针灸治疗损伤周围神经选穴方案的改进：节选督脉经穴电针为主配合局部选穴

SICENCE新闻发布作者：何冠蘅稿号：NRR_271_14针灸治疗损伤周围神经选穴方案的改进：节选督脉经穴电针为主配合局部选穴周围神经损伤后不仅可出现局部病变，同时会引起相应阶段脊髓神经元的凋亡。目前许多临床医生在周围神经损伤的治疗上只关注局部处理，而忽视了远离损伤部位的脊髓段病灶的治疗。传统针灸处方中也存在只注重选取局部经穴的问题。来自中国中山大学附属第一医院的何冠蘅等所在团队，设计了一项研究在针灸选穴处方上做出调整的实验方案，在周围神经损伤局部选穴的同时，还选取与脊神经元凋亡相关脊髓相应节段的督脉穴。研究第一阶段纳入周围神经损伤患者30例，随机等分为2组，督脉穴配合局部经穴组以刺激督脉经穴为主，上肢神经损伤选取百会(GV20)、风府(GV16)、大椎(GV14)、身柱穴(GV12)；下肢神经损伤选取脊中(GV6)、命门(GV4),、腰阳关(GV3)、腰俞穴(GV2)，并结合损伤神经的不同以循经取穴，局部经穴组根据损伤神经的不同循经取穴。在研究的第二阶段再次纳入周围神经损伤患者20例，针灸取穴、治疗方法及疗程与第一阶段的督脉配合局部经穴组相同，并在治疗前、后予电生理检查观察神经的传导情况以探讨作用机制。结果显示，研究采用的以节选督脉经穴电针为主配合局部取穴的治疗方法，对周围神经损伤后功能的修复有较好的促进作用，其作用机制可能与督脉电针能改善局部微环境，配合局部穴电针即时效应保证了周围神经与中枢神经的连续性有关。文章发表在《中国神经再生研究（英文版）》杂志2015年1月第1期。Article:Improvementinacupointselectionforacupunctureofnervessurroundingtheinjurysite:electro-acupuncturewithGovernorvesselwithlocalmeridianacupoints,byGuan-hengHe1,Jing-wenRuan1,Yuan-shanZeng2,XinZhou1,YingDing2,Guang-huiZhou3(1DepartmentofAcupuncture,theFirstAffliatedHospital,SunYat-senUniversity,Guangzhou,GuangdongProvince,China;2DivisionofNeuroscience,DepartmentofHistologyandEmbryology,ZhongshanSchoolofMedicine,SunYat-senUniversity,Guangzhou,GuangdongProvince,China;3RehabilitationDepartment,People’sHospitalofDongguanShilong,SouthernMedicalUniversity,Dongguan,GuangdongProvince,China)HeGH,RuanJW,ZengYS,ZhouX,DingY,ZhouGH(2015)Improvementinacupointselectionforacupunctureofnervessurroundingtheinjurysite:electro-acupuncturewithGovernorvesselwithlocalmeridianacupoints.NeuralRegenRes10(1):128-135.欲获更多资讯：NeuralRegenResElectro-acupuncturewithGovernorvesselwithlocalmeridianacupointsagainstPNIPeripheralnerveinjury(PNI)notonlyaffectsthesiteoftheinjury,butcanalsoinduceneuronalapoptosisatthespinalcord.However,manyacupuncturecliniciansstillfocusonlyontheinjurysite,selectingacupointsentirelyalongtheinjurednervetrunkandneglectingotherregions;thismaydelaytreatmentefficacyandrehabilitation.Traditionalprescriptionforclinicalacupuncturealsoonlyselectstheacupointsaroundthelocalinjury.Guan-hengHe,theFirstAffiliatedHospital,SunSICENCE新闻发布作者：何冠蘅稿号：NRR_271_14Yat-senUniversity,ChinaandhiscolleaguesacupuncturedatmeridianacupointsattheinjurysitecombinedwithGovernorvesselacupointslocatedonthesegmentofapoptoticspinalcordneuronsthatcorrespondedtotheinjurysite.Inthefirststudystage,30patientswithPNIwererandomlydividedintotwogroups:acupunctureatGovernorvesselandlocalmeridianacupointsgroup(GV/LMgroup)andacupunctureatlocalmeridianacupointsalonegroup(LMgroup).IntheGV/LMgroup,inadditiontomeridianacupointsattheinjurysite,thefollowingacupointsontheGovernorvesselwerestimulated:Baihui(GV20),Fengfu(GV16),Dazhui(GV14),andShenzhu(GV12),selectedtotreatnerveinjuryoftheupperlimb,andJizhong(GV6),Mingmen(GV4),Yaoyangguan(GV3),andYaoshu(GV2)totreatnerveinjuryofthelowerlimb.IntheLMgroup,onlymeridianacupointsalongtheinjurednervewereselected.Inthesecondstudystage,anadditional20patientsunderwentacupuncturewiththesameprescriptionastheGV/LMgroup.Electomyographicnerveconductiontestswereperformedbeforeandafteracupuncturetoexplorethemechanismofactionofthetreatment.TheirresultsindicatethatacupunctureatGovernorvesselandlocalmeridianacupointssimultaneouslybetterpromotesfunctionalrepairafterPNI.Themechanismofactionmayarisefromanimprovementofthelocalmicroenvironmentininjurednervoustissue,aswellasimmediateeffectsofGovernorvesselandlocalmeridianacupointstimulationtoensurethecontinuitybetweentheperipheralandcentralnervoussystems.TheseresultswerepublishedintheNeuralRegenerationResearch(Vol.10,No.1,2015).Article:Improvementinacupointselectionforacupunctureofnervessurroundingtheinjurysite:electro-acupuncturewithGovernorvesselwithlocalmeridianacupoints,byGuan-hengHe1,Jing-wenRuan1,Yuan-shanZeng2,XinZhou1,YingDing2,Guang-huiZhou3(1DepartmentofAcupuncture,theFirstAffliatedHospital,SunYat-senUniversity,Guangzhou,GuangdongProvince,China;2DivisionofNeuroscience,DepartmentofHistologyandEmbryology,ZhongshanSchoolofMedicine,SunYat-senUniversity,Guangzhou,GuangdongProvince,China;3RehabilitationDepartment,People’sHospitalofDongguanShilong,SouthernMedicalUniversity,Dongguan,GuangdongProvince,China)HeGH,RuanJW,ZengYS,ZhouX,DingY,ZhouGH(2015)Improvementinacupointselectionforacupunctureofnervessurroundingtheinjurysite:electro-acupuncturewithGovernorvesselwithlocalmeridianacupoints.NeuralRegenRes10(1):128-135.