传统配穴暨髋骨辨证针灸治疗妇女更年期症候群临床研究
摘要
目的：
本研究探讨以骨骼肌肉辩证与经络、全息的配穴方法,比较髋关节辩证的选穴与传统针灸选穴在针灸治疗更年期症候群的疗效。
每位更年期妇女的症状严重程度不一,某些症状不仅会造成更年期妇女身心的不适,而且也会影响生活品质。过去的研究均着重于改善更年期潮热、盗汗与睡眠障碍等主要症状,其可能的机转为针刺可以透过产生脑内啡(endorphins)等活性物质,来调节下视丘、脑下垂体与卵巢等生殖轴。针对华人更年期盛行率比较高的骨骼肌肉酸痛问题,却鲜少有研究针对此部分来探讨；因此本研究探讨经由骨骼肌肉辩证选穴,除在更年期内分泌失衡调理外,对更年期酸痛治疗更为重视。
方法：
筛选45-60岁更年期妇女,更年期身心症状评估量表(MRS)评分不得低于8分。依序遵照随机随机数表分配于三组治疗组,第1组传统主穴配穴针灸治疗组(主穴有关元、三阴交；配穴有悬钟、承山、照海总共九针)；第2组髋骨辨证针灸治疗组(有后阳陵泉、足三里、商丘、膝关、地机、丘墟共六针)；第3组主穴暨髋骨辨证针灸治疗组(主穴有关元、三阴交；配穴有后阳陵泉、足三里、商丘、膝关、地机、丘墟,总共九针)。施针主穴：关元(针上灸,两壮)、三阴交,以调理内分泌为主,传统配穴及髋骨辨证以加强治疗酸痛为主。三组均填写更年期身心症状评估量表(MRS)、疼痛量表(VAS)及与世界卫生组织生活质量问卷(WHOQOL-BREF),每周针灸2次,每次30分,治疗4周,再隔1周结案。每位受试者于第1周量测MRS、 WHOQOL-BREF、及VAS之基准资料、并于第2、4、5周填写后测问卷,即以评估针灸疗效。
结果：
筛选121位受试者,有39位未加入(I/E不合者25人,没意愿者9人,服用药物0人,没有出席研究者4人,没有严重症状者1人),资格符合而加入试验者实际有82人,其中有完成5周结案者74人约占90.2%,未按时回诊而退出者8人约占9.8%。27例患者入第1组而有23人完成结案,27例患者入第2组而有25人完成结案,28例患者入第3组而有26人完成结案。
(1)基准点(baseline)整体(不分组)资料,更年期11个主要症状,以症状总分评比则关节疼痛、肌肉疼痛居第1名,疲倦第2名,而睡眠障碍(失眠),易感染尿道炎、尿失禁,易激动、神经紧张,在临床上最为常见。
(2)就基准点(baseline)资料,更年期主要症状以MRS总分评比则关节疼痛、肌肉疼痛程度居冠,足见关节疼痛、肌肉疼痛在更年期症状中为极重要的问题；更年期疲倦问题与情绪方面有显着相关性。
(3)三组治疗后第四周MRS皆有疗效显着性(P<0.05),心理感觉改善程度和泌尿生殖症状改善程度由大到小组别排名3>2>1,躯体感觉改善程度排名组别由大到小排列2>3>1。
(4)三组治疗后第四周VAS皆有疗效显着性(P<0.05),在疼痛方面整体改善以主穴暨髋骨辨证针灸治疗组的疗效为优。而上肢疼痛以传统主穴配穴组的疗效为优,腰、背、腹面、下肢疼痛以主穴暨髋骨辨证针灸治疗组优。
(5)MRS各组内治疗前后比较,采用自身配对t检验,根据结果我们可以发现3组各组P值为0.000<0.05,皆有统计上显着的差异。3组在经过4周治疗皆有疗效。MRS第4周治疗后与治疗前(基准点)3组间比较分析,ANCOVA的报告结果：分组的F值为3.364, P值为0.040<0.05,即3组差异达到显着水平。修正均数的两两比较的LSD检验显示,第1组与第3组比较疗效有显着差异,第3组的疗效优于第1组的疗效。但第2组与第1组及第3组比较疗效并没有显着差异。
结论：
整体而言,妇女更年期障碍是来自内分泌功能失调,而导致自律神经系统功能紊乱,自律神经与激痛点有其相互作用,主穴之“关元”及“三阴交”调理更年期妇女的内分泌,对睡眠、泌尿系统、情绪方面均有明显的改善。
参与本研究案更年期妇女之受试者,对于所提供的针灸及卫教大都持正面的评价,在心悸、胸闷、腰痛、膝盖酸痛、肌肉酸痛、疲倦、多梦有明显改善,尤其频尿及漏尿、睡眠障碍、腰酸有七成左右都有改善,在针灸结案后一个月左右随访,仍持续遵循卫教自我保建之患者亦能维持不错的健康,在睡眠、频尿、酸痛改善方面仍有维持。
本研究辨证髋骨论点：因荐尾椎的变动而引起髋骨的正位不稳,两者之间所形成的多种多样的变化形态,先辨病位,再辨阴阳盛衰,确立施治方法,降低激痛点敏感化改善问题,三组更年期针灸治疗虽皆有显着改善,而以第3组主穴暨髋骨辨证针灸治疗组的疗效较佳。
Objective:
A clinical research for using the dialectical and meridian to skeletal muscle with relation to meridian, hologram to select acupoints, and comparing the curative effect of acupuncture treatment for climacteric syndrome between methods using traditional acupoints and hip's mechanics discriminated.
For each of the climacteric symptom of varying severity, climacteric women will suffer proportionately from not only physical and psychological discomfort but also the quality of life getting worse. Acupuncture in the treatment of menopausal syndrome. Furthermore, past studies almost focused on improving major symptoms such as hot flashes, night sweats, and insomnia. Probably, acupuncture with the mechanism of stimulating natural production of endorphins and releasing various hormones could regulate the hypothalamus, pituitary, and ovarian. For the relatively high prevalence of climacteric symptom of musculoskeletal pain, there has been few research to explore in this area. With respect to treatment of climacteric symptoms, especially for musculoskeletal pain, this study for the acupoints selection by hip's mechanics discriminated according to musculoskeletal changes not only deals with endocrine imbalance but also pay more attention to musculoskeletal pain problems.
Methods:
The patients enrolled in the study were climacteric women, ranging from45to60years of age with Menopause Rating Scale (MRS) score of not less than8points. the sequence according to the random number table assigned to three treatment groups, group1:master acupoints plus traditional method [master acupoints of guanyuan (RN4) and sanyinjiao (SP6), associated with Xuanzhong(GB39)、 Chengshan (BL57)、 Zhaohai (K16); totally9acupoints]; group2:hip's mechanics discriminated method [rear Yanglingquan (GB34)、 Zusanli (ST36)、 Shangqiu (SP5)、 xiguan (LR7)、 Dij I (SP8)、 Qiuxu (GB40); totally6acupoints]; group3:master caupoints plus hip's mechanics discriminated method [master acupoints of guanyuan (RN4) and sanyinjiao (SP6), associated with rear Yanglingquan (GB34)、 Zusanli (ST36)、 Shangqiu (SP5)、 xiguan (LR7)、 Diji (SP8)、 Qiuxu (GB40); totally9acupoints]. The master acupoints of guanyuan (RN4) and sanyinjiao (SP6) is to regulate endocrine disorders and selecting acupoint of traditional method and hip's mechanics discriminated is to enhance the effect of pain cure. The patients in three groups should fill in the questionnaires of MRS, Visual Analogue Scale (VAS), and The World Health Organization Quality of Life (WHOQOL-Brief), and take acupuncture of twice a week for four weeks,30minutes for each, and then closed at following week intervals, acupuncture twice a week for four weeks. Baseline scores were measured on the MRS, WHOQOL, and VAS, at the beginning of week one, as followed by further measures at the end of weeks two, fore, and five. The curative effect were assessed to explore the score differences among the baseline.
