Qiu Maoliang, Sheng Canruo, et al. (Department of Acupuncture and Moxibustion, Hospital of Nanjing College of Traditional Chinese Medicine)
Li Naiying, Wang Junmei (Laboratory, ditto)
Wang Jinsheng (Department of Infectious Diseases, 81st Hospital of PLA)
Xu Bingqing, Lu Zhenchu, et al. (Department of Biochemistry, Jiangsu Provincial Research Institute of Traditional Chinese Medicine)
Deng Guoguang, Zhang Wanwen (Department of Physiology, ditto)
1. Clinical study
The article deals with acute bacillary dysentery which has been treated exclusively by acupuncture. In 645 cases with stool cultures positive (Shigella flexneri 478 cases, Shigella sonnei 121 cases, Shigella boydii 10 cases and Shigella schmitzii 36 cases), the changes in clinical manifestations and stool cultures from positive to negative were observed. The result is as follows:
All the cases had abdominal pain, diarrhea, red and white mucus in stools, tenesmus, etc. 576 cases had fever (the highest was 40.2ºC). Treatment was given as follows. Points Qihai, Tianshu (both sides) and Shangjuxu (both sides) were selected. For those cases with fever above 38ºC, Quchi (both sides) and Hegu (both sides) were added. Xei (reducing) method of manipulation (i.e., repeatedly thrusting the needle with force and lifting it gently combined with twisting of the needle) was used. Needles were retained for 30-60 minutes. (During retention of needles, in case the patient has a sudden motion of emptying his bowels, twisting the needles may cause it to disappear, and it is not necessary to take out the needles). Treatment was given 1-3 times a day according to the severity of the disease. In all the cases, 10 days of treatment were taken as a course.
The therapeutic effects are as follows: 596 cases were cured in one course of treatment (92.4%). The average time it took for the main symptoms to subside were: fever -- 1.88 days, abdominal pain -- 2.95 days, tenesmus -- 2.15 days, frequency of bowel movements -- 3.40 days, turning of the stools to negative under microscopic examination -- 3.74 days, turning of the stool culture to negative -- 5.05 days.
A control group of 281 cases treated by medication was observed for comparison. It was found that the improvement of clinical manifestations in the group treated by acupuncture was a little superior to that in the control group. 268 cases were followed up after six months. Among them 33 cases had relapses, accounting for 12.3%.
The article also analyzed the pathological changes of 131 cases which were examined with the sigmoidoscope before and after treatment, discussed the classification of different types of dysentery in traditional Chinese medicine and the seasons in which it prevailed, the questions having relation to therapeutic effects, suggested the importance of selection of channels, points and methods of manipulation in accordance with the condition of the disease, and finally, combining the results of clinical study with those of laboratorial researches, pointed out the significance of the principle "dispelling etiological factors by strengthening the general body resistance" to the treatment of this disease.
2. Laboratorial researches
After good results had been achieved clinically in treating bacillary dysentery with acupuncture, we made laboratorial researches on the following 8 criteria of immunological functions in 50 in-patients.
(1) Electrophoresis of serum protein
Electroneedling was given to rabbits at points Shangjuxu and Tianshu. On the 6th day of needling, albumin (A) and à[1], à[2] globulins decreased markedly in comparison with those before needling, while á and globulins were 28% higher than those in the control group (P<0.01).
In patients with acute bacillary dysentery, on the 6th day of needling, albumin decreased by 5.6% in comparison with that before needling (P<0.01).
The 4 globulins increased in different degrees.
(2) Serum level of total complement
In patients with acute bacillary dysentery, the level of total complement in the serum increased markedly on the 3rd day of needling in comparison with that before needling (P<0.01) and it showed a tendency of further increase even on the 12th day of needling.
(3) Contents of immunoglobulins (IgG, IgA, IgM)
The contents of immunoglobulins (IgG, IgA, IgM) increased in different degrees after needling in patients with acute bacillary dysentery and in healthy individuals as well. On the 3rd day of needling, the contents of immunoglobulins increased markedly in comparison with those before needling (P<0.01) except the content of IgM in healthy individuals. The content of IgA increased by 43% on the 12th day of needling in comparison with that before needling. The content of IgM began to decrease on the 5-7th days of needling. Its early appearance and quick disappearance reveals its participation in bacteriocidal action at the initial stage of the disease.
(4) Observation of bacteriocidal power of plasma
No matter whether in the rabbits which were given electroneedling at Shang-juxu and Tianshu or in the patients with acute bacillary dysentery treated by acupuncture, it was observed that 30 minutes to 3 hours after the second time of needling, the power of the plasma in destroying bacilli was markedly raised in comparison with that before needling. In rabbits, 30 minutes after electroneedling, the bacteriocidal power was raised by 50%, and 30 minutes to 3 hours after the second time of electroneedling, it was raised by 61-73% in comparison with that before needling (P<0.05). Among 37 cases of acute bacillary dysentery, 31 cases showed a raise in the bacteriocidal power after needling, accounting for 83.8%. The mean value of colony of the 37 cases was 43.4±76 before needling and 235±42 after needling (P<0.01). Through preliminarily tests, it was found that this bacteriocidal substance had a low resistance to heat. When it was heated at 56ºC for 30 minutes, its bacteriocidal activity was markedly lowered.
