摘要
背景
近视是指眼在调节静止的状态下,平行光线经过眼的屈光系统后,在视网膜前形成焦点的一种屈光不正的眼病。其主症特点为患者眼对远距离物体的辨认发生困难,即近看清楚,远视模糊,中医称为“能近怯远”症。传统的砭石疗法治疗近视具有痛苦小,安全可靠,简便易学,稍加指导后,患者即可在家白行治疗,时间也可由患者自行安排,不影响工作、学习和生活。
泗滨砭石是一种无毒无害,无放射性的微晶石灰岩。含有几十种人体所需的元素,其中有已被确认与人体健康和生命有关的必需微量元素,如铁、铜、锌、钴、锰、铬、硒、碘、镍、氟、钼、钒、锡、硅、锶、硼、铷、砷等。泗滨砭石具有脉冲频率在20kHz-20mHz之间超声波。用泗滨砭石刮擦人体时产生的超声波脉冲达3698次,超声刺激有较深的穿透性。根据泗滨砭石的这些特征,我们就从其理化特征出发,从中医及现代生物医学角度,砭石对机体可通过以下影响起到治疗近视的作用。
泗滨砭石可产生对人体有益的远红外线。人体通过辐射吸收后,使体表温度升高并不断向皮下组织传递,使该处血管扩张,血流加速,血流量增多,局部血液循环得到改善,增加血液的物质交换,给病变区域提供有利于机体康复的重要生化反应的动力和营养物质,加速代谢,改善人体免疫功能,促进疾病恢复。泗滨砭石超声脉冲频率在20kHz-20mHz之间。用泗滨砭石刮擦人体时产生的超声波脉冲达3698次。超声刺激有较好的穿透性。当用砭石按摩治疗时,由于超声脉冲刺激作用可明显缓解局部肌肉和韧带的紧张,消除机体的炎症和水肿,改善损伤组织周围的血液循环,有利于症状的改善,从而达到治疗疾病的目的。
传统中医学作为几千年中国文化的结晶,在中华文明上下传承过程中起着巨大的作用,在防病治病特别是科技不发达时代的预防保健过程中不可或缺,而且是被实践证实了的历代医家的经验总结。随科技文化的发展,在中医理论指导下开展的保守治疗手段不但在华人区,而且在欧美发达区广泛作为补充或替代治疗。针灸,吸引了大量国内外学者对它进行深入研究。回顾针灸经络研究历史,国内外进行了临床、实验、机理方面的研究,证实了经络客观存在,而且循经感传及经穴-脏腑相关性亦存在,并且发现经穴具有跨体节传导性、循经双向传递性及低阻高导性、高温发光性和钙离子富集性等特征。经络研究历经风雨,逐渐形成神经生理学派-神经传导学说及生理生化学派-体液循环学说,生物物理学派-生物场学说等,但各学说各执一词,仅从某一侧面或角度证实了经络的存在但未概括全部。近来自原林教授原林教授主持国家“863,,计划“中国数字人研究”课题的过程中,提出结缔组织在人体构成相互联系的“筋膜支架,,与后来由Langevin从针灸与皮下疏松结缔组织相互关系的角度出发,提出全身疏松结缔组织在人体构成“片状网络支架”和“信号网络”的观点后,研究人员逐渐认识到筋膜在人体的重要性,原林通过对人体结缔组织构成的筋膜支架进行标记和计算机三维重建之后得出筋膜在人体内从浅入深由5种结构构成。包括真皮致密结缔组织、皮下疏松结缔组织、肌肉表面疏松结缔组织、肌间隔和肌间隙结缔组织、内脏器官门、被膜和内部间隔结缔组织等。同时发现人体穴位的针刺部位均位于筋膜的不同层次。原林教授通过对发育生物学追溯,提出：中胚层间充质分化成多个器官系统后,所剩下的部分形成遍布全身的“筋膜支架”。该支架构成人体的“支持与储备系统”。皮下筋膜组织在机体对内在或外源性拉伸刺激的应答中起着重要的媒介及调控作用,并以此推测各种替代疗法的作用靶点正是机体内的网状筋膜支架。该课题组在利用超声、CT. MRI等影像手段和数字人海量数据集研究中发现：针刺的过程的提插、捻转等操作,可带动或牵动周边较大范围的筋膜结缔组织。当针灸针尖到达外肌膜时可出现“得气”现象；而到达肌肉处时“得气”减弱；若停留在外肌膜上再增加刺激,“得气”感会增强。经络中的经穴循经分布而阿是穴分布则没有固定位置,由此提出全身的结缔组织支架可能是针灸经络的解剖学物质基础；穴位是在筋膜结缔组织支架上能产生较强生物学信息的部位；穴位与非穴位在信息量多少上有的差异。从广义的角度讲全身各部位均可认为是穴位。各种研究显示,中医经络和穴位的研究重点均指向结缔组织。我们通过对断层图像和数字人数据在结缔组织聚集处的标记和重建后,构建出与人体经络记载接近的图像,进一步扩大可以构建出一个与人体轮廓一致的结缔组织支架。我们认为该支架是为人体经络的解剖学基础。原林教授主持国家“863”计划“中国数字人研究”课题的过程中,通过对人体结缔组织的标记和三维重建,所发现的与中医“经络”走行接近的影像结构。在对全身结缔组织的发育生物学进行追溯后,从多细胞生物内的细胞外基质,到二胚层生物内的中胶质、三胚层生物内的间充质,以至于人体的结缔组织,都为同源结构,且在此基础上提出了筋膜学理论。该学说认为在个体发生过程中由中胚层的间充质分化成多个器官系统后所遗留的部分形成了遍布全身的结缔组织筋膜支架,该支架形成一个独立功能体系,在神经系统和免疫系统的参与下构成一个新的功能系统----支持与储备系统,这样将机体分为支持与储备系统和功能系统,即“两系统理论”。支持与储备系统使生物维持较长的生命周期和维持机体稳定的内环境。由非特异性结缔组织构成的支持与储备系统间充质终结演化而成的筋膜结缔组织支架在机体内形成了一个能监测和调节机体功能组织细胞的生命活动和功能活动、维持机体内环境稳定的功能系统,这一系统在中枢神经系统和免疫系统的共同参与下,实现维持机体内环境稳定的作用,调节人体的功能活动和生命活动。而腧穴正是通过筋膜结缔组织系统发生作用的。从动态的角度(机体是在不断的更新代谢中维持平衡--生存),提出了人体新的解剖学分科方法：人体结构的两系统理论。即人体由已分化的功能细胞所构成功能系统与尚未分化的全身非特异性结缔组织所构成的支持与储备系统构成。根据这一分科方法进一步提出一个新的学术研究领域：筋膜学。