Results:
Of the121recruited patients,39were found to be ineligible. The principal reasons for ineligibility were failure to meet eligibility criteria (n=25), loss of interest in participation after detailed explanation (n=9), medical conditions and medications (n=0), loss to follow up after the initial visit (n=4), and no evidence of severe climacteric symptoms (n=1). In all,74(90.2%) of the initial83participants completed the5-week study without any major protocol violation.8((9.8%)) of reasons for withdrawal were failure to return.23of the initial27participants completed in group1,25of the initial27participants completed in group2, and26of the initial28participants completed in group3.
(1) According to the baseline of the overall data (without separating group), the score rating of the joint pain&muscle pain ranks first on the11major symptoms of the menopause symptom, and that of fatigue ranks second. Furthermore, sleep disorders (insomnia), urethritis, urinary incontinence, irritability, nervousness is more common in clinical practice.
(2) From baseline of the overall data, MRS assessment in joint pain and muscle pain, the total score of the highest indicates the joint pain and muscle pain in menopause symptoms as a very important issue. Relationship between fatigue and emotional aspects is significant.
(3) After4weeks cure, the MRS score of three groups indicates the efficacy of treatments with statistically significant (P<0.05). Improvement in psychological and urogenital aspect among the three groups with efficacy ranking as group3>2>1. Improvement in somatic&vegetative aspects among the three groups with efficacy ranking as group2>3>1.
(4) After4weeks cure, the VAS score of three groups indicates the efficacy of treatments with statistically significant (P<0.05). Overall improvement in pain was excellent on the efficacy of the group3, improvement in upper limb pain was excellent on the efficacy of the group1, and improvement in lumbar, back, lower limb pain was excellent on the efficacy of the group3.
(5) According to the comparison of MRS for before and after treatment within each group, using paired t test, each group's P-values for0.000<0.05based on results indicated that the differences within each group is statistically significant. All of three groups after4weeks of treatment are efficacy. Based on ANCOVA reports as F=3.364 &P-value for0.040<0.05, the comparisons of MRS for before and after treatment among three groups at week4show that the differences among three Groups is statistically significant. The pairwise comparisons of adjusted means based on Least Significant Difference (LSD) test show that the difference between group1and group3is statistically significant and the Comparative efficacy of group3is better than group1, but there are no significant differences as group2compared to group1and group3respectively.
Conclusion:
In general, the women's menopausal problems caused by the endocrine dysfunction in addition to autonomic nervous system disorder. It seems that autonomic nervous system and trigger points may interact with each other. The acupuncture of guanyuan (RN4) and sanyinjiao (SP6) is to regulate endocrine disorders and can make a great improvements for the sleep, urinary system, and emotions.
With respect to acupuncture treatment and health education, participants of menopausal women in this study mostly expressed positive feedback and obtain a great improvements in heart palpitations, chest tightness, back pain, knee pain, muscle pain, fatigue, and dreaminess. Improvement especially in urinary incontinence, sleep disorders (insomnia), and backache can achieve a70%of recovery. With a follow-up around one month after completed acupuncture treatment, they always can maintain good health in sleep, urinary incontinence, and pain, if continued to follow the health education and to take care by themselves.
Discussion in hip's mechanics discriminated:anatomical variations of sacral-caudal segments caused by instability of the hip, and those variations can make a various changes in form. First to inspect location of the variations, and then to identify horizontal or vertical shift point at hip region. At last, to determine the strategy of acupuncture treatment, to reduce the sensitization of trigger points, and to solve the problems. The curative effect of acupuncture treatment for climacteric syndrome among the three groups indicates the efficacy of treatments with statistically significant. The efficacy of acupuncture treatment of the group3is better than the others.
本研究探讨以骨骼肌肉辩证与经络、全息的配穴方法,比较髋关节辩证的选穴与传统针灸选穴在针灸治疗更年期症候群的疗效。
每位更年期妇女的症状严重程度不一,某些症状不仅会造成更年期妇女身心的不适,而且也会影响生活品质。过去的研究均着重于改善更年期潮热、盗汗与睡眠障碍等主要症状,其可能的机转为针刺可以透过产生脑内啡(endorphins)等活性物质,来调节下视丘、脑下垂体与卵巢等生殖轴。针对华人更年期盛行率比较高的骨骼肌肉酸痛问题,却鲜少有研究针对此部分来探讨；因此本研究探讨经由骨骼肌肉辩证选穴,除在更年期内分泌失衡调理外,对更年期酸痛治疗更为重视。
方法：
筛选45-60岁更年期妇女,更年期身心症状评估量表(MRS)评分不得低于8分。依序遵照随机随机数表分配于三组治疗组,第1组传统主穴配穴针灸治疗组(主穴有关元、三阴交；配穴有悬钟、承山、照海总共九针)；第2组髋骨辨证针灸治疗组(有后阳陵泉、足三里、商丘、膝关、地机、丘墟共六针)；第3组主穴暨髋骨辨证针灸治疗组(主穴有关元、三阴交；配穴有后阳陵泉、足三里、商丘、膝关、地机、丘墟,总共九针)。施针主穴：关元(针上灸,两壮)、三阴交,以调理内分泌为主,传统配穴及髋骨辨证以加强治疗酸痛为主。三组均填写更年期身心症状评估量表(MRS)、疼痛量表(VAS)及与世界卫生组织生活质量问卷(WHOQOL-BREF),每周针灸2次,每次30分,治疗4周,再隔1周结案。每位受试者于第1周量测MRS、 WHOQOL-BREF、及VAS之基准资料、并于第2、4、5周填写后测问卷,即以评估针灸疗效。
结果：
筛选121位受试者,有39位未加入(I/E不合者25人,没意愿者9人,服用药物0人,没有出席研究者4人,没有严重症状者1人),资格符合而加入试验者实际有82人,其中有完成5周结案者74人约占90.2%,未按时回诊而退出者8人约占9.8%。27例患者入第1组而有23人完成结案,27例患者入第2组而有25人完成结案,28例患者入第3组而有26人完成结案。
(1)基准点(baseline)整体(不分组)资料,更年期11个主要症状,以症状总分评比则关节疼痛、肌肉疼痛居第1名,疲倦第2名,而睡眠障碍(失眠),易感染尿道炎、尿失禁,易激动、神经紧张,在临床上最为常见。
(2)就基准点(baseline)资料,更年期主要症状以MRS总分评比则关节疼痛、肌肉疼痛程度居冠,足见关节疼痛、肌肉疼痛在更年期症状中为极重要的问题；更年期疲倦问题与情绪方面有显着相关性。
(3)三组治疗后第四周MRS皆有疗效显着性(P<0.05),心理感觉改善程度和泌尿生殖症状改善程度由大到小组别排名3>2>1,躯体感觉改善程度排名组别由大到小排列2>3>1。
(4)三组治疗后第四周VAS皆有疗效显着性(P<0.05),在疼痛方面整体改善以主穴暨髋骨辨证针灸治疗组的疗效为优。而上肢疼痛以传统主穴配穴组的疗效为优,腰、背、腹面、下肢疼痛以主穴暨髋骨辨证针灸治疗组优。
(5)MRS各组内治疗前后比较,采用自身配对t检验,根据结果我们可以发现3组各组P值为0.000<0.05,皆有统计上显着的差异。3组在经过4周治疗皆有疗效。MRS第4周治疗后与治疗前(基准点)3组间比较分析,ANCOVA的报告结果：分组的F值为3.364, P值为0.040<0.05,即3组差异达到显着水平。修正均数的两两比较的LSD检验显示,第1组与第3组比较疗效有显着差异,第3组的疗效优于第1组的疗效。但第2组与第1组及第3组比较疗效并没有显着差异。
结论：
整体而言,妇女更年期障碍是来自内分泌功能失调,而导致自律神经系统功能紊乱,自律神经与激痛点有其相互作用,主穴之“关元”及“三阴交”调理更年期妇女的内分泌,对睡眠、泌尿系统、情绪方面均有明显的改善。
参与本研究案更年期妇女之受试者,对于所提供的针灸及卫教大都持正面的评价,在心悸、胸闷、腰痛、膝盖酸痛、肌肉酸痛、疲倦、多梦有明显改善,尤其频尿及漏尿、睡眠障碍、腰酸有七成左右都有改善,在针灸结案后一个月左右随访,仍持续遵循卫教自我保建之患者亦能维持不错的健康,在睡眠、频尿、酸痛改善方面仍有维持。
本研究辨证髋骨论点：因荐尾椎的变动而引起髋骨的正位不稳,两者之间所形成的多种多样的变化形态,先辨病位,再辨阴阳盛衰,确立施治方法,降低激痛点敏感化改善问题,三组更年期针灸治疗虽皆有显着改善,而以第3组主穴暨髋骨辨证针灸治疗组的疗效较佳。
Objective:
A clinical research for using the dialectical and meridian to skeletal muscle with relation to meridian, hologram to select acupoints, and comparing the curative effect of acupuncture treatment for climacteric syndrome between methods using traditional acupoints and hip's mechanics discriminated.
