RESUMEN
OBJECTIVE: To compare the clinical efficacy on cervical spondylosis of nerve root type with qi stagnation and blood stasis treated with warming needle with different lengths of moxa stick. METHODS: Six hundred patients with cervical spondylosis of nerve root type with qi stagnation and blood stasis were randomly divided into 4 groups: a 4 cm length group (150 cases, 5 cases dropped off, 2 cases suspended), a 3 cm length group (150 cases, 6 cases dropped off, 2 cases suspended), a 2 cm length group (150 cases, 6 cases dropped off), and a routine acupuncture group (150 cases, 6 cases dropped off). Warming needle with moxa stick in the length of 4 cm, 3 cm and 2 cm was delivered in the 4 cm length group, the 3 cm length group and the 2 cm length group, respectively. In the routine acupuncture group, simple acupuncture was applied. The acupoints selected in the above groups included Dazhui (GV 14) and bilateral Jiaji (EX-B 2) of C5 and C7, Fengchi (GB 20), Jianzhen (SI 9), Quchi (LI 11), Zhongzhu (TE 3), etc. In each group, the intervention was delivered once daily and 5 times a week. One course of intervention was composed of 2 weeks and 2 courses were required. The TCM syndrome score, the score of clinical assessment scale for cervical spondylosis (CASCS), the score of the brachial plexus traction test of the affected upper limb, F wave occurrence rate and conduction velocity of the ulnar nerve, the median nerve and the radial nerve of the affected upper limb were compared before and after treatment in the patients of each group. The levels of serum inflammatory factors, i.e. interleukin-1ß (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α) and hypersensitive C-reactive protein (hs-CRP), were measured before and after treatment in the patients of each group. The clinical cfficacy was evaluated in the 4 groups. RESULTS: After treatment, the results of TCM syndrome evaluation, i.e. the scores of neck pain, activity limitation and upper limb numbness and pain, as well as the total scores; and the scores of brachial plexus traction test were reduced when compared with those before treatment in each group (P<0.01, P<0.05). The scores of subjective symptoms and adaptability, and the total scores of CASCS were elevated in comparison with those before treatment in each group (P<0.01, P<0.05). In the 4 cm length group, compared with the other 3 groups, the scores of neck pain and activity limitation for TCM syndrome evaluation, and its total score were lower (P<0.05, P<0.01); and the scores of subjective symptoms and adaptability, and the total score of CASCS were higher (P<0.05, P<0.01). The score of the brachial plexus traction test in the 4 cm length group was lower than that of the routine acupuncture group (P<0.05). After treatment, F wave occurrence rates and conduction velocity of median nerve and radial nerve were increased when compared with those before treatment in each group (P<0.05, P<0.01). F wave occurrence rate and conduction velocity of the radial nerve in the 4 cm length group were higher than those of the other 3 groups (P<0.05), and those of the median nerve were higher when compared with the routine acupuncture group (P<0.05). After treatment, the levels of serum IL-1ß, IL-6 and TNF-α were all reduced when compared with those before treatment in each group (P<0.01, P<0.05); the level of serum IL-6 in the 4 cm length group was lower than those of the other 3 groups and serum level of TNF-α was lower compared with that in the routine acupuncture group (P<0.05). The total effective rate of the 4 cm length group was 78.3% (112/143), which was higher when compared with the 3 cm length group (67.6%, 96/142), the 2 cm length group (65.3%, 94/144) and the routine acupuncture group (53.5%, 77/144), respectively (P<0.05). CONCLUSION: Warming needle with moxa stick of 4 cm in length effectively relieves the clinical symptoms of cervical spondylosis of nerve root type with qi stagnation and blood stasis, improves the nerve function of the upper limbs, and reduces the inflammatory responses caused by nerve compression. The clinical efficacy of this therapy with moxa stick of 4 cm in length is superior to the warming needle with moxa sticks of 3 cm and 2 cm, as well as the routine acupuncture.
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Interleucina-6 , Espondilosis , Humanos , Dolor de Cuello , Qi , Factor de Necrosis Tumoral alfa , Espondilosis/terapiaRESUMEN
OBJECTIVE: To explore the therapeutic effect of acupuncture combined with thunder-fire moxibustion on cervical spondylotic radiculopathy of wind-cold-damp type and its impacts on the conduction velocity of F wave of median nerve and ulnar nerve, as well as hypersensitive C-responsive protein (hs-CRP), interleukin 6 (IL-6), IL-1ß and tumor necrosis factor α (TNF-α) in serum. METHODS: A total of 94 patients with cervical spondylotic radiculopathy of wind-cold-damp type were randomly divided into a control group and a combined therapy group, 47 cases in each group. In the control group, acupuncture was applied to Fengchi (GV20), Tianzhu (BL10), Neck-Jiaji (EX-B5), Dazhui (GV14) and others, 30 min each time, once daily, 5 times a week, totally for 4 weeks. In the combined therapy group, on the base of the treatment as the control group, the thunder-fire moxibustion was adopted over GV20, EX-B5, GV14, Jianjing (ST21) and Tianzong (SI11), 20 min each time, once every other day, for 4 weeks in total. After the treatment, the curative effect was compared in the patients between two groups. The short-form McGill pain questionnaire (SF-MPQ), the neck specificity scale and the MOS 36-item short form health survey (SF-36) were scored. The conduction velocity of F wave in median nerve and ulnar nerve was detected by electromyography. The expression of hs-CRP was measured by immunoturbidimetry. IL-6, IL-1ß and TNF-α in serum were determined by enzyme linked immunosorbent assay. RESULTS: The total effective rate in the combined therapy group was 95.7% (45/47), which was higher than 80.9% (38/47) in the control group (P<0.05). Compared with their own pretreatment, the scores of SF-MPQ, neck specificity scale and SF-36 were all obviously improved after treatment in the patients of either group (P<0.05), while the conduction velocity of F wave in median nerve and ulnar nerve was accelerated and hs-CRP, IL-6, IL-1ß and TNF-α in serum were decreased (P<0.05). Compared with the control group, the improvements in the scores of SF-MPQ, neck specificity scale and SF-36 were more obvious (P<0.05), the increase of the conduction velocity of F wave in median nerve and ulnar nerve and the decrease of hs-CRP, IL-6, IL-1ß and TNF-α in serum were more remarkable (P<0.05) in the combined therapy group. CONCLUSION: Acupuncture combined with thunder-fire moxibustion relieves the clinical symptoms of cervical spondylotic radiculopathy of wind-cold-damp type.
