OBJECTIVE: To observe the effect and safety of injection of vitamin B1 into Zusanli (ST36) and Hegu (LI4) in the treatment of functional dyspepsia (FD).
METHODS: A total of 100 FD patients were equally divided into medication group and acupoint injection group (n=50/group) according to a random number table. Patients in the medication group were ordered to take mosapride citrate tablets (5 mg) orally 30 min before each of the three meals, while those in the acupoint injection group received injection of vitamin B1 into ST36 and LI4, once every other day, three times a week. One week later, the clinical symptom scores, total effective rates, serum gastrin (GAS) and plasma motilin (MTL) contents, and gastric emptying rates between the two groups were compared, followed by the observation of adverse reactions. Two weeks\' follow-up survey was conducted after the end of treatment, and the clinical symptom scores and total effective rates of the two groups were further compared.
RESULTS: Compared with the data before treatment in the same one group, the clinical symptom scores and serum GAS contents of post-treatment as well as the follow-up symptom scores were all significantly decreased (P<0.05，P<0.01), while the plasma MTL levels and gastric emptying rates were obviously increased in both groups (P<0.01). Comparison between the two groups showed that the clinical symptom score, serum GAS content after the treatment and follow-up symptom score were considerably lower (P<0.01), but the total effective rate, plasma MTL, gastric emptying rate after the treatment and total effective rate of follow-up notably higher in the acupoint injection group than those in the medication group (P<0.01,P<0.05).
CONCLUSIONS: Injection of vitamin B1 into ST36 and LI4 is effective in improving symptoms of PD patients, which may be related to its functions in regulating the levels of GAS and MTL in blood, and facilitating gastrointestinal motility.
目的：观察足三里、合谷穴位注射维生素B1治疗功能性消化不良（FD）的疗效及安全性。方法：选择FD患者100例，按照随机数字表法分为西药组和穴位注射组，每组50例。西药组于每日三餐前30 min口服枸橼酸莫沙必利片5 mg，共1周；穴位注射组给予足三里、合谷穴位注射维生素B1，隔日1次，共3次。1周后比较两组临床症状积分、总有效率、血清胃泌素(GAS)含量、血浆胃动素(MTL)含量及胃排空率，观察两组患者的不良反应。结束治疗后2周随访，比较两组临床症状积分及总有效率。结果：与本组治疗前比较，两组治疗后、随访时临床症状积分、血清GAS含量均降低(P<0.05，P<0.01)，血浆MTL含量、胃排空率升高(P<0.01)。与西药组比较，穴位注射组治疗后、随访时临床症状积分、血清GAS含量降低(P<0.01)，血浆MTL含量、胃排空率升高(P<0.01)。穴位注射组治疗后、随访时总有效率分别为91.84%（45/49）、93.88%（46/49），西药组治疗后、随访时总有效率分别为75.51%（37/49）、77.55%（38/49），穴位注射组临床疗效优于西药组（P<0.05）。结论：足三里、合谷穴位注射维生素B1治疗FD疗效显著，机制可能与其调节胃肠道激素GAS、MTL含量，增强胃肠动力有关。.

In traditional Chinese medicine, the well-known saying that \"in the treatment of disorders of the orofacial region, Hegu(LI4)is usually taken\" is a highly summary of functions of acupoint LI4, the Yuan-primary point of the Large Intestine Meridian of Hand Yangming. By consulting the related literature and viewing from the angle of differentiation of meridians, the present paper expounded the characteristics of location, the attributed meridian and clinical functions of LI4, and summarized its underlying mechanisms in the treatment of some orofacial disorders revealed by experimental researches. In addition, some examples of clinical application of LI4 were listed, including peripheral facial palsy, oral diseases, problems of the nose and headache.
“面口合谷收”是医疗实践过程中对合谷治疗口面部疾病功效的高度总结。笔者查阅相关文献，从中医经络辨证角度出发，结合现代医学对其生理机制的研究，探讨支撑其证治规律的理论实质；同时对临床运用合谷穴治疗口面部疾病的报道进行举案归纳，浅析“面口合谷收”的理论基础与临床运用。.

OBJECTIVE: To explore the correlation between blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) signal and neurotransmitter γ-aminobutyric acid (GABA) concentration in the prefrontal cortex area after acupuncture or Von Frey filament stimulation (epidermal stimulation) at the right Hegu (LI4).
METHODS: A total of 76 healthy volunteers (23 men and 53 women, 24.5±1.4 years in age) were recruited in the pre-sent study. Each volunteer received two sessions of fMRI magnetic resonance scanning (MRS) examinations, with an interval of one week between two sessions. The MRI scan sequences included pre-task MRS, resting state BOLD and task MRS, BOLD. A region of Interest (ROI) of 35 mm×30 mm×25 mm was located at the bilateral medial prefrontal cortex areas. In the two sessions of examinations, the right LI4 point was stimulated by manual acupuncture or Von Frey filament-pressing. The tasks were designed as the block design. Each block contained 3 intermittent acupoint stimulations, lasting 30 s in each stimulation and with two minutes\' pause between two stimulations. The MRS data were processed by using Linear Combination (LC) Model software (for assessing GABA content), and the BOLD data of fMRI was analyzed by using SPM12 software (comparison within each group), REST1.8 (comparison between two groups), separately.
RESULTS: Extensive deactivations were induced by both stimulations, mainly involving the midline regions as the medial prefrontal lobe, and limbic lobe. The deactivation effect of manual acupuncture stimulation was more extensive and intensive than that of Von Frey filament stimulation, especially in the medial prefrontal lobe. Data from 66 volunteers (after exclusion of 10 participants due to bigger standard deviation of GABA/Glx) showed no marked correlation between the GABA concentration and BOLD activation in the anterior cingulate cortex area in both groups(manual acupuncture stimulation group: r=－0.07, －0.08, 0.04; P=0.57, 0.88, 0.74; Von Frey filament epidermal stimulation group: r=－0.10, －0.09, －0.01; P=0.43, 0.46, 0.96).
CONCLUSIONS: Acupuncture of LI4 elicits a stronger and broader negative activation effect in the limbic-paralimbic-neocortical network including the medial prefrontal cortex in comparison with Von Frey filament stimulation, but no apparent correlation was found between the GABA concentration and BOLD activation in the anterior cingulate cortex after manual acupuncture and Von Frey stimulation.