For each of the climacteric symptom of varying severity, climacteric women will suffer proportionately from not only physical and psychological discomfort but also the quality of life getting worse. Acupuncture in the treatment of menopausal syndrome. Furthermore, past studies almost focused on improving major symptoms such as hot flashes, night sweats, and insomnia. Probably, acupuncture with the mechanism of stimulating natural production of endorphins and releasing various hormones could regulate the hypothalamus, pituitary, and ovarian. For the relatively high prevalence of climacteric symptom of musculoskeletal pain, there has been few research to explore in this area. With respect to treatment of climacteric symptoms, especially for musculoskeletal pain, this study for the acupoints selection by hip's mechanics discriminated according to musculoskeletal changes not only deals with endocrine imbalance but also pay more attention to musculoskeletal pain problems.
Methods:
The patients enrolled in the study were climacteric women, ranging from45to60years of age with Menopause Rating Scale (MRS) score of not less than8points. the sequence according to the random number table assigned to three treatment groups, group1:master acupoints plus traditional method [master acupoints of guanyuan (RN4) and sanyinjiao (SP6), associated with Xuanzhong(GB39)、 Chengshan (BL57)、 Zhaohai (K16); totally9acupoints]; group2:hip's mechanics discriminated method [rear Yanglingquan (GB34)、 Zusanli (ST36)、 Shangqiu (SP5)、 xiguan (LR7)、 Dij I (SP8)、 Qiuxu (GB40); totally6acupoints]; group3:master caupoints plus hip's mechanics discriminated method [master acupoints of guanyuan (RN4) and sanyinjiao (SP6), associated with rear Yanglingquan (GB34)、 Zusanli (ST36)、 Shangqiu (SP5)、 xiguan (LR7)、 Diji (SP8)、 Qiuxu (GB40); totally9acupoints]. The master acupoints of guanyuan (RN4) and sanyinjiao (SP6) is to regulate endocrine disorders and selecting acupoint of traditional method and hip's mechanics discriminated is to enhance the effect of pain cure. The patients in three groups should fill in the questionnaires of MRS, Visual Analogue Scale (VAS), and The World Health Organization Quality of Life (WHOQOL-Brief), and take acupuncture of twice a week for four weeks,30minutes for each, and then closed at following week intervals, acupuncture twice a week for four weeks. Baseline scores were measured on the MRS, WHOQOL, and VAS, at the beginning of week one, as followed by further measures at the end of weeks two, fore, and five. The curative effect were assessed to explore the score differences among the baseline.
Results:
Of the121recruited patients,39were found to be ineligible. The principal reasons for ineligibility were failure to meet eligibility criteria (n=25), loss of interest in participation after detailed explanation (n=9), medical conditions and medications (n=0), loss to follow up after the initial visit (n=4), and no evidence of severe climacteric symptoms (n=1). In all,74(90.2%) of the initial83participants completed the5-week study without any major protocol violation.8((9.8%)) of reasons for withdrawal were failure to return.23of the initial27participants completed in group1,25of the initial27participants completed in group2, and26of the initial28participants completed in group3.
(1) According to the baseline of the overall data (without separating group), the score rating of the joint pain&muscle pain ranks first on the11major symptoms of the menopause symptom, and that of fatigue ranks second. Furthermore, sleep disorders (insomnia), urethritis, urinary incontinence, irritability, nervousness is more common in clinical practice.
(2) From baseline of the overall data, MRS assessment in joint pain and muscle pain, the total score of the highest indicates the joint pain and muscle pain in menopause symptoms as a very important issue. Relationship between fatigue and emotional aspects is significant.
(3) After4weeks cure, the MRS score of three groups indicates the efficacy of treatments with statistically significant (P<0.05). Improvement in psychological and urogenital aspect among the three groups with efficacy ranking as group3>2>1. Improvement in somatic&vegetative aspects among the three groups with efficacy ranking as group2>3>1.
(4) After4weeks cure, the VAS score of three groups indicates the efficacy of treatments with statistically significant (P<0.05). Overall improvement in pain was excellent on the efficacy of the group3, improvement in upper limb pain was excellent on the efficacy of the group1, and improvement in lumbar, back, lower limb pain was excellent on the efficacy of the group3.
(5) According to the comparison of MRS for before and after treatment within each group, using paired t test, each group's P-values for0.000<0.05based on results indicated that the differences within each group is statistically significant. All of three groups after4weeks of treatment are efficacy. Based on ANCOVA reports as F=3.364 &P-value for0.040<0.05, the comparisons of MRS for before and after treatment among three groups at week4show that the differences among three Groups is statistically significant. The pairwise comparisons of adjusted means based on Least Significant Difference (LSD) test show that the difference between group1and group3is statistically significant and the Comparative efficacy of group3is better than group1, but there are no significant differences as group2compared to group1and group3respectively.
Conclusion:
In general, the women's menopausal problems caused by the endocrine dysfunction in addition to autonomic nervous system disorder. It seems that autonomic nervous system and trigger points may interact with each other. The acupuncture of guanyuan (RN4) and sanyinjiao (SP6) is to regulate endocrine disorders and can make a great improvements for the sleep, urinary system, and emotions.