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Terapia por Acupuntura , Moxibustión , Radiculopatía , Puntos de Acupuntura , Humanos , Radiculopatía/terapia , VientoRESUMEN
A prospective observational study collected temperature data from 51 patients in 11 neurosurgical centers and follow-up outcome information at 6 months in 49 patients. Brain temperature (Tbr) was measured directly by an intraventricular temperature sensor. Axillary temperature (Tax) and rectal temperature (Tre) were measured by electric thermometers. Tbr was 0.4 to 1.5°C higher than body temperature. Tre correlated well with the Tbr (coefficient: 0.7378; p < 0.05). Among all patients, Glasgow Coma Scale (GCS) scores on admission were significantly lower in the patients with post-operatively extreme peak temperature (Tpeak, < 37°C or >39°C in first 24 h) and major temperature variation (Tvari > 1°C in first 12 h; p < 0.05, p < 0.01, respectively). Among the patients with no temperature intervention, the extreme Tpeak group showed a lower Glasgow Outcome Scale-Extended (GOS-E) score at 6 months (p < 0.05) with lower GCS scores on admission (p < 0.01), compared with the moderate Tpeak group. Remarkably, the major Tvari group showed significantly lower GOS-E scores (p < 0.05) with the same GCS scores as the minor Tvari group. Thus, Tre is the better candidate to estimate Tbr. Spontaneously extreme Tpeak in TBI represents both more serious injury on admission and worse prognosis, and Tvari might be used as a novel prognostic parameter in TBI. Brain temperature is therefore one of the critical indicators evaluating injury severity, prognostication, and monitoring in the management of TBI. This prospective observational study has been registered in ClinicalTrials.gov ( https://clinicaltrials.gov ), and the registration number is NCT03068143.
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Temperatura Corporal/fisiología , Lesiones Traumáticas del Encéfalo/fisiopatología , Lesiones Traumáticas del Encéfalo/terapia , Encéfalo/fisiopatología , Adulto , Anciano , Femenino , Escala de Coma de Glasgow , Escala de Consecuencias de Glasgow , Humanos , Hipotermia Inducida , Masculino , Persona de Mediana Edad , Pronóstico , Estudios ProspectivosRESUMEN
OBJECTIVE: As an extended study of beta-Carotene-vitamin A equivalence in Chinese adults, we carried out an experiment on 10 (5 males and 5 females) rural volunteers aged 38 - 49 years, which would be complementary to the early reported study on subjects aged 50 - 60 years. METHODS: Ten healthy Chinese adult volunteers aged 38-49 years were recruited in a 56 days experiment, which included residency in the Metabolic Research Unit (first 10 days and in home (last 46 days). A physiological dose of 2H8 beta-C (11,011 (nmole or 6 mg) in oil was given with a liquid diet (25% energy from fat) to the volunteers in the first day of the experiment. Three days after the 2H8 beta-C, each volunteer took a reference dose of 2H8 retinyl acetate (8,915 nmole or 3 mg) in oil with the same liquid diet. Serum samples were collected at 0, 3, 5, 7, 9, 11 and 13 hours of the first and the fourth days of study, and fasting serum samples were also collected daily in first 10 days and then weekly at morning of 14th, 21st, 28th, 35th, 42nd, 49th and 56th day after a 12-hours overnight fast. Serum retinol and carotenoids concentrations were measured by high performance liquid chromatography (HPLC). Also retinol fraction was extracted from serum and isolated by HPLC. The serum retinal enrichments were determined by using gas chromatograph/mass spectrometry with electron capture negative chemical ionization (GC-MS). RESULTS: The average 52-day area under the serum 2H4 retinol response curve (from the 2H8 beta-C dose) was (1289 +/- 547) nmol/d and the 52-day area under the serum 2H8 retinol response curve (from the 2H8 retinyl acetate dose) was (3560 +/- 1058) nmol/d. By using 2H8 retinyl acetate as the vitamin A reference, the 2H4 retinol formed from 2H8 beta-C (11,011 nmol) was calculated to be equivalent to (3434 +/- 1449) nmol of retinol. The calculated conversion factor of beta-C to retinol ranged from 2.00 - 9.61 to 1 with an average of (3.89 +/- 2.76) to 1 on a molar basis, or 3.76 - 18.05 to 1 with an average of (7.30 +/- 5.18) to 1 on a weight basis. CONCLUSION: The conversion of beta-C to vitamin A in 10 middle-aged Chinese adults had been quantitatively determined by using a stable isotope reference method, and an average conversion ratio of 7.30 : 1 to 1 on a weight basis was found in this study.