| This text studied the literature of autism and music therapy, and carried on a research about acupuncture combined music therapy from clinical observation and experiment.Objiective: To observe the clinical curative effect of acupuncture combine music therapy treat autism, and from experiment angle explore to its mechanism carry on a first step study, providing new way of thinking for the treatment of autism.Methods: At clinical observation, take Americans Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as diagnosis standard. 3~8 years old 57 children match the diagnosis were distributed into group A and group B randomly. Group A accept acupuncture treatment, 30 minute each time, 6 times a week, 120 times as a period of treatment. Prescription: sishenzhen, naosanzhen, niesanzhen, zhisanzhen, shouzhizhen, zuzhizhen, shesanzhen, siguanxue;modification: flaring-up of heart and liver, shaofu, Xingjian;phlegm confusing mind, fenglong, daling;deficiency of kidney essence, taixi. Performance abbeied the design manipulating methods. Group B accept acupuncture combine music therapy treatment. Acupuncture applied the same as group A, music therapy carried on every 3 days. 30 minute each time, 40 times as a period. Take percussion instrument cooperate Mozart music;apply different therapy principle accord with phase of children performance. The outcome measures are Childhood autism rating scale;Autism Behavior Checklist and modified autism music therapy scale. Evaluate was carried on before and after treatment, statistical analysis the values with software of spss10.0.In experiment studies, from the theory of TCM, the chronic stress and liver stagnation is an important link and factor that cause autism, so establish the chronic stress liver stagnation rat animal model, imitating the cause of autism from an aspect. 40 rats are divided into normal control group (A), model group (B), acupuncture treatment group (C) and acupuncture combine music therapy treatment group (D) randomly, each group 10 rats, rats of B, C and D group were raised separateness. Chronic stress liver stagnation rat model was build include following method: break to eat 24 hr;Break water 24 hr;ice water (4℃) swim 5 minutes;45 ℃ hot environment 5 minutes;Fetter 3 hr;stimulate tail 1 minute;24 hr daytime and night reverse. Above-mentioned stimulate everyday 1 kind, random arrangement;make the animal cannot predict the incitement of next day, establish mold time for total 21 days. The rat of group (C) accept acupuncture treat from the 1st day of experiment, taking taichong and hegu in one side alternate everyday. 30th 0.5 inch needles, insert into acupoint for 1 mm, the needle handle connects G6805-1 instrument of theelec-acupuncture, the electric voltage 4.5 Vs, dilatational wave, frequency 20 Hz, strength with the partial skin muscle vibrates slightly, retain the needle for 25 minutes, once a day, total 21 days. Except acupuncture, the rats of Group (D) also accept music therapy once a day. Mozart's ((the D major double piano sonata)) was played by MP3 in quiet room. While the position of sound box and rat cage fixed, stereo set strength fixed, 20 minutes each time, continue 21 days. Observe weight variety of rat, carry on experiment of open field and the liquid consumption, observe rat hippocampi CA3 region pyramidal cell, and the immunohistochemistry research of the hippocampi Bcl-2 and Bax protein expression.Results: statistical result show that both SABC and ABC score have a great different between before and after treatment in group A (PO.05), that is to say acupuncture is valid to autism. Society association ability, sport ability, felling ability, speech ability and look after oneself ability factor in scale ABC all decreased after treatment, show different compared with before (P<0.05), acupuncture improve autism symptom is across - the -board. The different of treatment method between group A and B is music therapy added in group B. statistical result show, the curative effect in group B is better than group A. music therapy has good effect in society association ability and sport ability of ABC;other factors had no change, method of music therapy adopt in this text is partial emphasis on improving symptom of autism, the effect rate is 86.21 %.The data analysis show that, weight of model group (B) increase slowly, the consumption of 1 % sugar water decrease, level activity and perpendicular activity reduces obviously, having difference (PO.05) compared with control group (A). The increased level of weight were different among groups (PO.05). Normal control group> acupuncture combine music therapy treatment group> acupuncture treatment group> model group. Long-term chronic stress influence growth of the rat, acupuncture treatment can ease the influence, combine with music therapy is better than acupuncture alone. Before experiment, the sugar water consumption of groups had no obvious difference (P>0.05), and control group has stable variety during the period of experiment. But the consumption of model group (B) decrease continuously, at the end of experiment, it show great different with before (PO.05). This hinted, the animal model reflected the descent of ability to happy affairs, the happiness experience ability lacked. Group C acupuncture treatment can decelerate this kind of ability to descend (the 14th day appear), and maintain in the certain,, level (14th day and 21th day relatively has no difference). Group D acupuncture combined with music treatment, it can early prevent this kind of ability from descending (7th. day appear), and maintain at certain level (7th, 14th day and 21th day relatively has. no difference). In experiment, hippocampi pyramidal cell of CA3 region in normal controlgroup arrange closely, intensive, nissl bodies are clearly in cytoplasm. In modle group hippocampi pyramidal cell of CA3 region in normal control group arrange sparse, cell cleft enlarge, nissl bodies reduce or disapper in greatly parts of cytoplasm, and there had great different compared with contral group (PO.05). Acupuncture group and acupuncture combine music therapy group had great different compared with modle group (P<0.05). This hint treatment of acupuncture and acupuncture combine music therapy can reduce the damage of hippocampi pyramidal cell caused by chronic stress.The immunohistochemistry research show, there were little Bcl-2 and Bax protein expression in hippocampi CA3 region in normal control group, and there were more expression in other three groups, optical dentisy and cell number of Bcl-2 and Bax had great different compared with normal contral group (PO.05). Expression in group C and group D were less compared with group B (PO.05), but the ratio of Bcl-2/Bax were higher than group B. It hints chronic stress can increase the expression of Bax and Bax protein in hippocampi CA3 region, and increase with an emphasis on Bax. Acupuncture and acupuncture combine music therapy can drcrease the expression, and increase the ratio of Bcl-2/Bax in hippocampi CA3 region, protect the cell of hippocampi.Conclusion: Acupuncture can greatly improve autism child's social association ability, sport ability, feel ability, speech and look after ability by one's own, acupuncture treat autism is valid. Music therapy (manipulating method of percussion instrument cooperate with background music) has good effect of improving an autism society association ability and sport ability, but the effective on felling ability, speech and look after ability by one's own were not obvious. The treatment result of music therapy combine acupuncture is better than treat by acupuncture alone. Acupuncture and music therapy can improve the behave of chronic stress liver stagnation rats, increase the ability of reaction to happyness affair, increase the growing speed, improve the adaptability to surrounding. Its treatment mechanism may partly relevant with regulate the expression of Bax and Bcl-2 protein and protect hippocampi cell. |
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