The Clinical Study On Treatment Of Nucha Electrical Acupuncture To Adult Hypoxic Ischemic Encephalopathy Patients

Objective:To observe the clinical effectiveness of the nucha electrical acupuncture on the hypoxic ischemic encephalopathy(HIE) patients, and to investigate the mechanism of the treatment.Method: 80 HIE patients were assigned numbers by sequence of admission and were divided into nucha electrical acupuncture group and controll group under the table of random number. Excluding incomplete information, the nucha electrical acupuncture group included 38 patients and the control group included 36 patients. To compare the change of Glascow coma scale(GCS) and Glasgow-Pittsberg coma scale(G-PCS)of before and after theray beween two groups , and to assess the effectiveness according to GCS and G-PCS; To compare the Bispectual index (BIS) value of before and after theray beween two groups, and in nucha electrical acupuncture group, to compare the instant change of BIS value before , during and after theray ; To compare the prognosis of HIE patients with different cerebral oxygen utiliation cofficients(O2UCc), and to compare the change of O2UCc before and after theray beween two groups.Results:1. In nucha electrical acupuncture group, the GCS and G-PCS of adult HIE patients after therapy were higher than that of before therapy; there was no significance about GCS and G-PCS before therapy, and the GCS and G-PCS of nucha electrical acupuncture group was higher than that of control group after therapy.2.As effectiveness cretirion by GCS , the total effective rate of nucha electrical acupuncture group was 73.7%, that of control group was 50%(P<0.05)..As effectiveness cretirion by G-PCS , the total effective rate of nucha electrical acupuncture group was 84.2%, that of control group was 61.1%(P<0.05).3. To prognose the death of HIE patients ,the AUC of GCS was 0.868(P P<0.01), The AUC of G-PCS was 0.990 ( P<0.01),the cutoff of G-PCS was 11; 4. In the G-PCS>11 group ,the instant BIS value during and after nucha electrical acupuncture therapy were both significantly higher than before therapy; the instant BIS value after therapy in the G-PCS>11 group were higher than that of the G-PCS≤11 group;5.excluding death cases ,the BIS value after therapy in the nucha electrical acupuncture group was higher than the control group;6.There were no manifest change before and after therapy in the patients with O2UCc <25% and normal O2UCc. In the patients with O2UCc >45% ,the O2UCc level after therapy were both decreased , the nucha electrical acupuncture group was better than the control group( P<0.01). In the nucha electrical acupuncture group ,the O2UCc level after therapy was lower insignificantly than before therapy(P<0.01).Conclusions:1.The nucha electrical acupuncture therapy can improve neurologica outcome of HIE patients, have exact effect.2.The nucha electrical acupuncture can increase instant BIS value, it declare that the nucha electrical acupuncture can increase cortical excitability by pulsating current exciting ARAS and has consciousness-promoted effect;3.The nucha electrical acupuncture can increase long-term BIS value ,it illustrate that long term electrical stimulus on ARAS can form LTP to reconstruct reflex arc and rusume nerve function.4.The nucha electrical acupuncture lower the O2UCc of the HIE patients with high O2UCc, it illustrate that the nucha electrical acupuncture can improve vertebral-basilar artery circulation ,recover cerebral blood ,improve ischemia and hypoxia status , lower cerebral oxygen utiliation cofficients and recover normal cerebral metabolism.