人体是由遍布全身的筋膜结缔组织支架所构成的支持与储备系统及被该支架所支持和包绕的各种功能细胞所构成的功能系统所构成。其中支持与储备系统为功能系统的各种细胞提供稳定的内环境,并为功能系统各种细胞的更新、修复提供细胞等供应,同时对其功能和更新修复进行调控。对支持与储备系统自身机制的研究和该系统与功能系统相互作用的研究领域称之为筋膜学。
砭石疗法可以通过泗滨砭石在眼周皮层摩擦时产生刺激,从而治疗假性近视。其机制与泗滨砭石对于筋膜的刺激有关。泗滨砭石在眼周皮肤上摩擦时能产生超声波脉冲刺激,平均超声波脉冲可达3000多次。该超声波刺激可引起球后脂肪组织发生震动,牵拉筋膜,其持续作用的结果,可以使积聚的脂肪消散；使凸出的眼球逐步恢复原样而改善或治愈近视的症状。临床初步观察表明,该疗法对于近视有一定疗效。目的：本课题研究新泗滨砭石疗法的临床疗效。通过对新泗滨砭石疗法治疗近视的临床研究,科学的评价新泗滨砭石疗法的临床疗效,为新泗滨砭石疗法的推广提供依据。
方法：观察广州南方医院针灸科门诊假性近视患者60例,根据随机对照的临床试验原则,将符合纳入标准的病人随机分为两组,即治疗组30例,采取新泗滨砭石疗法。对照组30例,采取针刺疗法,分别按照治疗方案进行治疗。评价患者治疗前、后视力(远视力、近视屈光度)改善情况以及治疗前、后视疲劳及全身症状改善情况；并将观察结果进行统计学处理,最终得出结论。
结果：新泗滨砭石疗法通过泗滨砭石在眼周皮层摩擦时可以产生刺激,从而治疗假性近视。效果均优于针灸疗法。治疗组视力恢复明显优于对照组；视疲劳症状总有效率,经统计学分析,两组比较具有显著性差异(P<0.05)。
结论：泗滨砭石疗法治疗青少年假性近视疗效较好。两种疗法均有良好的远期综合疗效与远期功能改善疗效。1、新泗滨砭石疗法能有效缓解近视病人的眼部不适症状,改善眼功能,并具有良好的视力恢复效果和良好的远期疗效。且本疗法安全性高、稳定性强、方便、无创伤,易于被患者接受。2、与针灸疗法相比,新泗滨砭石疗法的综合效果改善视力效果和改善视疲劳症状均优于针灸疗法。
Background
Myopia is refers to a state of rest on adjustment of the eye, parallel light after eye refractive system in the retina, after a former form focus correct refractive error eye disease. Its ZhuZheng characteristics as the patients for long-distance objects eye problem that identify nearly see clear, farsightedness fuzzy, TCM called "timid far" syndrome can close. The traditional Bian-stone therapy myopia have anguish small, safe and reliable, simple easy, slightly more guidance, patients can at home after treatment, time can also be themselves by patients arrange, do not affect work, study and life.
Traditional Chinese medicine for thousands of Chinese culture as a crystallization of Chinese civilization in the process of upper and lower transmission plays an important role in Chinese science and technology to prevent and cure diseases, especially of the time developed an indispensable process of preventive health care, are confirmed in practice scholars of the ancient Chinese medicine experience lofty ideals, for which won the admiration of the public. In recent years, with the development of technology, cultural exchanges and people to accelerate the treatment of Green's request, in theory under the guidance of traditional Chinese medicine treatments not only in the Chinese residential area but also in Europe and the United States developed regions such as the United Kingdom, Germany, France, Belgium, the Netherlands, the United States, Canada extensively as a supplement or alternative treatment which is carried out. In recent years, with the development of technology, cultural exchanges and people to accelerate the request of Green's treatment, treatments under the guidance of traditional