With respect to acupuncture treatment and health education, participants of menopausal women in this study mostly expressed positive feedback and obtain a great improvements in heart palpitations, chest tightness, back pain, knee pain, muscle pain, fatigue, and dreaminess. Improvement especially in urinary incontinence, sleep disorders (insomnia), and backache can achieve a70%of recovery. With a follow-up around one month after completed acupuncture treatment, they always can maintain good health in sleep, urinary incontinence, and pain, if continued to follow the health education and to take care by themselves.
Discussion in hip's mechanics discriminated:anatomical variations of sacral-caudal segments caused by instability of the hip, and those variations can make a various changes in form. First to inspect location of the variations, and then to identify horizontal or vertical shift point at hip region. At last, to determine the strategy of acupuncture treatment, to reduce the sensitization of trigger points, and to solve the problems. The curative effect of acupuncture treatment for climacteric syndrome among the three groups indicates the efficacy of treatments with statistically significant. The efficacy of acupuncture treatment of the group3is better than the others.
引文
[1]McKinlay SM, Brambilla DJ, Posner JG. The normal menopause transition[J]. Maturitas,1992,14 (2):103-115.
[2]朱燕宁译,葛秦生审校.最新消息—有关绝经名词新与精确的国际标准定义[J].生殖医学杂志,2000,9(3)：192-193.
[3]Aristotle/Balme, D. M. Historia Animalium[M]. Cambridge University:2002, 1(I-X).
[4]王洪图主编.内经讲义素问上古天真论[M].人民卫生出版社,2006.
[5]张清学,杨冬梓,王文军,等.妇女更年期症状调查结果分析[J].生殖医学杂志,2004,19(21)：96-98.
[6]夏建红,田丰莲,赵庆国,等.围绝经期妇女就诊及激素替代治疗态度调查[J].中国公共卫生,2005,21(1)：83-84.
[7]嘉鸿科技开发有限公司.中华医典[M].台北：长亨文化出版公司,2004.
[8]袁立霞,刘刚.从肝论治妇女更年期综合征[J].山东中医杂志,2007,26(7)：439-440
[9]陈家旭,万霞,胡立胜.围绝经期综合征辨证分型的文献研究[J],中华中医药杂志(原中国医药学报),2006,21(11)：649-651.
[10]张桂珍.补肾六法治疗女性更年期综合征[J].福建中医学院学报,2004,14(1)：6-8.
[11]高莉萍.更年期综合征的中医辨证疗法举隅[J].泰州职业技术学院学报,2006,4(1)：63-64.
[12]彭姝峰.加味六味地黄汤治疗绝经后骨质疏松症的研究[J].现代中西医结合杂志,2007,16(31)：4592-4593.
[13]李淑荣,都亚娟,张淑杰.针刺背腧穴为主治疗女性更年期综合征200例[J].针灸临床杂志,2005,21(11)：39.
[14]李连香综述,陈亚琼审校.雌激素受体和绝经的研究进展[J].国外医学妇幼保健分册,2003,14(4)：214-216.
[15]段淑香,李亚东,李健男,等.针刺对更年期雌性大鼠血清雌二醇、睾酮、促性腺激素水平的影响[J].针灸临床杂志,2006,22(11)：44-45.
[16]王朝晖.性腺激素在绝经和继发性闭经中水平的对比研究[J].放射免疫学杂志, 2007,20(5)：417-419.
[17]沈皓,蔡德培,陈伯英.补肾中药对下丘脑-垂体促性腺机能的影响[J].中西医结合学报,2004,2(1)：53-57.
[18]夏晓娜,李芬,宋晖,等.陕西农村更年期妇女潮热情况的调查[J].中国妇幼健康研究,2011,4：439-442.
[19]黄学惠,敬晓涛,金玉妮,等.更年期妇女潮热的健康教育[J].昆明医学院学报,2007,28(1)：74-76.
[20]Lobo RA. Treatment of the postmenopausal woman:basic and clinical aspects, New York:Raven Press,1994,97-117.
[21]Ballinger CB. Psychiatric aspects of the menpause, Br J Psychiatry,1990, 156:773-787.
[22]李连香,陈亚琼,吕葆真,等.GnRH受体和5-HT受体与更年期大鼠潮热的关系[J].解剖学杂志,2004,27(4)：80-81.
[23]罗晓梅,陈亚琼.绝经期潮热与5-羟色胺[J].国外医学(妇产科学分册)2003,30(6)：394-395.
[24]刘亚妮,麻玲玲,孙静,等.关于更年期潮热的机制探讨[J].中华现代妇产科学杂志,2005,2：
[25]Casper RF. Menopausal flushes:a neuroendocrine link with pulsatile luteinizing hormone secretion. Science,1979,205:823-825.
[26]Mulley G. Hot flashes after hypophysectomy. BMJ,1977,2:1062.
[27]胡玲,汪惠丽,高忻洙,等.电针“关元”与“三阴交”对围绝经期模型大鼠性激素及下丘脑β EP调整作用的比较[J].中国针灸,2004,24(9)：649-651.
[28]罗晓梅,陈亚琼.围绝经期潮热的非激素治疗[M].国外医学妇幼保健分册,2004,15(2)：107-109.
[29]Wyon Y. Lindgren R. Hammar M Acupuncture against climacteric disorders? Lower number of symptoms after menopause in Swedish,1994, (91).
[30]徐春琳,吴瑞芳,王振海.一氧化氮介导的雌激素在输卵管结扎术后盆腔瘀血综合征中的应用[J].中华妇产科杂志,2000,35(7)：439-440.
[31]司丽云八段锦运动对更年期妇女身体组成更年期困扰症状血脂肪相关因子成效之探讨[D].台北：国立台北护理学院,中西医结合护理研究所,2004.
[32]郭大江,张敏.针灸治疗心血管疾病中关于代谢组学的研究概况[J].河北中医,2008,30(10).
[33]易绍东,阮云军,董凤英,等.雌激素对去卵巢大鼠血清一氧化氮和内皮素水平的影响[J].中国医师杂志,2001,3(5).
[34]蒋竞,张绍芬,陆维仙,等.孕激素对更年期雌性大鼠脾细胞凋亡及相关基因的调控作用[J].现代免疫学,2006,26(1)：26-29.
[35]Hofmann Lehmann R, Holznagel E, Lutz H. Femalecats have lower rates of apoptosis in peripheral blood lymphocytes than male cats:correlation with estradiol-17beta, but not with progesterone blood levels[J]. Vet Immunol Immunopathol,1998,5 (2-4):151-160.
[36]李沛,纪峰,陈贵珍.针药结合对绝经后骨代谢相关激素影响的临床观察[J].福建中医学院学报,2005,15(3)：21-22.
[37]颜晓东,黄忠,朱敏嘉,等.绝经后妇女血清调钙激素水平与骨代谢关系探讨[J].中国骨质疏松杂志,2001,7(3)：207-209.
[38]权晓慧,朱秀英,武小薇,等.绝经后妇女年龄、绝经年龄、绝经年限与腰椎和髋部骨密度的关系分析[J].中国骨质疏松杂志,2006,12(3)：226-228.
[39]刘雁峰,李峰,王洪彬,等.绝经期妇女中医症状、证型特征的调查及分析[J].生殖医学杂志,2006,29(1)：56-59.
[40]高莉萍.更年期综合征的中医辨证疗法举隅[J].泰州职业技术学院学报,2004,4(1)：63-64.
[41]段淑香,李亚东,李健男,等.补肾活血方对更年期大鼠FSH的影响[J].实验动物科学与管理,2005,22(2)：4-5.
