Observation of the therapeutic effect of Tongyuan needling combined with jingyu herb-separated moxibustion on recurrent implantation failure of kidney deficiency and blood stasis. / "é€šå ƒé’ˆæ³•"联合精玉药灸治疗肾虚血瘀型反复种植失败疗效观察.

OBJECTIVES: To observe the therapeutic effect of Tongyuan needling combined with jingyu herb-separated moxibustion on the patients with recurrent implantation failure (RIF) of kidney deficiency and blood stasis undergoing frozen embryo transfer of the conventional hormone replacement therapy cycle. METHODS: Sixty RIF of kidney deficiency and blood stasis patients who planned for frozen embryo transfer were randomly divided into a combined treatment group (30 cases) and a western medication group (30 cases). In the western medication group, the conventional hormone replacement therapy was performed for endometrial preparation during transfer cycle. On the basis of treatment as the western medication group, in the combined treatment group, Tongyuan needling combined with jingyu herb-separated moxibustion was adopted. Regarding tongyuan needling, the acupoint prescription for Tongdu Tiaoshen (promoting the governor vessel and regulating the spirit, e.g. Dazhui [GV 14], Ganshu [BL 18], Shenshu [BL 23] and back-shu points) and that for Yinqi Guiguan (conducting qi back to the primary, e.g. Zhongwan [CV 12], Qihai [CV 6], Guanyuan [CV 4] and front-mu points) were selected. Acupuncture was delivered at these two prescriptions alternatively each time. After acupuncture, the herb-separated moxibustion (in which, the herbal powder was prepared with the modified Yangjing Zhongyu decoction for cultivating the kidney essence and promoting pregnancy) was operated at Shenque (CV 8). This combined therapy was delivered once every two days, 3 sessions a week till the day of embryo transfer. The pregnancy outcomes (positive rate of human chorionic gonadotropin [ß-HCG] and clinical pregnancy rate) were compared between the two groups, as well as the TCM syndrome score, serum estradiol (E2) and progesterone (P) levels, endometrial thickness and type, endometrial blood flow index (pulsatility index [PI], resistance index [RI]) before and after treatment. RESULTS: After treatment, the clinical pregnancy rate of the combined treatment group was 40.0% (12/30), higher than that of the western medication group (16.7%, 5/30, P<0.05); and the difference in the positive rate of ß-HCG was not significant statistically between the two groups (P>0.05). After treatment, the serum levels of E2 and P were elevated (P<0.05), the endometrial thickness was thickened (P<0.05); the scores of TCM syndrome, and the levels of PI and RI were reduced (P<0.05) when compared with those before treatment in the two groups. The proportion of type A endometrium increased compared with that before treatment in the combined treatment group (P<0.05). Except the levels of E2 and P, the above indexes in the combined treatment group were superior to the western medication group (P<0.05). CONCLUSIONS: On the basis of frozen embryo transfer of conventional hormone replacement cycle, the intervention of Tongyuan needling combined with jingyu herb-separated moxibustion can effectively relieve the clinical symptoms, increase the endometrial blood flow and its thickness, and improve the endometrial receptivity, thereby ameliorate pregnancy outcomes in RIF patients of kidney deficiency and blood stasis.

[Effect of staging treatment of Tongyuan acupuncture on pregnancy outcome in patients with recurrent implantation failure of thin endometrium type].

OBJECTIVE: To compare the effect of Tongyuan acupuncture combined with medication and medication alone on pregnancy outcome in patients with recurrent implantation failure (RIF) of thin endometrium type. METHODS: A total of 74 patients with RIF of thin endometrium type undergoing freeze-thaw embryo transfer were randomly divided into an observation group (37 cases) and a control group (37 cases). The patients in the control group were treated with freeze-thaw embryo transfer in hormone replacement cycle, and the estradiol valerate tablets were taken orally from the fifth day of menstruation, 2 mg per day. On the basis of the control group, the observation group was additionally treated with Tongyuan acupuncture at Baihui (GV 20), Dazhui (GV 14), Qihai (CV 6), Guanyuan (CV 4), etc., combined with other acupoints based on syndrome differentiation and menstrual stage, once every other day. Both groups were treated for 3 menstrual cycles. The clinical pregnancy rate and embryo implantation rate of the two groups were observed after transplantation; the endometrial thickness and type, resistance index (RI) and pulsatility index (PI) of endometrial blood flow were measured before treatment and one day before transplantation, and adverse reactions was recorded. RESULTS: The clinical pregnancy rate was 37.8% (14/37) in the observation group, which was higher than 16.2% (6/37) in the control group (P<0.05). There was no significant difference in embryo implantation rate between the two groups (P>0.05). One day before transplantation, the endometrial thickness and the proportion of type A in endometrial classification in the two groups were increased compared with those before treatment (P<0.01), and those in the observation group were higher than the control group (P<0.01, P<0.05). The PI and RI of endometrial blood flow in the two groups were lower than those before treatment (P<0.01), and those in the observation group were lower than the control group (P<0.01, P<0.05). During the treatment, 6 patients in the control group had discomfort such as breast distending pain, stomach pain, dizziness and nausea, and there were no adverse reaction in the observation group. CONCLUSION: On the basis of conventional medication, Tongyuan acupuncture could increase the endometrial thickness, improve endometrial receptivity, improve pregnancy outcome and reduce adverse reactions in patients with RIF of thin endometrial type.