(5) Titer of specific antibody (indirect hemoagglutination)
Before needling, the titer of specific antibody in patients with acute bacillary dysentery was lower than that in healthy individuals. On the 3rd day of needling, it increased a little; on the 5-7th days the mean value increased from 1:93±1.98 to 1:349±3.15; and on the 7-12th days, it further increased to 1:425±2.7.
(6) Content of SIgA in stools
In 12 cases, in whom no pus and blood were observed by the naked eye on their hospitalization, the content of SIgA in stools on the first day of needling was a little lower than that in healthy individuals, and it markedly increased after needling in comparison with that before needling. In the other 24 cases with pus and blood in stools, the content of SIgA was higher than that in healthy individuals on the 1st-3rd days of needling. Its being higher than in healthy individuals on the first day of needling might be explained by the presence of pus and blood in stools. But on the 3rd day of needling when 3/4 of the 24 cases had no pus and blood in their stools, the content of SIgA was still high. On the 5th day, the condition of the disease changed for the better, and the content of SIgA decreased and approximated to the normal value.
(7) Content of lysozyme in the serum
The content of lysozme in the serum of patients with acute bacillary dysentery was higher than that of healthy individuals before needling. It increased markedly on the 3rd day of needling and decreased when the condition of the disease changed for the better with stool culture turning to negative. But it tended to increase continuously in the cases with stool culture not turning to negative. Patients with enteritis showed no marked changes.
(8) Phagocytic activity of reticuloendothelial system of the liver
Electroneedling was given to rabbits at points Shangjuxu and Tianshu. On the 6th day after needling was stopped, the phagocytic activity was 49% higher and on the 12th day 63.3% higher than that of the control group (both P<0.01). Referring to what had been observed in electrophoresis of serum protein, we found that the time when the phagocytic activity increased markedly coincided with the time when the globulin in the serum increased.
Conclusion: Cases of acute bacillary dysentery treated with acupuncture usually had a smooth progress, quick recovery and good prognosis. This shows that during the course of disease, the immunological power in the body is strengthened continuously. The strengthening of the humoral immunological function (including specific and non-specific) provides an important material base for treatment of acute bacillary dysentery by acupuncture.
Li Naiying, Wang Junmei (Laboratory, ditto)
Wang Jinsheng (Department of Infectious Diseases, 81st Hospital of PLA)
Xu Bingqing, Lu Zhenchu, et al. (Department of Biochemistry, Jiangsu Provincial Research Institute of Traditional Chinese Medicine)
Deng Guoguang, Zhang Wanwen (Department of Physiology, ditto)
1. Clinical study
The article deals with acute bacillary dysentery which has been treated exclusively by acupuncture. In 645 cases with stool cultures positive (Shigella flexneri 478 cases, Shigella sonnei 121 cases, Shigella boydii 10 cases and Shigella schmitzii 36 cases), the changes in clinical manifestations and stool cultures from positive to negative were observed. The result is as follows:
All the cases had abdominal pain, diarrhea, red and white mucus in stools, tenesmus, etc. 576 cases had fever (the highest was 40.2ºC). Treatment was given as follows. Points Qihai, Tianshu (both sides) and Shangjuxu (both sides) were selected. For those cases with fever above 38ºC, Quchi (both sides) and Hegu (both sides) were added. Xei (reducing) method of manipulation (i.e., repeatedly thrusting the needle with force and lifting it gently combined with twisting of the needle) was used. Needles were retained for 30-60 minutes. (During retention of needles, in case the patient has a sudden motion of emptying his bowels, twisting the needles may cause it to disappear, and it is not necessary to take out the needles). Treatment was given 1-3 times a day according to the severity of the disease. In all the cases, 10 days of treatment were taken as a course.
The therapeutic effects are as follows: 596 cases were cured in one course of treatment (92.4%). The average time it took for the main symptoms to subside were: fever -- 1.88 days, abdominal pain -- 2.95 days, tenesmus -- 2.15 days, frequency of bowel movements -- 3.40 days, turning of the stools to negative under microscopic examination -- 3.74 days, turning of the stool culture to negative -- 5.05 days.
A control group of 281 cases treated by medication was observed for comparison. It was found that the improvement of clinical manifestations in the group treated by acupuncture was a little superior to that in the control group. 268 cases were followed up after six months. Among them 33 cases had relapses, accounting for 12.3%.
