| 1.Research background,purpose and significanceMental Retardation(MR)is a group of developmental handicaps,with intellectual slowness lagging behind the normal level and disability to adapt to life as the main symptom,and is caused by a variety of biological, psychological and social factor.MR is one of the commonest developmental disabilities and is a more deleterious handicap to children's health both physically and mentally.Therefore,to conduct research actively on the effective treatment on MR and to minimize the MR prevalence rate are significant to improve the China's population quality,and promote social and economic development.Based on the previous researches,this study took the factor of age as starting point,in which 90 children of different ages with mild to moderate MR were selected as clinical objects;the purpose of the study was to observe the effect of Jin-three-needle therapy on MR children of different ages;in the experiment,the variable of month was taken as starting point and 60 rats of different month—ages were selected as the objects, to test the intervention effect of Jin—three—needle therapy on the rats of different month—ages and to further explore the mechanism of the therapy on MR patients of different ages.2.MethodThe literature review covered the following aspects:the cognition of modern medicine on MR,including studies of epidemiology,etiology and pathology,diagnostic criteria and treatment principles;the rich experience of traditional medicine on the treatment of MR and the clinical and experimental studies of MR done by contemporary Chinese medicine practitioners who,based on the previous studies,employed integrated medicine;the various methods of making model conducted on animal and the corresponding advantages and disadvantages;the progress of modern medicine on the central nervous system which is associated with learning and memory;the progress of modern medicine on the relationship between apoptosis and cerebral ischemia;the comments and expectations based on every aspects of the literature review.The clinical study selected 90 children of different ages with mild to moderate MR as objects and according to diagnostic criteria,inclusion criteria and exclusion criteria the objects were divided into three age groups as Group A(3—4 years old),Group B(5—6 years old)and Group C(7—8 years old), each with 30 patients,In each group,acupuncture,point injection and oral medication approach were used and a course of treatment consisted of 120 times with six times a week and once everyday except for Sunday."Wechsler Scale" was used to test the intelligence quotient(IQ)and "The Rating Scale of Children's Adaptive Behaviors"was used to test the adaptive behavior quotient (ADQ).The results of the two scales were taken as the therapeutic evaluation standards,to assess before and after treatment respectively.In the experimental research,60 SD female rats of different month—ages were selected and according to month—ages there 60 rats were divided into such three groups as 1—month—old Group,3—month—old Group and 6—month—old Group,with 20 rats in each group.Each group was subdivided randomly into such four groups as Normal Group,Sham—operated Group,Model Group and Acupuncture Group with 5 rats in each sub—group.The model—making method of permanent occlusion of bilateral common carotid artery was employed to make disabled model rat,while Acupuncture Group was treated on acupuncture therapy, with a course of treatment lasting four weeks with six times a week and once everyday except for Sunday.And the rats' behavior,the cholinergic function of the brain,the content and activity of monoamine neurotransmitter and the expression of apoptosis control gene Bcl—2 and Bax were tested as the therapeutic evaluation standards,to assess each group respectively after disposed.3.Results 3.1 Literature reviewLiterature review suggested that the current clinical treatment on MR was a combination of medicament therapy and education & training therapy,which lacked pertinence and could not reach pathogenic treatment but for the mere symptomatic treatment;this kind of ineffective treatment had many sideaffects, and was harmful to children both physically and mentally.While Acupuncture Therapy,under the guidance of overall concept,conducted treatment on the individual dialectically;Acupuncture Therapy not only had pertinence and accorded with the modern medical model of biology—psychology—society, but also had such advantages as overall conditioning,multi—targets and no side—affects,no addiction,etc.3.2 Clinical studyEvaluation results of "Wechsler Scale":after treatment each MR group's intelligence quotient(IQ)had been improved than before,while VIQ of Group A was increased most significantly(P＜0.01),Group B second most(P＜0.05), Group C with no significant difference(P＞0.05).From the average VIQ of each group,it was found that,after treatment,for Group A and Group B,the increase extent of VIQ was larger than the increase extent of PIQ,while for Group C, the increase extent of PIQ was larger than the increase extent of VIQ; comparison between groups suggests that VIQ was on a downward trend with the increase of age,while PIQ was on a upward trend with the increase of age.However,FIQ and VIQ showed the similar changes in general,that is: FIQ of Group A changed significantly,which had statistical significance (P＜0.05);the changes of FIQ in Group B and Group C had no statistical significance(P＞0.05)Evaluation results of "The Rating Scale of children's Adaptive Behaviors":after treatment each MR group's adaptive behavior quotient(ADQ) had been improved than before.From the average ADQ of all the groups,it was found that in Group A,the cognitive factor had changed significantly,which had statistical significance(P＜0.01),while the independent function factor and social/self—control factor had not changed significantly(P＞0.05);in Group B,the independent function factor had changed most significantly, which had statistical significance(P＜0.01),the cognitive factor second most significantly,which still had statistical significance(P＜0.05),social/self—control factor had not changed significantly(P＞0.05);in Group C,social/self —control factor had the most significant changes,which had statistical significance(P＜0.05),the independent function factor and the cognitive factor had not changed significantly(P＞0.05).The evaluation results of clinical curative effect:for MR children of different ages,Jin—three—needle therapy has better effect for the younger ones.3.3 The experimental resultsThe results of Positioning Navigation Experiment:in the experiment, the delitescence for the rats in each group to look for platform was on a notable downward trend during the training process.All the rats