[Effects of natural moxibustion on cytokines and specific transcription factors in asthma rats].

OBJECTIVE: To explore the mechanism of natural moxibustion on regulating immune imbalance in asthma rats. METHODS: Seventy SD male rats were divided into a normal group, a placebo group, a dexamethasone group, a big-cake for long-course moxibustion group, a big-cake for short-course moxibustion group, a small-cake for long-course moxibustion group and a small-cake for short-course moxibustion group, ten rats in each one. The rat model of asthma was established by egg albumen sensitization and stimulation in all the groups except the normal group. The natural moxibustion was used in all moxibustion groups, in which big cake of 1 cmX 1 cm size was used in the big-cake groups and small cake of 0.5 cmX 0. 5 cm size was used in the small cake groups. According to relevant acupoints, the natural moxibustion was performed, 5 h per time, once a day. Four times of treatment was considered one course, and three courses were required in the long-course groups and one course was required in the short-course groups. Intraperitoneal injection of dexamethasone was applied in the dexamethasone group, which had the same course as long-course moxibustion group. After the treatment, changes of EOS in peripheral blood of asthma rats were observed; enzyme linked immunosorbent assay (ELISA) was applied to test the contents of IgE, IL-4 and IFN-gamma in the lung tissue; real-time Q-PCR method was adopted to measure the expression level of transcription factor T-bet and GATA binding protein 3 (GATA-3) in the lung tissue. RESULTS: Compared with the normal group, the EOS in whole blood as well as IL-4 and IgE in plasma were all increased in the placebo group (all P< 0. 01), IFN-gamma in plasma was obviously decreased (P<0. 01); while the levels of EOS, IgE and IL-4 were significantly reduced (all P<0. 01), the content of IFN-gamma was increased (P<0. 01) in all moxibustion groups and dexametnasone group. Compared with the normal group, the expression of T-bet mRNA in the placebo group was significantly reduced (P<0. 01). Each treatment group could significantly increase the expression of T-bet mRNA and reduce that of GATA-3 mRNA (P<0. 01). Compared with the short-course moxibustion groups, the expression of T-bet mRNA was obviously increased in the long-course moxibustion group and dexamethasone group (both P<0.01), and that of GATA-3 mRNA was reduced (P<0.01). There was no significant difference between long-course moxibustion group and dexamethasone group (P> 0. 05), and also no significant difference could be seen between big-cake moxibustion group and small-cake moxibustion group (P>0. 05). CONCLUSION: The natural moxibustion could obviously reduce airway inflammation in asthma rats. With time passing, the efficacy is enhanced, indicating evident timeliness, which has no apparent relationship with the size of moxibustion cake.

[New percutaneous absorption herbal patch for asthma of paracmasis and its effect on the relative transcription factors of patients].

OBJECTIVE: To observe the therapeutic effect and mechanism of new percutaneous absorption herbal patch for asthma of paracmasis, and to optimize the form of the patch. METHODS: One hundred and twenty cases of paracmasis asthma were randomly divided into medicine patch group, medicinal vesiculation group and western medication group with 40 cases for each. The new percutaneous absorption herbal patch was applied on medicine patch group. Traditional medicinal herbs cake of the hospital were applied on medicinal vesiculation group. Feishu (BL 13), Fengmen (BL 12) and Dazhui (GV 14) were adopted for both groups. Each patch was applied for 6 hours and once every other day. Accuhaler was applied on the western medicine group with 2 inhalations a time and twice a day. Clinical symptom scores, number of attacks and asymtomatic days were observed right before, after and half a year after the treatment. Meanwhile, the expression level of IgE, IL-4, GATA-3 mRNA and T-bet mRNA were observed and compared before and after the treatment. RESULTS: Clinical symptom scores of all the 3 groups were improved (all P < 0.01). The differences of the total effective rate, number of attacks and asymtomatic days of all the 3 groups are without statistical significance (all P > 0.05). However, the long-term therapeutic effect in half a year after the treatment showed that the total effective rate of the medicine patch group was 80.0% (32/40), and the medicinal vesiculation group was 70.0% (28/40). Both of the them were obviously higher than 47.5% (19/40) of the western medicine group (P < 0.01, P < 0.05). And the medicine patch group surpassed the other 2 groups in controlling the number of attacks and increasing the asymtomatic days (P < 0.05, P < 0.01). The level of IgE and IL-4 of all the 3 groups decreased sharply after the treatment (P < 0.05, P < 0.01). And there was no statistic significance in differences among groups (all P > 0.05). The level of GATA-3 mRNA was obviously decreased, while the level of T-bet mRNA was obviouly increased in the medicine patch and medicinal vesiculation groups (P < 0.05, P < 0.01). And the medicine patch group had obvious superiority on increasing the level of T-bet mRNA when compared with the medicinal vesiculation and western medicine groups (P < 0.01, P < 0.05). CONCLUSION: It is concluded that the new percutaneous absorption herbal patch has exact effect on asthma. The treatment may reverse the imbalance condition of Th1/Th2 through regulation on cell factor and its specific transcription factors.

