摘要：
Introduction: Whether acupuncture is efficacious for patients with functional dyspepsia is still controversial. So we designed a randomised controlled trial to settle the problem. Methods and analysis: We designed a multicentre, two-arm, sham-controlled clinical trial. 200 participants with functional dyspepsia will be randomly assigned to the true acupuncture (TA) group and sham acupuncture (SA) group in a 1:1 ratio. Participants in the TA group will receive acupuncture at points selected according to syndrome differentiation. Participants in the sham acupuncture group will receive penetrations at sham points. Participants in both groups will receive 20 sessions of electroacupuncture in 4 weeks, five times continuously with a 2 day rest in a week. The primary outcome is the proportion of patients reporting the absence of dyspeptic symptoms at 16 weeks after inclusion. The secondary outcome includes a Short- Form Leeds Dyspepsia Questionnaire, the Chinese version of the 36-Item Short Form Survey, the Chinese version of the Nepean dyspepsia index, etc. Ethics and dissemination: The study protocol has been approved by the institutional review boards and ethics committees of the first affiliated hospital of Chengdu University of TCM, the first affiliated hospital of Hunan University of TCM and Chongqing Medical University, respectively (from April to August 2012). The results of this trial will be disseminated in a peerreviewed journal and presented at international congresses.
通讯机构：
Key Laboratory of Correlativity between Meridian Point and Viscera, State Administration of Traditional Chinese Medicine, 113 Shaoshan Middle Road, China
关键词：
有烟艾灸;无烟灸;急性胃黏膜损伤;超氧化物歧化酶;丙二醛
摘要：
目的:观测有烟艾灸、无烟灸对急性胃黏膜损伤修复作用的差异.方法:40只SPF级SD大鼠随机分为4组,即正常对照组、模型组、有烟艾灸组、无烟灸组,每组10例,采用无水乙醇灌胃制备急性胃黏膜损伤模型.采用比色法检测体内超氧化物歧化酶(super oxide dismutase,SOD)的活性、丙二醛(malondialdehyde,MDA)的含量,HE染色光镜下观察胃黏膜组织形态学变化.结果:(1)胃黏膜组织炎症病理学评分比较:与正常对照组比较(0.75±0.46),模型组病理组织学评分明显升高(7.75±1.67 vs 0.75±0.46,P＜0.01)；有烟艾灸组、无烟灸组明显低于模型组(4.63±0.52 vs 7.75±1.67、4.75±0.46 vs 7.75±1.67,P＜0.01)；有烟艾灸组与无烟灸组比较无显著差异(4.63±0.52 vs 4.75±0.46)；(2)血清中SOD、MDA值比较:与正常对照组比较(301.48±16.675、6.77±0.529),模型组SOD值明显降低(260.07±15.481 vs 301.48±16.675,P＜0.01)、MDA值明显升高(9.73±0.704 vs 6.77±0.529,P＜0.01)；与模型组比较,有烟艾灸组、无烟灸组SOD值明显升高,且有显著性差异(281.03±17.713 vs 260.07±15.481、278.61±17.550 vs 260.07±15.481,P＜0.05)、MDA值降低,有显著性差异(7.52±0.361 vs9.73±0.704、7.78±0.387 vs 9.73±0.704,P＜0.01)；有烟艾灸组较无烟灸组SOD值稍高(281.03±17.713 vs 278.61±17.550)、MDA值稍低(7.52±0.361 vs 7.78±0.387),但两组无显著性差异.结论:(1)有烟艾灸、无烟灸对急性胃黏膜损伤具有修复作用,且两者之间抗氧化比较没有明显差异；(2)有烟艾灸、无烟灸通过上调SOD活性、降低MDA含量,调节氧化/还原的动态平衡,使胃黏膜达到抗氧化损伤的作用.
通讯机构：
College of Acupuncture and Massage, Hunan University of TCM, 113 Shaoshan Middle Road, China
关键词：
隔药饼灸;功能性胃肠病;肝郁脾虚证;ɑ-氨基羟甲基恶唑丙酸受体;大鼠
摘要：
目的:探讨隔药饼灸治疗功能性胃肠病(functional gastrointestinal disorders,FGIDs)(肝郁脾虚证)中枢α-氨基羟甲基恶唑丙酸(amino-3-hydroxy-5-methyl-4-isoxazole propionic acid,AMPA)受体基因的调节机制.方法:72只SD大鼠随机等分为6组,即空白组、模型组、隔药饼灸组、6-氰基-7-硝基喹喔啉-2,3-二酮(6-cyano-7-nitroquinoxaline-2,3-dione,CNQX)组、隔药饼灸+CNQX组、假手术组.除空白组外,其余5组均采用慢性束缚应激+过度疲劳+饮食失节方法造模,隔药饼灸组与隔药饼灸+CNQX组在造模前30 min隔药饼灸5壮.造模结束后,运用脑立体定位仪于杏仁核(双)上微量注射α-氨基羟甲基恶唑丙酸(amino-3-hydroxy-5-methyl-4-isoxazole propionic acid,AMPA)受体拮抗剂造CNQX组,加造假手术组为了评估手术创伤对模型的影响程度.采用Westem blot方法检测海马CA1区和杏仁核AMPA受体亚型GluR1、GluR2的表达变化,比较各组在各区指标变化.结果:在海马CA1区和杏仁核BLA区,与模型组相比,隔药饼灸组、隔药饼灸+CNQX组和CNQX组GluR1、GluR2表达差异均有统计学意义(GluR1表达分别为1.05±0.13 vs 0.59±0.14,1.05±0.13 vs 0.33±0.08,1.05±0.13 vs 0.49±0.14,0.95±0.22 vs 0.46±0.09,0.95±0.22 vs 0.31±0.18,0.95±0.22 vs 0.47±0.13,均P＜0.05;GluR2表达分别为0.33±0.08 vs 0.76±0.13,0.33±0.08 vs l.13±0.15,0.33±0.08 vs 0.60±0.08,0.29±0.04 vs 0.46±0.08,0.29±0.04 vs 0.85±0.13,0.29±0.04 vs 0.48±0.09,均P＜0.05)；隔药饼灸+CNQX组GluR1表达最低,但GluR2表达最高,与CNQX组相比,隔药饼灸+CNQX组GluR2表达在海马CA1区和杏仁核区差异均有统计学意义(0.60±0.08vs l.13±0.15,0.48±0.09 vs 0.85±0.13,均P＜0.05).结论:隔药饼灸可能通过调节FGIDs(肝郁脾虚证)模型大鼠杏仁核和海马AMPA受体,使杏仁核和海马的“兴奋-抑制”失衡得到调整,从而达到治疗肝郁脾虚证FGIDs的目的.
