电针对局灶性脑缺血大鼠脑内神经生长因子受体trkA的影响

神经生长因子对神经元凋亡有拮抗作用,其作用方式是通过特异性受体——ｔｒｋＡ实现。为了探讨针刺对内源性抗凋亡因素的调节作用。本研究用大鼠局灶性脑缺血再灌注模型,应用免疫组织化学方法观察缺血再灌注时ｔｒｋＡ的变化及针刺对ｔｒｋＡ的影响。结果发现：缺血组对照侧大脑皮层偶见散在ｔｒｋＡ免疫阳性神经元,缺血侧大脑皮层ｔｒｋＡ阳性神经元与对照侧相比,显微镜下见无显著性差异。电针组缺血侧大脑皮层见大量ｔｒｋＡ免疫反应阳性神经元,主要分布于半影区,与对照侧及未电针的缺血侧相比,显微镜下见阳性神经元数目有差异。结果提示：电针可以诱导脑缺血时神经营养因子受体表达,调动机体内抗凋亡因素的作用。     

针刺抗脑缺血性神经元凋亡作用与机制的研究

本研究在肯定针刺抗缺血性神经元凋亡的基础上,进一步探讨针刺对内源性促凋亡因素及抑制凋亡因素的调整作用,寻找针刺对元保护作用的切入点及作用机制。结果表明：（１）针刺能减轻脑缺血导致的神经缺损行为异常,缩小梗塞面积;（２）ＰＩ荧光染色及ＴＵＮＥＬ染以显示：大鼠缺血皮层梗塞区有大量凋亡阳性信号细胞,电针后细胞凋亡受到明显抑制测定ＮＯ含量及观察ｃＮＯＳ和ｉＮＯＳ免疫活性显示：大鼠脑缺血－再灌注后脑内ＮＯ水     

基于脑肠轴理论探讨健脾化痰方联合针刺对卒中后抑郁患者血清SP、NPY和炎症介质的影响

摘要 目的：基于脑肠轴理论探讨健脾化痰方联合针刺对卒中后抑郁（PSD）患者血清P物质（SP）和神经肽Y（NPY）和炎症介质的影响。方法：研究对象来自石家庄市中医院脑病科2019年3月~2022年4月期间收治的PSD患者，共计116例。按照随机数字表法，将患者分为对照组和实验组，各为58例。基于脑肠轴理论，对照组在接受西医常规治疗的基础上增加健脾化痰方治疗，实验组在对照组的基础上接受针刺治疗。观察两组的疗效、各项量表评分[汉密尔顿抑郁量表（HAMD）、美国国立卫生研究院卒中量表（NIHSS)、日常生活活动能力评分（ADL）]、SP、NPY、炎症介质[白介素-1β（IL-1β）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、高迁移率簇蛋白B1（HMGB1）]。结果：实验组的临床总有效率高于对照组（P<0.05）。实验组治疗后HAMD 、NIHSS评分低于对照组，ADL评分高于对照组（P<0.05）。实验组治疗后SP低于对照组，NPY高于对照组（P<0.05）。实验组治疗后IL-1β、IL-6、TNF-α、HMGB1低于对照组（P<0.05）。结论：基于脑肠轴理论健脾化痰方联合针刺治疗PSD，可以有效改善患者的临床症状，调节血清SP、NPY和炎症介质水平。     

基于脑肠轴理论探讨健脾化痰方联合针刺治疗卒中后抑郁的随机对照研究

摘要 目的：基于脑肠轴理论探讨健脾化痰方联合针刺治疗卒中后抑郁（PSD）的治疗效果。方法：选取石家庄市中医院2018年4月~2022年5月期间收治的113例PSD患者。按照双色球随机分组法将患者分为对照组（n=56，基于脑肠轴理论，常规治疗联合健脾化痰方治疗）和研究组（n=57，在对照组基础上联合针刺治疗）。对比两组疗效、中医证候积分、美国国立卫生研究院卒中量表（NIHSS)评分、汉密尔顿抑郁量表-17（HAMD-17）评分、日常生活活动能力（ADL）评分、P物质（SP）和神经肽Y（NPY），观察两组治疗期间不良反应发生情况。结果：研究组的临床总有效率高于对照组（P<0.05）。与对照组相比，研究组治疗4周后中医证候积分总分、NIHSS评分、HAMD-17评分和血清SP水平更低，ADL评分和血清NPY水平更高（P<0.05）。两组均未见明显的不良反应发生。结论：基于脑肠轴理论采用健脾化痰方联合针刺治疗PSD患者，可改善患者的临床症状、生活自理能力，同时还可减轻神经缺损状况，调节血清SP、NPY水平。     