Chinese medicine are carried out not only in the Chinese residential area but also in Europe and the United States developed regions such as the United Kingdom, Germany, France, Belgium, the Netherlands, the United States, Canada extensively as a supplement or alternative treatment. As the one of core of traditional Chinese medicine, the meridian theory, or the needle, moxibustion practice under the guidance of the meridian theory attract vast numbers of scholars to study it. Recalling the history of acupuncture meridians study, there has two climax periods in abroad from fifties to sixties of twentieth century and from the end of the twentieth century to now. Japan (Ryukyu countries) and Korea (Korea country) exchange culture with ancient china closely, but the "Golden Wind Han," Case stop the enthusiasm and led to the climax to End. Because of economy, technology, talented scholars, the United States far away in the western hemisphere had paid much attention to Acupuncture and Meridian Research and now they have a number of research papers published in SCI and had raised several hypothesis. As China, we have the duty to clarify the mechanism of acupuncture and meridians. Therefore, our country has invested substantial funds and a large number of scholars to study it, and has established "eight-five" and "nine-five" meridian climb research projects. Clinical, laboratory research confirmed the objective existence of meridians, and further found that Meridian has a cross-section of conductive body through by a two-way transmission, and low resistance, high conductivity, high temperature luminescence, and calcium ion concentration of characteristics of the population. Summed up decades researching, there had difficulties to unify the various theories. The biggest rift exists between "functional" and "structure", "overall" and "partial". Since the HM Langevin proposed the stand point of loose connective tissue in the human body constitutes a "flaky network support" and "signal network", the researchers come to realize the importance of structure in our bodies. It is worth mentioning that the Professor Yuan Lin Research Group think that fascia in the human body from the shallow into the deep structure has five kinds of components:1, dermal dense connective tissue; 2, subcutaneous loose connective tissue; 3, muscle surface of loose connective tissue; 4, muscle and muscle clearance interval connective tissue; 5, door internal organs, connective tissue envelope and internal partitions.