The article also analyzed the pathological changes of 131 cases which were examined with the sigmoidoscope before and after treatment, discussed the classification of different types of dysentery in traditional Chinese medicine and the seasons in which it prevailed, the questions having relation to therapeutic effects, suggested the importance of selection of channels, points and methods of manipulation in accordance with the condition of the disease, and finally, combining the results of clinical study with those of laboratorial researches, pointed out the significance of the principle "dispelling etiological factors by strengthening the general body resistance" to the treatment of this disease.
2. Laboratorial researches
After good results had been achieved clinically in treating bacillary dysentery with acupuncture, we made laboratorial researches on the following 8 criteria of immunological functions in 50 in-patients.
(1) Electrophoresis of serum protein
Electroneedling was given to rabbits at points Shangjuxu and Tianshu. On the 6th day of needling, albumin (A) and à[1], à[2] globulins decreased markedly in comparison with those before needling, while á and globulins were 28% higher than those in the control group (P<0.01).
In patients with acute bacillary dysentery, on the 6th day of needling, albumin decreased by 5.6% in comparison with that before needling (P<0.01).
The 4 globulins increased in different degrees.
(2) Serum level of total complement
In patients with acute bacillary dysentery, the level of total complement in the serum increased markedly on the 3rd day of needling in comparison with that before needling (P<0.01) and it showed a tendency of further increase even on the 12th day of needling.
(3) Contents of immunoglobulins (IgG, IgA, IgM)
The contents of immunoglobulins (IgG, IgA, IgM) increased in different degrees after needling in patients with acute bacillary dysentery and in healthy individuals as well. On the 3rd day of needling, the contents of immunoglobulins increased markedly in comparison with those before needling (P<0.01) except the content of IgM in healthy individuals. The content of IgA increased by 43% on the 12th day of needling in comparison with that before needling. The content of IgM began to decrease on the 5-7th days of needling. Its early appearance and quick disappearance reveals its participation in bacteriocidal action at the initial stage of the disease.
(4) Observation of bacteriocidal power of plasma
No matter whether in the rabbits which were given electroneedling at Shang-juxu and Tianshu or in the patients with acute bacillary dysentery treated by acupuncture, it was observed that 30 minutes to 3 hours after the second time of needling, the power of the plasma in destroying bacilli was markedly raised in comparison with that before needling. In rabbits, 30 minutes after electroneedling, the bacteriocidal power was raised by 50%, and 30 minutes to 3 hours after the second time of electroneedling, it was raised by 61-73% in comparison with that before needling (P<0.05). Among 37 cases of acute bacillary dysentery, 31 cases showed a raise in the bacteriocidal power after needling, accounting for 83.8%. The mean value of colony of the 37 cases was 43.4±76 before needling and 235±42 after needling (P<0.01). Through preliminarily tests, it was found that this bacteriocidal substance had a low resistance to heat. When it was heated at 56ºC for 30 minutes, its bacteriocidal activity was markedly lowered.
(5) Titer of specific antibody (indirect hemoagglutination)
Before needling, the titer of specific antibody in patients with acute bacillary dysentery was lower than that in healthy individuals. On the 3rd day of needling, it increased a little; on the 5-7th days the mean value increased from 1:93±1.98 to 1:349±3.15; and on the 7-12th days, it further increased to 1:425±2.7.
(6) Content of SIgA in stools
In 12 cases, in whom no pus and blood were observed by the naked eye on their hospitalization, the content of SIgA in stools on the first day of needling was a little lower than that in healthy individuals, and it markedly increased after needling in comparison with that before needling. In the other 24 cases with pus and blood in stools, the content of SIgA was higher than that in healthy individuals on the 1st-3rd days of needling. Its being higher than in healthy individuals on the first day of needling might be explained by the presence of pus and blood in stools. But on the 3rd day of needling when 3/4 of the 24 cases had no pus and blood in their stools, the content of SIgA was still high. On the 5th day, the condition of the disease changed for the better, and the content of SIgA decreased and approximated to the normal value.
(7) Content of lysozyme in the serum
The content of lysozme in the serum of patients with acute bacillary dysentery was higher than that of healthy individuals before needling. It increased markedly on the 3rd day of needling and decreased when the condition of the disease changed for the better with stool culture turning to negative. But it tended to increase continuously in the cases with stool culture not turning to negative. Patients with enteritis showed no marked changes.
(8) Phagocytic activity of reticuloendothelial system of the liver
Electroneedling was given to rabbits at points Shangjuxu and Tianshu. On the 6th day after needling was stopped, the phagocytic activity was 49% higher and on the 12th day 63.3% higher than that of the control group (both P<0.01). Referring to what had been observed in electrophoresis of serum protein, we found that the time when the phagocytic activity increased markedly coincided with the time when the globulin in the serum increased.
Conclusion: Cases of acute bacillary dysentery treated with acupuncture usually had a smooth progress, quick recovery and good prognosis. This shows that during the course of disease, the immunological power in the body is strengthened continuously. The strengthening of the humoral immunological function (including specific and non-specific) provides an important material base for treatment of acute bacillary dysentery by acupuncture.
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