[42]胡随瑜,尤劲松,向群辉.地贞颗粒对“更年期”拟阴虚内热证模型大鼠的影响[J].中药新药与临床药理,2000,11(3)：143.
[43]张桂珍.补肾六法治疗女性更年期综合征[J].福建中医学院学报,2004,14(1)：6-8.
[44]张佛明,郭长青.冲脉理论对于更年期反应的意义[J].中国针灸,2006,26(8)：602-604.
[45]王健,朱颖.冲脉初探[J].天津中医学院学报,2002,21(3)：10.
[46]陈兆军.浅谈人体“四海”[J].河南中医,1994,14(4)：206.
[47]石艳清,王爱玲,程建新,等.激素替代治疗更年期综合征的临床研究[J].实用医技杂志,2007,14(12)：1959-1596.
[48]沈洁,沈梅红,李忠仁针灸治疗围绝经期综合征临床及机制研究进展[J].山东中医杂志,2008,27(1)：62-64.
[49]张永臣,吴富东.四关和四关穴探析[J].针灸临床杂志,2005,21(6).
[50]段方胜,吴钢,郑依勇.针刺四关穴对头痛患者脑血流动力学的影响[J].上海针灸杂志,1996,15(2)：5.
[51]周敏,刘洁,唐勇.针刺四关穴治疗偏头痛即对一氧化氮水平的影响[J].中国中医急症,2003,12(2)：129.
[52]商阿萍,潘广博.“以通为补”针刺治疗更年期综合征[J].河北中医,2008,30(5).
[53]李淑荣,都亚娟,张淑杰.针刺背腧穴为主治疗女性更年期综合征200例[J].针灸临床杂志,2005,21(11)：39.
[54]柴铁劬.靳三针临床配穴法[M].北京：人民卫生出版社,2009,111-112.
[55]张颖清.全息胚及其医学应用[M].台北：艺轩图书出版社,1996,41-51,57-58.
[56]乔晋琳.全息胚针学临证概要[M].北京：人民军医出版社,1999：90-91.
[57]刘华,马琳琳译,林守清审校.北美绝经学会雌激素和孕激素在围绝经期及绝经后妇女应用的立场声明解读[J].中国实用妇科与产科杂志,2008,24(4)：244-248.
[58]赵瑾,何仲.绝经后妇女应用激素替代疗法的依从性研究[J].护理研究,2006,20(4)：859-861.
[59]石艳清,王爱玲,程建新,等.激素替代治疗更年期综合征的临床研究[J].实用医技杂志,2007,14(12)：1959-1596.
[60]章婷婷,刚君,方小玲.雌激素替代疗法的利与弊[J].医学与哲学,2006,27(1)：46-48
[61]席孟斯(Simons, David G.)肌筋膜疼痛与机能障碍：激痛点手册.第1册,身体的上半部[M].合记图书出版社,2010：12,19,82,121,82,49,57,17,53,97,103,122,115,69,76,70,122,16,54,46,74,59,19,75,72,105,56,185,186,111,112,110,184,24,19,81,20,21,24,114,21,82,123,44,122,102,138,45,41,42,94,22,72,178,101,14,31.
[62]吴韦廷.延迟性肌肉酸痛[J].台北市医师公会会刊,2007,(5)2：14-17.
[63]林颂凯,曾恺平,张焕祯.肌筋膜疼痛症候群[J].基层医疗,2007,22(4)：140-146.
[64]Dorsher P D. Trigger point and acupuncture points:anatomic and clinical. correlations[J]. Medical Acu-Punct,2006,17 (3):21-24.
[65]方胜林探索经络＆针刺的作用机制[J].亚太传统医药,2009,5(1)：13-14.
[66]葛廷云,刘丽萍.中医针灸在防治运动性疲劳中的作用[J].河北体育学院学报,2011,3(25)：85-87.
[67]鲍铁周.手法治疗肩背肌筋膜炎疗效观察与体会[J].四川中医,2005,8 (23)：109-111.
[68]黄强民,张雄文,赵永明,等.颈肌筋膜激痛点疼痛和头部牵涉痛的诊断与治疗[J].中国康复医学杂志.2004,5(19)：363-365.
[69]林颂凯,曾恺平,张焕祯肌筋膜疼痛症候群[J].基层医学,4(22)140-146.
[70]赵磊,郭义,阎丽娟,等.针灸治疗坐骨神经痛的文献计量学分析[J].辽宁中医杂志,2010,38(3)：526-529.
[71]王莉,杨洁.针刺申脉照海为主治疗失眠症疗效观察[J].四川中医,2011,7(29)：125-126.
[72]张世红,牛汉璋,江赛男.P物质在初级传人兴奋传递中的作用[J].西安医科大学学报,2000,21(5).
[73]孙怡,田玉科.一氧化氮对脊髓背角疼痛的调制作用[J].临床麻醉学杂志.2005,21(9).
[74]刘文彦,白波.脑内一氧化氮对大鼠痛阈影响的实验研究[J].中国行为医学科学,1999,4(8)：255-256.
[75]王跃秀,袁斌,唐敬师.丘脑中央下核在不同强度电针引起镇痛效应中的作用[J].中国临床康复,博士论文2006,10(27).
[76]郭磊,赵玉岩,范广宇,等.骨盆周围肌肉作用力影响骨盆环应力分布的实验研究[J].中国医科大学学报,2001,(30)5：361-362.
[77]Fischer AA. Tissue compliance meter for objective, quantitative documentation of soft tissue consistencyand pathology. Arch Phys Med Rehabil 1987,68:122-5.
[78]陈若佟,苏国伟,官大绅,等.肱二头肌不同部位于离心收缩后压痛阈值、压痛耐受度及组织顺应性之变化[J].台湾复健医志,2009,37(3)：169-177.
[79]Gibson W, Arendt-Nielsen L, Graven-Nilsen T. Delayed onset muscle soreness at tendon-bone junction and muscle tissue is associated with facilitated referred pain. Exp Brain Res 2006, 174: 351-60.
[80]吴亮,邱勇,王斌,等.特发性脊柱侧凸患者两侧椎旁肌中肌梭与运动终板病理学变化的对比研究[J].中国脊柱脊髓杂志,2008,3(18)：222-226.
[81]郑斌,周永德,吉士俊,等.脊柱侧弯患儿椎旁肌六种元素的含量观察[J].中国医科大学学报,1997,26(5)：505-507.
[82]夏月.建立信息化的中医和针灸临床研究：门德尔遗传定律的发现过程给我们的启示[J].针刺研究,2007,6(32)：393-398.
[83]吴文忠.针灸的“调衡”作用探讨[J].江苏中医药,2009,12(41)：8-9.
[84]高巍,黄裕新,陈洪,等.脑肠肽在针刺调节免疫反应中的作用[J].中国免疫学杂志,2000,(17)：473-477.
[85]周诚,王嘉洲,陈敏,等.针刺穴位与大脑皮层之间关系的脑功能MRI表现[J].中华放射学杂志,2005,3(39)：252-255.
[86]胡玲,汪惠丽,高忻洙,等.电针“关元”与“三阴交”对围绝经期模型大鼠性激素及下丘脑β-EP调整作用的比较[J].中国针灸,2004,9 (24)：649-651.
[87]刘晓艳,吕明.针剌雄性小鼠关元穴对性腺激素影响的实验研究[J].南京中医药大学学报,2010,5(26)：383-384.