[Effect of catgut implantation at acupoint on gonadal hormone and beta-endorphin in patients of climacteric syndrome].

OBJECTIVE: To explore the clinical therapeutic effect of catgut implantation at acupoint on climacteric syndrome (CS) and its mechanism. METHODS: Sixty cases were randomly divided into a catgut implantation group and a western medicine group, 30 cases in each group. The catgut implantation group was treated by catgut implantation at Shenshu (BL 23), Zigong (EX-CA 1), Sanyinjiao (SP 6). The western medicine group was treated by oral administration of Diethylstilbestrol tablet. Their therapeutic effects and changes of content of follicle-stimulating hormone (FSH), luteotrophic hormone (LH), estradiol (E2) and beta-endorphin (beta-EP) in serum were observed. RESULTS: The total effective rate was 93.3% in the catgut implantation group and 70.0% in the western medicine group with a significant difference between the two groups (P < 0.05). After treatment, the beta-EP concentration in the catgutation implant group was significantly increased (P < 0.05), the FSH concentration was significantly reduced and E2 concentration was significantly increased as compared with those in the western medicine group (P < 0.05, P < 0.01). CONCLUSION: Catgut implantation at acupoint has an obvious therapeutic effects on CS. It can significantly improve the ovaries function and has a favorable regulative action on the endogenous opioid peptides.

[Effects of electroacupuncture on plasma vasoactive intestinal peptide and substance P in perennial allergic rhinitis patients].

OBJECTIVE: To explore the underlying neuroimmunological mechanism of electroacupuncture (EA) in the treatment of perennial allergic rhinitis (PAR). METHODS: One hundred PAR outpatients were evenly randomized into EA group and medication group. Patients in EA group were treated with EA (5-10 mA, 80-100 Hz, and 30 min of stimulation) of Sphenopalatine ganglion area, Yingxiang (LI 20), Shangyingxiang (EX-HN 8), Yintang (EX-HN 3), supplemented with other acupoints according to syndrome-differentiation (once daily, 10 days being a therapeutic course). Patients of medication group were treated by Cetirizine (10 mg/times, t. i.d, peros). Before and after the treatment, blood samples of the ulnar vein were collected for detecting plasma vasoactive intestinal peptide (VIP) and substance P (SP) contents with radioimmunoassay. RESULTS: After the treatment, of the two 50 cases in EA and medication groups, 20 (40%) and 16 (32%) had an obvious improvement, 28 (56%) and 24 (48%) had an improvement, 2 (4%) and 10 (20%) failed, with the total effective rates being 96% and 80% separately. The therapeutic effect of EA group was significantly superior to that of medication group (P < 0.05). Self-comparison of each group showed that after the treatment, both plasma VIP and SP levels of two groups lowered apparently (P < 0.05, 0.01). Comparison between two groups showed that after the treatment, the content of VIP in EA group was markedly lower than that of medication group, while no significant difference was found between two groups in plasma SP levels (P > 0.05). CONCLUSION: EA can effectively relieve perennial allergic rhinitis patients' clinical symptoms, which is closely related to its functions in lowering plasma VIP and SP levels.

[Auricular point sticking plus moxibustion for treatment of recurrent herpes simplex].

OBJECTIVE: To search for the best therapy for recurrent herpes simplex. METHODS: Ninety-six cases were randomly divided into an auricular point sticking plus moxibustion group (treatment group, n = 54), a medication group (control group, n = 42). The treatment group were treated with auricular sticking at points Spleen, Lung, Kidney, and others, and moxibustion was applied at Zusanli (ST 36), Fenglong (ST 40), and local blister; the control group were treated by oral administration and external application of aciclovir. RESULTS: The cured rate and the total effective rate were 55.5% and 100.0% in the treatment group, and 9.5% and 61.9% in the control group, respectively, with a significant difference between the two groups (P<0.05). CONCLUSION: The auricular point sticking plus moxibustion is a better therapy for recurrent herpes simplex, with a significantly better therapeutic effect than that of the medication.