A Clinical Controlled Trial To Determine The Response Of Nape Acupuncture In The Treatment Of Various Syndrome Types Of Cerebral Ischemic Stroke

Objective:Through observing the influence of nape acunpuncture and head acupuncture therapy on mark of neurological functional dificit,speed of brain blood,high sensitive C-reactive protein, D-Dimer in patients who were diagnosed as the same syndrome type with ischemic apoplexy at the acute stage,we try to approach clinical application value and corresponding therapeutic mechanism of nape acupuncture in the treatment of cerebral ischemic stroke from the point of traditional chinese medicine syndrome types.Methods:We selected 150 cases that were diagnosed as cerebral ischemic stroke at the acute stage through the examination of CT or MRI,then differentiated syndromes.According to the degree of the symptom,we randomly divided each syndrome type of cases into two groups:the treatment group treated with nape acupuncture;the control group treated with scalp acupuncture. The group of nape acupuncture took Fengchi(GB 20) and Wangu(GB 12) combined with routine acupoints such as Jianyu(LI 15),Quchi(LI 11),Waiguan(SJ 5),Hegu(LI 4),Futu(ST 32), Zusanli(ST 36),Jiexi(ST 41),Taichong(LR 3);the group of head acupuncture take linea oblique anterior of top temple combined with routine acupoints the same as the group of nape acupuncture.The patients received the treatment of acupuncture once a day,with fifteen days as a period of treatment,the needles were remained 40 minutes each time.Pre and post treatment of acupuncture therapy,we gave a mark of the degree of neurologic impairment and checked transcranial Doppler,high sensitive C-reactive protein,D-Dimer.Results:We made evaluations on the degree of neurologic impairment for the patients with cerebral ischemic stroke pre and post treatment.After treatment,as far as average integrals of physical signs were concerned,the marks of each syndrome type of patients decreased.For the type of excess syndrome of Fu Organs due to phlegm heat,the group of nape acupuncture had an advantage in improving the muscle strength of upper and lower limbs and walking capability than control group;for the type of wind phlegm blocking the meridians,nape acupuncture therapy improved the walking ability more obviously than the control group.There was no distinction between two groups of the rest syndrome types.We selected randomly 80 cases from the whole,by checking transcranial doppler,high sensitive C-reactive protein,D-Dimer both pre and post treatment,we found that after therapy,nape acupuncture and scalp acupuncture therapy could improve the systolic flow velocity and mean flow velocity of the brain arteries of the patients who were diagnosed as the same syndrome type,and increase pars encephalica blood supply of patients.The two therapeutic methods also could cut down the levels of high sensitive C-reactive protein and D-Dimer in the blood.While to the extent of ameliorating transcranial doppler indexes,nape acupuncture therapy improved better than scalp acupuncture for the patients diagnosed as types of wind phlegm blocking the meridians and excess syndrome of Fu Organs due to phlegm heat.To the extent of the change of high sensitive C-reactive protein,nape acupuncture cut down the concentration of high sensitive C-reactive protein in the blood of the patients diagnosed as type of stirring up of endogenous wind due to deficiency of yin more significantly than head acupuncture.To the extent of the change of D-Dimer,nape acupuncture therapy improved better than head acupuncture for the patients diagnosed as type of excess syndrome of Fu Organs due to phlegm heat.Conclusion:There was different curative effect between the nape acupuncture and head acupuncture on the syndrome types of cerebral ischemic stroke at the acute stage,nape acupuncture could improve the clinical symptom of each syndrome type in patients with cerebral ischemic stroke,it confirmed that nape acupuncture had certain curative effect on healing apoplexy.Nape acupuncture improved the indexes of speed of brain blood,degraded the concentration of high sensitive C-reactive protein and D-Dimer more obviously than scalp acupuncture for some syndrome types in patients with apoplexy.That migh be the mechanism of different influence caused by nape acupuncture and head acupuncture on various syndrome types in patients with ischemic apoplexy.