-30 min and-72 hgroups(P<0.01).Comparison between the two Moxi groups showed that the number of TNF-αpositive cells was significantly lower in the dermis of the Moxi-72 hgroup than in that of the Moxi-30 min group in C 57 BL/6 Jmice(P<0.01),and significantly lower in both the epidermis and dermis of the Moxi-72 hgroup than in those of the Moxi-30 min group in TRPV1(-/-)mice(P<0.01).Conclusion Moxibustion stimulation of ST 36 can induce structural changes of the regional epidermis and dermis of the skin and up-regulate the number of TNF-αIR-positive cells in both C 57 BL/6 Jand TRPV1(-/-)mice(P<0.01).Conclusion Moxibustion stimulation of ST 36 can induce structural changes of the regional epidermis and dermis of the skin and up-regulate the number of TNF-αIR-positive cells in both C 57 BL/6 Jand TRPV1(-/-)mice,which may contribute to its therapeutic effect via local TRPV 1-independent immunoregulation.关键词：Moxibustion;Zusanli(ST 36);Skin structural changes;Tumor necrosis factor-α;Transient receptor potential vanilloid 1(TRPV 1)697|544|0更新时间：2023-08-11
- 摘要：Objective To observe the effect of electroacupuncture(EA)preconditioning on acute myocardial ischemia(MI)and expression of Toll-like receptor 4(TLR 4),myeloid differentiation factor 88(MyD 88)and nuclear factor-κB(NF-κB)mRNAs in the"Neiguan"(PC 6)area of rats with MI-reperfusion injury(MIRI),so as to explore its mechanisms underlying improvement of MIRI.Methods Forty-eight male Wistar rats were randomly divided into control,control+ EA,sham operation,model,EA and sham EA groups(n=8).The MIRI model was established by occlusion of the descending anterior branch of the left coronary artery for 30 min,followed by reperfusion.Before modeling,EA preconditioning was respectively applied to PC 6 or sham PC 6 for 30 min,once daily for 5 days.Electrocardiogram(ECG)of the standard limb-leadⅡ was recorded before and after the modeling,and 0.25 hafter reperfusion.The expression levels of TLR 4,MyD 88 and NF-κB genes in the PC 6 tissue were detected by Real-time PCR.Results Compared with the control group,the height of ECG J-point was significantly increased in the model group(P<0.01),suggesting an acute MI,and the height of J-point was significantly lower in the EA group than in the model and sham EA groups(P<0.01).In comparison with the control group,the expression levels of TLR 4,MyD 88 and NF-κB mRNAs were markedly up-regulated in the area of PC 6 in the model group(P<0.01).Compared with the model group,the increased expression levels of TLR 4,MyD 88 and NF-κB mRNAs in the EA preconditioning group were significantly inhibited(P<0.05).No significant differences were found among the control,control+EA and sham operation groups and between the model and sham EA groups in the expression levels of TLR 4,MyD 88 and NF-κB mRNAs(P>0.05).Conclusion EA preconditioning can improve myocardial ischemia and reduce the expression of TLR 4,MyD 88 and NF-κB mRNAs in PC 6 area of MIRI rats,suggesting an involvement of the regional cutaneous TLR 4/MyD 88/NF-κB signaling suppression in the initiation-transfer-amplification of EA stimulating signal inputs for relieving MIRI.关键词：Electroacupuncture;Myocardial ischemia-reperfusion injury;PC 6area;Cutaneous TLR 4/MyD 88/NF κB signaling732|689|3更新时间：2023-08-11
- 摘要：Objective To observe whether acupuncture of the tender-points of the Spleen Meridian can achieve a better therapeutic effect for primary dysmenorrhea(PD)patients,so as to verify the importance of examining meridian-acupoint reactions in clinical practice.Methods A total of 72PD patients were randomly assigned to tender-point group(observation group)and regular acupoint group(control group,n=36in each).For patients of the observation group,the tender-points around Sanyinjiao(SP 6),Diji(SP 8)and Yinlingquan(SP 9)were needled,and for those of the control group,the regular SP 6,SP 8and SP 9were needled.After"Deqi",the filiform needles were manipulated with lifting-thrusting reducing technique for about 30s,repeated once again every 10min during 30min’s needle retention,and