Group by studying the human body 14 GB 361 meridian acupuncture points needling sites and methods and found that parts of the body acupuncture points are located at different levels of the fascia, which is located in muscle connective tissue gap spacing and muscle up, followed by dense dermal connective tissue layer and the subcutaneous loose connective tissue layer, a small number of loose connective tissue at the muscle surface (deep fascia) and the internal organs door, envelope and internal partitions of connective tissue. By combination the above-mentioned studies and the developmental biology, Professor Yuan Lin research group pointed out:in multi-cellular organisms, mesenchyme is derived from jelly-like Extra Cellular Fluid (ECF) and further differentiates into many cell types, tissues, even organs. In higher creatures like human beings, mesenchyme gives rise to all the fasciae tissue throughout the body. The fasciae form support the a framework of connective tissues to growth of cells of all except for framework the central nerve system, can be regarded as one functional organs and therefore this of the essential elements of the internal environment for all kinds of living cells. Functionally, the connective tissue framework not only provides a soft support of the body but also maintains the systemic balance by regulating the neural reflexes, neuroendocrine activity, neuroimmunity, and by repairing the cell and tissue injuries. Therefore, they put forward a hypothesis that an auto-surveillance system may exist in the human body, which differs essentially from the nine established functional systems. The auto-surveillance system has two main functions. One is to regulate the functional state (metabolic activity and excitation), such as neural reflex regulation and neuroendocrine regulation. The other is to regulate the state of life activity (cell division, growth and apoptosis), including cell division and growth regulation through the sympathetic nerves and cell apoptosis regulation through lymphocyte- mediated immunity. In human, the auto-surveillance system is composed of the connective tissue network which monitors and regulates living and functional conditions of tissue cells. When professor Yuan Lin charged the national "863" plan and "Chinese digital study", through 3D reconstruction of connective tissue, we found the Chinese medicine "meridian" go close to image structure. Tracing the systemic connective tissue multi-cellular organisms in the developmental biology, the extracellular matrix, two within mesoderm creatures in biological tissue, three within mesoderm mesenchymal and human connective tissue, are all cognate structure, then we proposed the Fasciaology theory. The theory of the individual in the process that happened by mesoderm mesenchymal differentiation into multiple organ system from part after formed throughout the body connective tissue fascia, this stent form an independent function system, nervous system and immune system in the participation of constructing a new function system under-support and reserve system, so will the body into support and reserve system and function system, namely "two system theory". Support and storing system makes biological maintain long life cycle and maintain the stable internal environment. By nonspecific connective tissue support and reserve system mesenchymal end the fascia evolved in the connective tissue stents in formed a can monitor and regulate the function of cells life activities and functional activities, maintain stable function in the environment systems that are in the central nervous system and immune system, realize the common participation in the environment to maintain stable function, regulate the body's function activities and life activities. And the points are through fascia connective tissue of occurrence function system. The group's study by using ultrasound, CT, MRI and other medical imaging tools consider:In the course of acupuncture,by interpolation or twist, you can drive or affect a large scope of the connective tissue; When the acupuncture needle generally arrive outside the sarcolemma, a sense of "de qi" occurs, when the needle arrival the muscles, the sense "de qi" weakened, if the needle stays on outer sarcolemma to increase the excitement, this sense will enhance; By using CT images, we have built strip structure which run along the meridian. But group also acknowledged the existence of inconsistent line structure. Contrast to the record in Chinese medicine books:group think that: records related to acupuncture points: Systemic connective tissue scaffold may be the material basis of the meridian; the acupuncture point is the site which can generate strong biological information in the connective tissue scaffold; the difference between acupuncture point and non-acupuncture point is only the amount of information and not the t qualitative difference. From a broad perspective, all parts of the body are acupuncture points, because connective tissue exist almost all the body's tissue gap.
According to the current research in Traditional Chinese Medicine (TCM), meridians and acupoints have commonly been related to connective tissues. When using Tomography and Visualized Human Techniques to mark connective tissue sites of the cadaver and to create the three-dimensional reconstruction, we found that the traditional meridians and acupoints closely matched to our reconstruction. Furthermore, when marking all the connective tissues in the body, a complete body-shaped framework appeared. Therefore, we draw the conclusion that the connective tissue framework is the anatomical basis of the meridian.