针刺拔罐后金黄散外敷治疗五步蛇伤患肢肿胀的临床研究

目的研究五步蛇伤后局部组织病变性状,探索五步蛇伤后患肢肿胀的治疗方法。方法选择160例确诊为五步蛇伤患肢肿胀的住院患者随机分为两组,治疗组80例采用针刺拔罐后给予如意金黄散外敷,每天1次;对照组80例采用如意金黄散外敷,每天1次。两组均于治疗5天后观察疗效。结果治疗5天后,治疗组80例伤肢肿胀均消退,显效率为95％,有效率为5％,总有效率（显效＋有效）100％;对照组80例,显效率为34％,有效率为39％,总有效率73％。经统计学分析,治疗组的疗效优于对照组,差异有统计学意义（P〈O．05）。结论针刺拔罐后如意金黄散外敷治疗五步蛇伤患肢肿胀疗效显著,且操作简便、无损伤、无毒副作用、无并发症,安全高效,避免了传统上对五步蛇伤后肿胀切开引流减压造成的组织创伤和病人精神负担,同时可大大缩短住院时间,减轻了病人的经济负担,为临床提供了一种治疗五步蛇伤患肢肿胀的新方法。     

The Neuroscience Research Institute at Peking University: A Place for the Solution of Pain and Drug Abuse

Neuroscience research in China has undergone rapid expansion since 1980. The Neuroscience Research Institute of Peking University, one of the most active neuroscience research groups in China, was founded in 1987. Currently, the institute is overseeing four research areas, i.e., (1) pain and analgesia, (2) drug abuse and acupuncture treatment for drug addiction, (3) the mechanism of neurological degenerative disorders, and (4) the role of neuroglia in central nervous system injury. The institute is simultaneously investigating both theoretical and clinical studies. Acupuncture remains the core of research, while pain and drug abuse form the two disciplines.     

Proteomic analysis of the neuroprotective mechanisms of acupuncture treatment in a Parkinson's disease mouse model

Acupuncture is frequently used as an alternative therapy for Parkinson's disease (PD), and it attenuates dopaminergic (DA) neurodegeneration in the substantia nigra (SN) in PD animal models. Using proteomic analysis, we investigated whether acupuncture alters protein expression in the SN to favor attenuation of neuronal degeneration. In C57BL/6 mice treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 30 mg/kg/day), intraperitoneal (i.p.) for 5 days, 2 or 100 Hz electroacupuncture (EA) was applied at the effective and specific acupoint, GB34, once a day for 12 consecutive days from the first MPTP treatment. Both treatments in MPTP mice led to restoration of behavioral impairment and rescued tyrosine hydroxylase (TH)-positive DA neurodegeneration. Using peptide fingerprinting MS, we identified changes in 22 proteins in the SN following MPTP treatment, and nine of these proteins were normalized by EA. They were involved in cell death regulation, inflammation, or restoration from damage. The levels of cyclophilin A (CypA), which is a neuroprotective agent, were unchanged by MPTP treatment but were increased in MPTP-EA mice. These results suggest that acupoint GB34-specific EA changes protein expression profiles in the SN in favor of DA neuronal survival in MPTP-treated mice, and that EA treatment may be an effective therapy for PD patients.     

Acupuncture protects from 6-OHDA-induced neuronal damage by balancing the ratio of DMT1/Fpn1