the treatment was conducted once daily for 3days during every menstrual cycle,continuously for 3months.The visual analogue scale(VAS)was rated for assessing the pain severity,and the COX menstrual symptom scale(CMSS)consists of 17items and 5grades/item(0-4points)according to the severity of discomfort was rated before and after the treatment.Results After the treatment,the VAS and CMSS scores on the 1(st )days of the 1(st )days of the 1(st),2(st),2(nd )and 3(nd )and 3(rd )menstrual cycles were significantly decreased in both control and observation groups in comparison with their own individual pre-acupuncture(P<0.05),suggesting a marked relief of both pain and discomforts after the treatment,and the therapeutic effect of the tender-point needling was significantly superior to that of the regular acupoint needling in relieving pain in the 2(rd )menstrual cycles were significantly decreased in both control and observation groups in comparison with their own individual pre-acupuncture(P<0.05),suggesting a marked relief of both pain and discomforts after the treatment,and the therapeutic effect of the tender-point needling was significantly superior to that of the regular acupoint needling in relieving pain in the 2(nd )and 3(nd )and 3(rd )menstrual cycles.No significant difference was found between the two groups in the discomfort severity(P>0.05).Conclusion Acupuncture stimulation of the tender points around the SP 6,SP 8and SP 9has a stronger analgesic effect relevant to needling the regular acupoints in PD patients.关键词：Acupuncture;Primary dysmenorrhea;Acupoints of Spleen Meridian;Tender points;Randomized controlled trial577|826|12更新时间：2023-08-11
- 摘要：Objective To examine the distribution of heat-sensitive acupoints below the elbow and knee joints of the Yangming Meridians in patients with perennial allergic rhinitis(PAR).Methods A total of 27 PAR volunteers 16-55 years in age were recruited in the present study.In a quiet room,the patient was ordered to take a recumbent or sitting position,and the operator held an ignited moxa-stick to make a circling(about 2 min),sparrow-pecking(2 min)and forwards-backwards moving(1 min)moxibustion perpendicularly over the skin(about 3 cm away)along the running course of the Large Intestine Meridian of Hand Yangming below the elbow joints and the Stomach Meridian of Foot Yangming below the knee joints on both sides.The procedures were repeated again and again until the moxibustion sensation disappeared.The patient was asked to carefully perceive the heat diffusion,diathermic,extending,athermal(cool and itching)feelings,at the heated loci.If one or more of the feelings appeared,it was considered as the thermosensitive phenomenon and that spot was marked as the"thermosensitive spot"or"thermosensitive acupoint".Results In those 27 PAR patients,the thermosensitive response was found at Quchi(LI 11),Shousanli(LI 10),Hegu(LI 4),Sanjian(LI 3),and Zusanli(ST 36),constituting 59.25%(16/27),85.18%(23/27),44.44%(12/27),55.55%(15/27),and 11.11%(3/27),respectively,being 92.59%in total.Of the 27 patients,2,2,9,8,5 and 1 cases had0,1,2,3,4 and 5 thermosenitive acupoints appeared,accounting for 7.41%,7.41%,33.33%,29.63%,18.52% and3.70%,respectively.Conclusion There is a certain occurrence rate of the thermosensitive acupoints below the elbow and knee joints of the Yangming Meridians in PAR patients,which may provide a target-point for treating PAR.关键词：Thermosensitive acupoints;Allergic rhinitis;Yangming Meridian;Lower arms and limbs503|265|1更新时间：2023-08-11