On the other hand, acupoints were located mainly at certain connective tissue sites, such as the muscular septa of limbs, sensory nerve endings, internal organs with rich sensory nerve distribution, and mesenteries of viscera. Basing on the results of our research and the literature on meridians and acupoints, as well as their diversities and clinical applications, we have put forward the following opinions:The basis of the meridian is the connective tissue framework. Manipulation on connective tissue sites of the body can generate strong biological information, such as sensory information, stretch and injury stimuli of the local tissue.'Acupuncture points' and 'non-acupuncture points' of the whole body can generate different amount of biological information but without qualitative difference. In other words, acupoints are located everywhere of the body. There is a multileveled anatomical relevance between acupoints and disease sites in local structures, spinal cord segments, nerve pathways and central nerve distributions. The mechanism of acupuncture is to mechanically stimulate connective tissues to generate biological effects, which regulates the body functions and life activities.
To explore a theoretical support of our opinions, we looked back into developmental biology, the developmental process of an individual embryo, and the biological evolution of fascia connective tissue. We find that the connective tissue framework is derived from the leftover of the mesenchyme after it differentiates into variable organ systems. The extracellular matrix of a single germ-layer organism, the mesogloea of a two germ-layer organism, the mesenchyme of a three germ-layer organism, and the non-specific connective tissue of the human are all homologous structures. The non-specific connective tissue framework in the human body provides cell storage and maintains the stability of internal environment by cell proliferation and differentiation, cell repair and regeneration. Therefore, we proposed a new anatomical approach to the human body from a dynamic view, which is the two-system theory. In this theory, the human body can be classified into two systems. One is the supporting-storing system consisting of undifferentiated non-specific connective tissues. The other one is the functional system consisting of various differentiated functional cells. Basing on this theory, we further propose a research area, Fasciaology.
The human body is composed of the supporting-storing system formed by connective tissue framework and the functional system which consists of various functional cells surrounded by the framework. The supporting-storing system supplies various cells to renew and repair aging cells in the functional system to sustain a stable internal environment. The study on the mechanism of supporting-storing system, which is also called fasciae framework, and its interaction with the functional system, which refers to various functional cells, is called Fasciaology.
Sibin Bian-stone needling therapy in eye cortex, which produces stimulation when chafing treat falseness myopia. Its mechanism and Sibin Bian-stone needle for fascia stimulation involved. Sibin Bian-stone needling in eye skin friction producing ultrasonic pulse can stimulate, average ultrasonic pulse can reach more than 3000. The ultrasonic stimulation can cause ball happened after shock, pull adipose organization, its continuing role fascia, can make the result of the accumulation of fat hyperaemia; Make bulgy eyeball gradually back and improve or cure myopia symptoms. Clinical preliminary observation shows that the treatment for myopia has certain curative effect.
Objective:The objective of this thesis is to study the clinical curative effect of the new therapy of the Sibin Bian-stone needle. It takes the clinical trial of the pseudomyopia treated by Sibin Bian-stone needle to make out objective and scientific estimate, and provide therapeutic evidence for spreading of the new therapy of the Sibin Bian-stone needle.
Methods:It takes randomize and comparison as the principles of clinical trials. Sixty patients of Southern Hospital Guangzhou who suffer from eye disease and accord with the diagnose standards will be divided into two groups, thirty patients each group. These patients of two groups accept different treatment. The treatment group including 30 patients takes the new therapy of the Sibin Bian-stone needle; the control group including 30 patients takes the treatment of acupuncture. Both two treatments comply with therapy scheme. The fraction of eye pain and shoulder activity is selected as observed index. The results and conclusion are based on the statistical processing and analysis of the index.
Results:The new therapy of the Sibin Bian-stone needle has better effect on easing pain and improving eyesight activity than that of the treatment of acupuncture. There is no notable difference on instant effect of relieving pain between two therapies. Further-more, the new therapy of the Sibin Bian-stone needle has better effect on the total effect, effect of easing pain than the control group. Both two therapies have long-date effect of easing pain and improving shoulder activity.
Conclusion:
1. The new therapy of the Sibin Bian-stone needle has good effect on easing pain, improving eyesight.
2. The effect on total effect, easing pain, improving eye activity of the new therapy of the Sibin Bian-stone needle is better than that of acupuncture.
引文
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