in Normal Group and Sham—operated Group had no obvious escape delitescence difference for the first 1 to 4 days.Compared with Normal Group and Sham—operated Group,escape delitescence of the rats in Model Group had a corresponding extension(P＜0.01, P＜0.05).After being given acupuncture treatment,compared with Model Group, escape delitescence of Acupuncture Group was shortened to various degrees; of which,escape delitescence of 1—month—old group was shortened for the first 1 to 4 days and the differences were statistically significant(P＜0.05), for the 3—month—old group,only the escape delitescence of the first day had statistical significance(P＜0.05),while for the 6—month—old group, escape delitescence was also shortened,but had no statistical significance (P＞0.05).Test results of Space Exploration Experiment:in the experiment,for all the rats in Normal Group and Sham—operated Group,the percentages of distance and time for crossing the original quadrant of the platform accounted for the total swimming distance and time showed no obvious differences.Compared with Normal Group and Sham—operated Group,for Model Group,the percentages of distance and time for crossing the original quadrant of the platform accounted for the total swimming distance and time were decreased correspondingly (P＜0.01,P＜0.05),indicating that for Model Group,the memory retention was lowered.After being given acupuncture treatment,compared with Model Group, for Acupuncture Group,the percentages of distance and time for crossing the original quadrant of the platform accounted for the total swimming distance and time were increased to various degrees,indicating that the damaged memory retention of the rats had been improved;of which,the percentages of distance and time for crossing the original quadrant of the platform accounted for the total swimming distance and time for the 1—month—old group were statistically significant(P＜0.01,P＜0.05),for the 3—month—old group only the percentage of distance had statistical significance(P＜0.05),while the percentage of time had no statistical significance(P＞0.05),for the 6—month—old group,neither of the percentages had statistical significance (P＞0.05).From the results of the whole Morris water maze test,Model Group needed longer time to acquire the memory than Normal Group and Sham-operated Group;acupuncture treatment had the most significant effect on the 1—month—old group,3—month—old group second,but the 6—month—old group, ineffective.The results of Passive Avoidance Reflex Experiment:in the platformjumping experiment,for all the rats in Normal Group and Sham—operated Group, their learning and memory test results had no significant differences.Compared with Normal Group and Sham-operated Group,the test results of Model Group were declining corresponding(P＜0.01,P＜0.05).After being given acupuncture treatment,compared with Model Group,for Acupuncture Group,their test results were increasing to various degrees;of which,the differences during the training and memory results for the 1—month—old group were statistically significant(P＜0.05),for the 3—month—old group,only part of the results differences had statistical significance(P＜0.05,P＞0.05),and for the 6—month-old group,neither of the results differences scored statistical significance(P＞0.05).Test results of the cholinergic function in the brain:for all the rats in Normal Group and Sham—operated Group,the Ach content in the brain,ChAT and AchE activity had no significant difference.Compared with Normal Group and Sham—operated Group,for Model Group,the Ach content in the brain has decreased corresponding(P＜0.01,P＜0.05),ChAT and AchE activity were significantly reduced corresponding(P＜0.01,P＜0.05).After being given acupuncture treatment,compared with Model Group,for Acupuncture Group, the Ach content has increased to various degrees,and ChAT and AchE activity had also increased to various degrees;of which,the differences of Ach content, ChAT and AchE activity of the 1—month—old group were statistically significant(P＜0.05),only ChAT activity of the 3—month—old group had statistical significance(P＜0.05),and for the 6—month—old group,none of the Ach content,ChAT and AchE activity had statistical significance(P＞0.05). Test results of monoamine neurotransmitter concentration and activity: for all the rats in Normal Group and Sham—operated Group,the content of monoamine neurotransmitter NE,DA and 5—HT in the brain had no significant difference.Compared with Normal Group and Sham—operated Group,for Model Group,the content of monoamine neurotransmitter NE,DA and 5—HT in the brain had decreased to different degrees(P＜0.01,P＜0.05).After being given acupuncture treatment,compared with Model Group,for Acupuncture Group, the content of monoamine neurotransmitter NE,DA and 5—HT in the brain had increased to various degrees;of which,the content of monoamine neurotransmitter NE,DA and 5—HT in the brain of the 1—month—old group had statistical significance(P＜0.05),for the 3—month—old group,only the differences of 5—HT content has statistical significance(P＜0.05),and for the 6—month—old group,all the indexes had also increased,but,none of the difference has statistical significance(P＞0.05).Test results of the expression of apoptosis control gene Bcl—2 and Bax: for all the rats in Normal Group and Sham—operated Group,the apoptosis control gene Bcl—2 and Bax had no obvious expression(negative or weakly positive).Compared with Normal Group and Sham—operated Group,for Model Group,Bcl—2 and Bax in the brain had different degrees of expression (positive,P＜0.01,P＜0.05).After being given acupuncture treatment,compared with Model Group,for Acupuncture Group,the expression of Bcl—2 in the brain had different degrees of increase,Bax expression had different degrees of decline;of which,the Bcl—2 and Bax expression in the 1—month—old group had changed significantly,with Bcl—2/Bax ratio increased,and the differences had statistical significance(P＜0.05),for the 3—month—old group and the 6—month—old group,the expression of Bcl—2 and Bax had not changed significantly,with Bcl—2/Bax ratio also increased,but had no statistical significance(P＞0.05).4.ConclusionJin—three—needle therapy can have obvious clinical efficacy on children with Mental Retardation,and the younger the children,the better the efficacy; especially,the best efficacy will be achieved for the age group of 3 to 4 years.The mechanism of efficacy of the therapy on MR of different ages may lie in:the affects on behavior,the affects on the cholinergic function in the brain,the affects on the content and activity of monoamine neurotransmitter in the brain,the affects on the expression of apoptosis control gene Bcl—2 and Bax in the brain. |
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