- 摘要：Objective To observe the effect of electroacupuncture(EA)on insulin signaling pathway in liver tissues of central neuronal specific signal transduction and activator of transcription 5 conditional-knockout(Stat 5 NKO)mice,so as to explore its mechanism underlying improvement of insulin resistance(IR).Methods Twenty-four male Stat 5 NKO mice were randomly divided into model and EA groups(n=12 mice/group),and 12 Stat 5 fl/fl mice were used as the normal control group.EA(2 Hz/15 Hz,0.8-1.0 mA)was alternatively applied to ipsilateral"Zusanli"(ST 36)and"Neiting"(ST 44)for 20 min,once a day,6 times a week for 4 weeks.The glucose tolerance test(GTT)and insulin tolerance test(ITT)were performed,and the values of fasting plasma glucose(FPG)and fasting insulin(FINS)were measured by glucometer and ELISA,separately.The insulin sensitivity index(ISI)was calculated.The phosphorylation protein expressions of insulin receptor substrate 1(IRS 1),insulin receptorβ(IRβ)and protein kinases B(Akt)in the liver tissues were detected by Western blot.Results In Stat 5 NKO mice(model group),FPG level and glucose area under the curve(GAUC)of ITT and GTT were significantly increased(P<0.01,P<0.05,P<0.001),while the ISI was notably down-regulated in comparison with the Stat 5 fl/fl mice(normal group,P<0.01),suggesting an impairment of both glucose tolerance(GT)and insulin tolerance(IT)in mice of the model group.After the EA treatment,the increased FPG and GAUC levels and the decreased ISI were reversed markedly(P<0.05,P<0.01,P<0.001).No significant differences were found in FINS among the three groups(P>0.05).Compared with the normal group,the protein expression levels of liver p-IRS 1 and p-IRβwere significantly up-regulated(P<0.001),and the p-Akt expression was significantly down-regulated(P<0.01)in the model group.Following EA treatment,the increased p-IRS 1 and p-IRβprotein expression and the decreased p-Akt expression were apparently reversed in the EA group relevant to the model group(P<0.001,P<0.01).Conclusion EA can improve the IR induced by central neuronal Stat 5-knockout in mice,which may contribute to its effectiveness in regulating hepatic IRβ/IRS 1/Akt signaling pathway.关键词：Electroacupuncture;Insulin resistance;Insulin receptor substrate 1;Insulin receptorβ;Protein kinases B684|242|2更新时间：2023-08-11
- 摘要：Objective To examine the effects of different sensitivities on the effectiveness of acupuncture analgesia by observing activation change characteristics of cerebral areas resulting from the influences of constitutions on analgesia effects and to discuss the response mechanism of central nervous system(CNS)to determine the factor of constitutions on acupuncture efficacy using cerebral functional magnetic resonance imaging arterial spin labeling(fMRI-ASL).Methods Participants with different sensitivities were assessed according to standard screening and grouped into two groups:insensitivity group(n=24)and sensitivity group(n=22).All participants were given acupuncture at the left-sided Zusanli point.Pressure pain threshold(PPT)of their body surface was determined before and after the acupuncture,and the two groups were subsequently compared in terms of analgesic effects and PPT rate of change;cerebral fMRI-ASL was performed;software such as SPM 8 and ASLtbx were utilized to preprocess the results,and correlation between regional cerebral blood flow(rCBF)and visual analog scale(VAS)score was determined using Pearson's correlational analysis.Results VAS score in the sensitivity group was significantly higher than that in the insensitivity group(P< 0.05);after acupuncture,PPT rate of change in the sensitivity group was higher than that in the insensitivity group(P< 0.05).The analyses revealed that there was a negative correlation between rCBF and VAS score for the right-sided anterior cingulate cortex in the insensitivity group and superior frontal gyrus in the sensitivity group( r >0.3 and P<0.05).Conclusion Different sensitivity to acupuncture is one of the crucial factors influencing analgesia effects.The sensitivity group had superior analgesia effect than the insensitivity group.Acupuncture might deactivate cerebral functional areas to generate analgesic effects.The superior frontal gyrus and bilateral anterior cingulate cortex,because of deactivation,play apositive role in sensitive patients,which is probably one of the CNS cerebral areas responding to acupuncture analgesia of people who are sensitive to acupuncture.关键词：Acupuncture analgesia;Constitution;Cerebral functional magnetic resonance imaging;Arterial spin labeling technology594|226|2更新时间：2023-08-11