[88]李晓泓,宋晓琳,张露芬,等.逆灸关元穴对自然更年期大鼠子宫HSP70、 HSP70mRNA、 SOD、 NOS的影响[J].中华中医药杂志(原中国医药学报),2010,1(25)：46-49.
[89]白巍,姜国华,徐强,等.针刺足三里、关元穴对更年期雌性大鼠卵巢NO、 SOD、 MDA含量影响[J].中医药学报,2009,37(6)：90-91.
[90]王洪彬,李晓泓,何玉伟.逆针灸关元穴对自然更年期大鼠ACTH、 NE和5-HT含量的影响[J].北京中医药大学学报,2008,31(12)：826.
[91]李晓泓,解秸萍,张露芬,等.逆灸关元穴对不同月龄更年期大鼠肿瘤坏死因 数α及脾脏雌激素受体α的影响[J].中国临床康复,2006,43(10)：171-173.
[92]李亚东,高洪泉,朱梅,等.针刺老年大鼠“足三里” “关元”穴对NO、 SOD、 MDA以及免疫影响的实验研究[J].中国针灸,2002,11(22)：772-774.
[93]李晓泓,宋晓琳,徐莉莉,等.即刻针刺和“逆针”三阴交穴对痛经大鼠子宫HSP70、MDA及SOD的影响[J].中华中医药杂志(原中国医药学报),2010,11(25)：1860-1863.
[94]诸晓英.浅议三阴交穴在妇科中的应用[J].中国针灸,1997,17(9)：554.
[95]梁繁荣,刘雨星,罗荣,等.不同针法对急性佐剂性关节炎大鼠下丘脑β 2内啡肽的后效应观察[J].中国针灸,2004,11(24)：782-784.
[96]王跃秀,袁斌,唐敬师.丘脑中央下核在不同强度电针引起镇痛效应中的作用[J].中国临床康复,2006,10(27).
[97]朱娟霞,唐敬师,贾红.阿片受体在大鼠丘脑中央下核和顶盖前区前核介导电针镇痛中的不同作用(英文)[J].生理学报,2004,(6).
[98]易建良.电针对神经病理痛大鼠痛觉过敏及脊髓NOS/NO系统的干预作用.南京中医药大学,(硕士论文)针灸推拿学,2008.
[99]杨峰.内经针灸理论分部思想探讨[J].辽宁中医杂志,2010,10(37)：1939.
[100]饶伟文.全息胚学说在中医基础理论研究中的应用[J].中国中医基础医学杂志,2009,8(15)：628-630.
[101]王军,吴金鹏,鲁朝敏.基于MR I图像三维重建人体上肢经络[J].中国针灸,2010,30(2)：125-128.
[102]彭增福.西方针刺疗法之激痛点与传统针灸腧穴的比较[J].中国针灸,2008,5(28)：349-352.
[103]龚彦颖,陈方佩,陈纯娟,等.运动点在穴位和针灸治疗的角色[J].中华针灸医学会杂志,2003,6：43-47.
[104]林昭庚新针灸大成.中国医药学院针灸研究中心,1992,991-995.
[105]Starr A, Mckeon B, Skuse N, Burke D. Cerebral potentials evoked by muscle stretch in man. Brain 1981,104,149-166.
[106]Fukuda M, Kameyama S, Tanaka R. Thalamic potentials evoked by motor point stimulation. Muscle & Nerve,2000, 23, 246-251.
[107]卜彦青,陈少宗,杜广中.原发性痛经现代针灸腧穴谱[J].辽宁中医杂志, 2010,6(37)：1110-1112.
[108]林颂凯,曾恺平,张焕祯.肌筋膜疼痛症候群[J].基层医学,2007,22(4)140-146.
[109]茹凯,刘天君.“经筋”实质的系统科学研究[J].北京中医药大学学报,2010,33(4)：229-234.
[110]Robert D G. Myofascial and visceral pain syndromes:visceral-somatic pain representation [J]. J Musculo-skeletal Pain,2002,10 (1-2):165-175.
[111]潘惠娟,王海燕,许建阳,等.电针对实验性RA大鼠痛闽及脑干 NO/NOS变化的研究[J].上海针灸杂志,2002,21(5)：48-50.
[112]葛廷云,刘丽萍.中医针灸在防治运动性疲劳中的作用[J].河北体育学院学报,2011,3(25)：85-87.
[2]朱燕宁译,葛秦生审校.最新消息—有关绝经名词新与精确的国际标准定义[J].生殖医学杂志,2000,9(3)：192-193.
[3]Aristotle/Balme, D. M. Historia Animalium[M]. Cambridge University:2002, 1(I-X).
[4]王洪图主编.内经讲义素问上古天真论[M].人民卫生出版社,2006.
[5]张清学,杨冬梓,王文军,等.妇女更年期症状调查结果分析[J].生殖医学杂志,2004,19(21)：96-98.
[6]夏建红,田丰莲,赵庆国,等.围绝经期妇女就诊及激素替代治疗态度调查[J].中国公共卫生,2005,21(1)：83-84.
[7]嘉鸿科技开发有限公司.中华医典[M].台北：长亨文化出版公司,2004.
[8]袁立霞,刘刚.从肝论治妇女更年期综合征[J].山东中医杂志,2007,26(7)：439-440
[9]陈家旭,万霞,胡立胜.围绝经期综合征辨证分型的文献研究[J],中华中医药杂志(原中国医药学报),2006,21(11)：649-651.
[10]张桂珍.补肾六法治疗女性更年期综合征[J].福建中医学院学报,2004,14(1)：6-8.
[11]高莉萍.更年期综合征的中医辨证疗法举隅[J].泰州职业技术学院学报,2006,4(1)：63-64.
[12]彭姝峰.加味六味地黄汤治疗绝经后骨质疏松症的研究[J].现代中西医结合杂志,2007,16(31)：4592-4593.
[13]李淑荣,都亚娟,张淑杰.针刺背腧穴为主治疗女性更年期综合征200例[J].针灸临床杂志,2005,21(11)：39.
[14]李连香综述,陈亚琼审校.雌激素受体和绝经的研究进展[J].国外医学妇幼保健分册,2003,14(4)：214-216.
[15]段淑香,李亚东,李健男,等.针刺对更年期雌性大鼠血清雌二醇、睾酮、促性腺激素水平的影响[J].针灸临床杂志,2006,22(11)：44-45.
[16]王朝晖.性腺激素在绝经和继发性闭经中水平的对比研究[J].放射免疫学杂志, 2007,20(5)：417-419.
[17]沈皓,蔡德培,陈伯英.补肾中药对下丘脑-垂体促性腺机能的影响[J].中西医结合学报,2004,2(1)：53-57.
[18]夏晓娜,李芬,宋晖,等.陕西农村更年期妇女潮热情况的调查[J].中国妇幼健康研究,2011,4：439-442.
[19]黄学惠,敬晓涛,金玉妮,等.更年期妇女潮热的健康教育[J].昆明医学院学报,2007,28(1)：74-76.
[20]Lobo RA. Treatment of the postmenopausal woman:basic and clinical aspects, New York:Raven Press,1994,97-117.
[21]Ballinger CB. Psychiatric aspects of the menpause, Br J Psychiatry,1990, 156:773-787.
[22]李连香,陈亚琼,吕葆真,等.GnRH受体和5-HT受体与更年期大鼠潮热的关系[J].解剖学杂志,2004,27(4)：80-81.
[23]罗晓梅,陈亚琼.绝经期潮热与5-羟色胺[J].国外医学(妇产科学分册)2003,30(6)：394-395.