ObjectiveAcupuncture is a commonly used method to provide motor-symptomatic relief for patients with Parkinson s disease (PD). Our objective was to evaluate protective effects of acupuncture treatment and potential underlying mechanisms according to the “gut-brain axis” theory.MethodsWe employed a 6-OHDA-induced PD rat model. The effects of acupuncture on disease development were assessed by behavioural tests and immunohistochistry (IHC). ELISA, qPCR and western blot (WB) were employed to measure inflammatory parameters and Fe metabolism in the substantia nigra (SN), striatum, duodenum and blood, respectively.ResultsOur data show that acupuncture can significantly increase the expression of tyrosine hydroxylase (TH), compared with untreated and madopa treated rats (P < 0.01 and P < 0.05, respectively). Furthermore we could observe significantly decreased levels of pro-inflammatory markers in the duodenum and serum (P < 0.05), reduced deposition of Fe in the substantia nigra (P < 0.05) and but no change in transferrin expression after acupuncture treatment. The mRNA ratio of DMT1/Fpn1 in the SN of acupuncture treated rats (1.1) was comparable to that of the sham group (1.0) which differed both significantly from the untreated and madopa treated groups (P < 0.05). Furthermore, after acupuncture expression of α-synuclein was decreased in the duodenum.ConclusionsAcupuncture can reduce iron accumulation in the SN and protect the loss of dopamine neurons by promoting balanced expression of the iron importer DMT1 and the iron exporter Fpn1. Furthermore CNS iron homeostasis may be affected by reduced systemic and intestinal inflammation.     

培元还五汤联合针灸治疗缺血性脑卒中恢复期患者的疗效及对血清细胞因子和睡眠质量的影响

目的:探讨培元还五汤联合针灸治疗缺血性脑卒中恢复期患者的疗效及对血清细胞因子和睡眠质量的影响。方法:选取北京王府中西医结合医院于2017年1月～2018年12月间接收的99例缺血性脑卒中恢复期患者,根据数表法将患者随机分为对照组(n=49,给予基础治疗和常规康复训练)和研究组(n=50,在对照组基础上给予培元还五汤联合针灸治疗),比较两组患者临床疗效、神经功能缺损情况、上肢运动功能、睡眠质量以及血清超敏C-反应蛋白(hs-CRP)、妊娠相关蛋白A(PAPP-A)、神经生长因子(NGF)、脑源性神经营养因子(BDNF)水平变化,记录两组治疗期间不良反应发生情况。结果:研究组治疗后临床总有效率为92.00%(46/50),显著高于对照组患者的71.43%(35/49)(P0.05)。两组患者治疗2个月后神经功能缺损(NIHSS)评分、睡眠质量评分降低,且研究组低于对照组(P0.05),Fugl-Meyer运动(FMA)评分则升高,且研究组高于对照组(P0.05)。两组患者治疗2个月后血清hs-CRP、PAPP-A水平降低,且研究组低于对照组(P0.05),血清NGF、BDNF水平则升高,且研究组高于对照组(P0.05)。两组不良反应发生率比较无差异(P0.05)。结论:培元还五汤联合针灸治疗缺血性脑卒中恢复期患者,疗效确切,可有效改善患者神经功能、上肢运动功能、睡眠质量,改善相关细胞因子水平,且不增加不良反应发生率,具有一定的临床应用价值。     

针灸联合康复理疗对急性脑梗死患者脑部血流供应及炎性因子的影响

目的:探讨针灸联合康复理疗对急性脑梗死(ACI)患者脑部血流供应及炎性因子的影响。方法:选取2017年1月～2018年8月期间我院收治的ACI患者63例,根据随机数字表法将患者分为对照组(n=31)和研究组(n=32),对照组在常规西医治疗基础上给予康复理疗治疗,研究组在对照组基础上结合针灸进行治疗,1周为1个疗程,两组均治疗4个疗程。比较两组患者治疗4个疗程后的临床疗效,治疗前、治疗4个疗程后的脑部血流供应指标、炎性因子指标以及Fugl-Meyer运动功能评分(FMA)、改良Barthel指数评分(MBI)、神经功能缺损评分(NIHSS)。结果:研究组治疗4个疗程后总有效率为78.13%(25/32),高于对照组的51.61%(16/31)(P0.05)。两组患者治疗4个疗程后FMA、MBI均较治疗前升高,且研究组高于对照组(P0.05),NIHSS较治疗前降低,且研究组低于对照组(P0.05)。两组患者治疗4个疗程后平均血流量(Qm)、平均血流速度(Vm)均较治疗前升高,且研究组高于对照组(P0.05),外周阻力(Rv)、动态阻力(DR)均较治疗前降低,且研究组低于对照组(P0.05)。两组患者治疗4个疗程后血清白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平均低于治疗前,且研究组较对照组降低(P0.05)。结论:针灸联合康复理疗治疗ACI患者,效果明显,可有效改善患者运动功能、神经功能及脑部血流供应情况,降低机体炎性因子水平,提高日常生活能力,具有一定的临床应用价值。