- 摘要：Objective To examine the clinical benefits of acupuncture combined with intra-articular injection of sodium hyaluronate for knee osteoarthritis(KOA)patients.Methods A total of 150 KOA patients were randomized into simple medication and acupuncture plus medication(combined treatment)groups(n=75 in each).For all the patients,intra-articular injection of sodium hyaluronate(2 mL)was performed once a week for 5 weeks,and for patients of the combined treatment group,filiform needles were separately inserted into unilateral or bilateral Zusanli(ST 36),Liangqiu(ST 34),Yanglingquan(GB 34),Yinlingquan(SP 9),Xiyangguan(GB 33),Dubi(ST 35),Neixiyan(EX-LE 4)and Xuehai(SP 10)according to the focus,and manipulated with the uniform reinforcing and reducing technique,followed by retaining the needles for 30 min.The acupuncture treatment was given once every day or every other day,5 weeks in total.The visual analog scale(VAS)was used to assess the pain severity of kneejoint,and the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)employed to assess the 1)pain severity during various positions or movements(20 points),2)severity of joint stiffness(8 points),and 3)difficulty in performing daily functional activities(68 points).The therapeutic effect was evaluated according to the decreased level of WOMAC subscale scores and improvement of daily activities.Results After the treatment,the VAS scores of both medication and combined treatment groups were decreased significantly in comparison with their own pre-treatment in each group(P<0.05),and that of the combined treatment group was significantly lower than that of the medication group(P<0.05).WOMAC and daily activity findings showed that of the two 75 KOA patients in the medication and combined treatment groups,16(21.33%)and 32(42.67%)experienced marked improvement,46(61.33%)and 38(50.67%)were improved,and 13(17.33%)and 5(6.67%)ineffective,with the total effective rates being 82.67% and 93.33%,respectively.The therapeutic effect of the combined treatment group was apparently superior to that of the simple medication group(P<0.05).Conclusion Acupuncture combined with intraarticular injection of sodium hyaluronate is effective in improving KOA patients' pain severity and other symptoms as well as functional activities.关键词：Knee osteoarthritis;Acupuncture;Intra-articular injection;Sodium hyaluronate;Pain563|400|4更新时间：2023-08-11
- 摘要：The objectification of"Deqi"of acupuncture is a hot topic in acupuncture research at present,and functional magnetic resonance imaging(fMRI)is one of the most frequently-used techniques for revealing its brain responses.We searched literature about"Deqi"from PubMed in recent 10 years by using key words"Deqi""acupuncture sensation""needling sensation"and fMRI,trying to expound the central mechanism of"Deqi"and to put forward our understandings.Acupuncture"Deqi"evoked deactivation of the limbic-paralimbic-neocortical network(LPNN)/default mode network(DMN),including medial prefrontal cortex(frontal pole,anterior cingulate),temporal lobe(amygdala,hippocampus,parahippocampus gyrus,temporal pole),and apparent activation of brain regions as the somatosensory cortex,thalamic-somatosensory area-insular lobe,orbitofrontal cortex,etc.,which may enhance the connectivity of brain networks and function in analgesia,anti-anxiety,anti-depression,etc.,but the activated and deactivated brain regions are different from study to study possibly due to the stimulated different acupoints,subjects' psychophysical conditions,scanning parameters,image acquiring sequences,etc.It is recommended that the coming studies should pay more attention to the influence of acupuncture "Deqi"on brain functions in subjects suffering from diseases,the brain response characteristics of the longer post-effects and the accumulated effects of acupuncture treatment.关键词：Deqi;Acupuncture;Functional magnetic resonance imaging;Central nervous response647|696|5更新时间：2023-08-11
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