[24]刘亚妮,麻玲玲,孙静,等.关于更年期潮热的机制探讨[J].中华现代妇产科学杂志,2005,2：
[25]Casper RF. Menopausal flushes:a neuroendocrine link with pulsatile luteinizing hormone secretion. Science,1979,205:823-825.
[26]Mulley G. Hot flashes after hypophysectomy. BMJ,1977,2:1062.
[27]胡玲,汪惠丽,高忻洙,等.电针“关元”与“三阴交”对围绝经期模型大鼠性激素及下丘脑β EP调整作用的比较[J].中国针灸,2004,24(9)：649-651.
[28]罗晓梅,陈亚琼.围绝经期潮热的非激素治疗[M].国外医学妇幼保健分册,2004,15(2)：107-109.
[29]Wyon Y. Lindgren R. Hammar M Acupuncture against climacteric disorders? Lower number of symptoms after menopause in Swedish,1994, (91).
[30]徐春琳,吴瑞芳,王振海.一氧化氮介导的雌激素在输卵管结扎术后盆腔瘀血综合征中的应用[J].中华妇产科杂志,2000,35(7)：439-440.
[31]司丽云八段锦运动对更年期妇女身体组成更年期困扰症状血脂肪相关因子成效之探讨[D].台北：国立台北护理学院,中西医结合护理研究所,2004.
[32]郭大江,张敏.针灸治疗心血管疾病中关于代谢组学的研究概况[J].河北中医,2008,30(10).
[33]易绍东,阮云军,董凤英,等.雌激素对去卵巢大鼠血清一氧化氮和内皮素水平的影响[J].中国医师杂志,2001,3(5).
[34]蒋竞,张绍芬,陆维仙,等.孕激素对更年期雌性大鼠脾细胞凋亡及相关基因的调控作用[J].现代免疫学,2006,26(1)：26-29.
[35]Hofmann Lehmann R, Holznagel E, Lutz H. Femalecats have lower rates of apoptosis in peripheral blood lymphocytes than male cats:correlation with estradiol-17beta, but not with progesterone blood levels[J]. Vet Immunol Immunopathol,1998,5 (2-4):151-160.
[36]李沛,纪峰,陈贵珍.针药结合对绝经后骨代谢相关激素影响的临床观察[J].福建中医学院学报,2005,15(3)：21-22.
[37]颜晓东,黄忠,朱敏嘉,等.绝经后妇女血清调钙激素水平与骨代谢关系探讨[J].中国骨质疏松杂志,2001,7(3)：207-209.
[38]权晓慧,朱秀英,武小薇,等.绝经后妇女年龄、绝经年龄、绝经年限与腰椎和髋部骨密度的关系分析[J].中国骨质疏松杂志,2006,12(3)：226-228.
[39]刘雁峰,李峰,王洪彬,等.绝经期妇女中医症状、证型特征的调查及分析[J].生殖医学杂志,2006,29(1)：56-59.
[40]高莉萍.更年期综合征的中医辨证疗法举隅[J].泰州职业技术学院学报,2004,4(1)：63-64.
[41]段淑香,李亚东,李健男,等.补肾活血方对更年期大鼠FSH的影响[J].实验动物科学与管理,2005,22(2)：4-5.
[42]胡随瑜,尤劲松,向群辉.地贞颗粒对“更年期”拟阴虚内热证模型大鼠的影响[J].中药新药与临床药理,2000,11(3)：143.
[43]张桂珍.补肾六法治疗女性更年期综合征[J].福建中医学院学报,2004,14(1)：6-8.
[44]张佛明,郭长青.冲脉理论对于更年期反应的意义[J].中国针灸,2006,26(8)：602-604.
[45]王健,朱颖.冲脉初探[J].天津中医学院学报,2002,21(3)：10.
[46]陈兆军.浅谈人体“四海”[J].河南中医,1994,14(4)：206.
[47]石艳清,王爱玲,程建新,等.激素替代治疗更年期综合征的临床研究[J].实用医技杂志,2007,14(12)：1959-1596.
[48]沈洁,沈梅红,李忠仁针灸治疗围绝经期综合征临床及机制研究进展[J].山东中医杂志,2008,27(1)：62-64.
[49]张永臣,吴富东.四关和四关穴探析[J].针灸临床杂志,2005,21(6).
[50]段方胜,吴钢,郑依勇.针刺四关穴对头痛患者脑血流动力学的影响[J].上海针灸杂志,1996,15(2)：5.
[51]周敏,刘洁,唐勇.针刺四关穴治疗偏头痛即对一氧化氮水平的影响[J].中国中医急症,2003,12(2)：129.
[52]商阿萍,潘广博.“以通为补”针刺治疗更年期综合征[J].河北中医,2008,30(5).
[53]李淑荣,都亚娟,张淑杰.针刺背腧穴为主治疗女性更年期综合征200例[J].针灸临床杂志,2005,21(11)：39.
[54]柴铁劬.靳三针临床配穴法[M].北京：人民卫生出版社,2009,111-112.
[55]张颖清.全息胚及其医学应用[M].台北：艺轩图书出版社,1996,41-51,57-58.
[56]乔晋琳.全息胚针学临证概要[M].北京：人民军医出版社,1999：90-91.
[57]刘华,马琳琳译,林守清审校.北美绝经学会雌激素和孕激素在围绝经期及绝经后妇女应用的立场声明解读[J].中国实用妇科与产科杂志,2008,24(4)：244-248.
[58]赵瑾,何仲.绝经后妇女应用激素替代疗法的依从性研究[J].护理研究,2006,20(4)：859-861.
[59]石艳清,王爱玲,程建新,等.激素替代治疗更年期综合征的临床研究[J].实用医技杂志,2007,14(12)：1959-1596.
[60]章婷婷,刚君,方小玲.雌激素替代疗法的利与弊[J].医学与哲学,2006,27(1)：46-48
[61]席孟斯(Simons, David G.)肌筋膜疼痛与机能障碍：激痛点手册.第1册,身体的上半部[M].合记图书出版社,2010：12,19,82,121,82,49,57,17,53,97,103,122,115,69,76,70,122,16,54,46,74,59,19,75,72,105,56,185,186,111,112,110,184,24,19,81,20,21,24,114,21,82,123,44,122,102,138,45,41,42,94,22,72,178,101,14,31.
[62]吴韦廷.延迟性肌肉酸痛[J].台北市医师公会会刊,2007,(5)2：14-17.
[63]林颂凯,曾恺平,张焕祯.肌筋膜疼痛症候群[J].基层医疗,2007,22(4)：140-146.
[64]Dorsher P D. Trigger point and acupuncture points:anatomic and clinical. correlations[J]. Medical Acu-Punct,2006,17 (3):21-24.
[65]方胜林探索经络＆针刺的作用机制[J].亚太传统医药,2009,5(1)：13-14.
[66]葛廷云,刘丽萍.中医针灸在防治运动性疲劳中的作用[J].河北体育学院学报,2011,3(25)：85-87.
[67]鲍铁周.手法治疗肩背肌筋膜炎疗效观察与体会[J].四川中医,2005,8 (23)：109-111.
[68]黄强民,张雄文,赵永明,等.颈肌筋膜激痛点疼痛和头部牵涉痛的诊断与治疗[J].中国康复医学杂志.2004,5(19)：363-365.
[69]林颂凯,曾恺平,张焕祯肌筋膜疼痛症候群[J].基层医学,4(22)140-146.
[70]赵磊,郭义,阎丽娟,等.针灸治疗坐骨神经痛的文献计量学分析[J].辽宁中医杂志,2010,38(3)：526-529.
[71]王莉,杨洁.针刺申脉照海为主治疗失眠症疗效观察[J].四川中医,2011,7(29)：125-126.
[72]张世红,牛汉璋,江赛男.P物质在初级传人兴奋传递中的作用[J].西安医科大学学报,2000,21(5).
[73]孙怡,田玉科.一氧化氮对脊髓背角疼痛的调制作用[J].临床麻醉学杂志.2005,21(9).
[74]刘文彦,白波.脑内一氧化氮对大鼠痛阈影响的实验研究[J].中国行为医学科学,1999,4(8)：255-256.
[75]王跃秀,袁斌,唐敬师.丘脑中央下核在不同强度电针引起镇痛效应中的作用[J].中国临床康复,博士论文2006,10(27).
[76]郭磊,赵玉岩,范广宇,等.骨盆周围肌肉作用力影响骨盆环应力分布的实验研究[J].中国医科大学学报,2001,(30)5：361-362.
[77]Fischer AA. Tissue compliance meter for objective, quantitative documentation of soft tissue consistencyand pathology. Arch Phys Med Rehabil 1987,68:122-5.
[78]陈若佟,苏国伟,官大绅,等.肱二头肌不同部位于离心收缩后压痛阈值、压痛耐受度及组织顺应性之变化[J].台湾复健医志,2009,37(3)：169-177.
[79]Gibson W, Arendt-Nielsen L, Graven-Nilsen T. Delayed onset muscle soreness at tendon-bone junction and muscle tissue is associated with facilitated referred pain. Exp Brain Res 2006, 174: 351-60.
[80]吴亮,邱勇,王斌,等.特发性脊柱侧凸患者两侧椎旁肌中肌梭与运动终板病理学变化的对比研究[J].中国脊柱脊髓杂志,2008,3(18)：222-226.
[81]郑斌,周永德,吉士俊,等.脊柱侧弯患儿椎旁肌六种元素的含量观察[J].中国医科大学学报,1997,26(5)：505-507.
[82]夏月.建立信息化的中医和针灸临床研究：门德尔遗传定律的发现过程给我们的启示[J].针刺研究,2007,6(32)：393-398.
[83]吴文忠.针灸的“调衡”作用探讨[J].江苏中医药,2009,12(41)：8-9.
[84]高巍,黄裕新,陈洪,等.脑肠肽在针刺调节免疫反应中的作用[J].中国免疫学杂志,2000,(17)：473-477.
[85]周诚,王嘉洲,陈敏,等.针刺穴位与大脑皮层之间关系的脑功能MRI表现[J].中华放射学杂志,2005,3(39)：252-255.
[86]胡玲,汪惠丽,高忻洙,等.电针“关元”与“三阴交”对围绝经期模型大鼠性激素及下丘脑β-EP调整作用的比较[J].中国针灸,2004,9 (24)：649-651.
[87]刘晓艳,吕明.针剌雄性小鼠关元穴对性腺激素影响的实验研究[J].南京中医药大学学报,2010,5(26)：383-384.
[88]李晓泓,宋晓琳,张露芬,等.逆灸关元穴对自然更年期大鼠子宫HSP70、 HSP70mRNA、 SOD、 NOS的影响[J].中华中医药杂志(原中国医药学报),2010,1(25)：46-49.
[89]白巍,姜国华,徐强,等.针刺足三里、关元穴对更年期雌性大鼠卵巢NO、 SOD、 MDA含量影响[J].中医药学报,2009,37(6)：90-91.
[90]王洪彬,李晓泓,何玉伟.逆针灸关元穴对自然更年期大鼠ACTH、 NE和5-HT含量的影响[J].北京中医药大学学报,2008,31(12)：826.
[91]李晓泓,解秸萍,张露芬,等.逆灸关元穴对不同月龄更年期大鼠肿瘤坏死因 数α及脾脏雌激素受体α的影响[J].中国临床康复,2006,43(10)：171-173.
[92]李亚东,高洪泉,朱梅,等.针刺老年大鼠“足三里” “关元”穴对NO、 SOD、 MDA以及免疫影响的实验研究[J].中国针灸,2002,11(22)：772-774.
[93]李晓泓,宋晓琳,徐莉莉,等.即刻针刺和“逆针”三阴交穴对痛经大鼠子宫HSP70、MDA及SOD的影响[J].中华中医药杂志(原中国医药学报),2010,11(25)：1860-1863.
[94]诸晓英.浅议三阴交穴在妇科中的应用[J].中国针灸,1997,17(9)：554.
[95]梁繁荣,刘雨星,罗荣,等.不同针法对急性佐剂性关节炎大鼠下丘脑β 2内啡肽的后效应观察[J].中国针灸,2004,11(24)：782-784.
[96]王跃秀,袁斌,唐敬师.丘脑中央下核在不同强度电针引起镇痛效应中的作用[J].中国临床康复,2006,10(27).
[97]朱娟霞,唐敬师,贾红.阿片受体在大鼠丘脑中央下核和顶盖前区前核介导电针镇痛中的不同作用(英文)[J].生理学报,2004,(6).
[98]易建良.电针对神经病理痛大鼠痛觉过敏及脊髓NOS/NO系统的干预作用.南京中医药大学,(硕士论文)针灸推拿学,2008.
[99]杨峰.内经针灸理论分部思想探讨[J].辽宁中医杂志,2010,10(37)：1939.
[100]饶伟文.全息胚学说在中医基础理论研究中的应用[J].中国中医基础医学杂志,2009,8(15)：628-630.
[101]王军,吴金鹏,鲁朝敏.基于MR I图像三维重建人体上肢经络[J].中国针灸,2010,30(2)：125-128.
[102]彭增福.西方针刺疗法之激痛点与传统针灸腧穴的比较[J].中国针灸,2008,5(28)：349-352.
[103]龚彦颖,陈方佩,陈纯娟,等.运动点在穴位和针灸治疗的角色[J].中华针灸医学会杂志,2003,6：43-47.
[104]林昭庚新针灸大成.中国医药学院针灸研究中心,1992,991-995.
[105]Starr A, Mckeon B, Skuse N, Burke D. Cerebral potentials evoked by muscle stretch in man. Brain 1981,104,149-166.
[106]Fukuda M, Kameyama S, Tanaka R. Thalamic potentials evoked by motor point stimulation. Muscle & Nerve,2000, 23, 246-251.
[107]卜彦青,陈少宗,杜广中.原发性痛经现代针灸腧穴谱[J].辽宁中医杂志, 2010,6(37)：1110-1112.
[108]林颂凯,曾恺平,张焕祯.肌筋膜疼痛症候群[J].基层医学,2007,22(4)140-146.
[109]茹凯,刘天君.“经筋”实质的系统科学研究[J].北京中医药大学学报,2010,33(4)：229-234.
[110]Robert D G. Myofascial and visceral pain syndromes:visceral-somatic pain representation [J]. J Musculo-skeletal Pain,2002,10 (1-2):165-175.
[111]潘惠娟,王海燕,许建阳,等.电针对实验性RA大鼠痛闽及脑干 NO/NOS变化的研究[J].上海针灸杂志,2002,21(5)：48-50.
[112]葛廷云,刘丽萍.中医针灸在防治运动性疲劳中的作用[J].河北体育学院学报,2011,3(25)：85-87.