Preliminary Study On The Mechanism And Curative Effect Of "Xingnao Kaiqiao" Acupuncture In The Treatment Of Acute Ischemic Stroke With Hemiplegia

Objective:Although the mortality rate of stroke patients is decreasing,the disability rate caused by stroke is still high.Ischemic stroke hemiplegia is mainly treated with drugs and rehabilitation,and acupuncture of traditional Chinese medicine in rehabilitation is with good clinical effect.The study is to explore the therapeutic effect and the possible mechanism of "Xingnao Kaiqiao" acupuncture in treating hemiplegia after acute ischemic stroke.Methods: Fifty-nine patients with acute ischemic stroke and hemiplegia in Qingdao Municipal Hospital of Traditional Chines Medicine from June 2019 to June 2021 were selected.According to the random number table method,59 patients were randomly divided into the conventional treatment group(n=29)and acupuncture treatment group(n=30).The patients in conventional treatment group were treated with conventional western medicine combined with rehabilitation training,the patients in acupuncture treatment group were treated with "Xingnao Kaiqiao" acupuncture on the basis of conventional treatment group.The Self-Care Ability Scale(ESCA)was used to assess self-care ability in patients with stroke hemiplegia;the Modified Barnett Index(MBI)was used to assess the ability of daily living(ADL);the NIH Stroke Scale(NIHSS)and Fugl-Meyer Assessment(FMA)were used to assess neurobehavioral function.The serum nitric oxide(NO)content was determined by colorimetric method,the serum levels of angiotensin II(Ang-II),synaptophysin p38(SYP-p38)and growth-associated protein 43(GAP-43)were detected by enzyme-linked immunosorbent assay(ELISA).The blood rheology indexes [plasma viscosity,whole blood viscosity(high-cut,low-cut),hematocrit and platelet adhesion rate] were detected by hemorheological analyzer before and after treatment in patients with stroke hemiplegia.Results:(1)The conventional treatment group: Compared with before treatment,ESCA,ADL,MBI scores increased while NIHSS scores decreased significantly after treatment(P<0.05).The serum levels of NO,SYP-p38 and GAP-43 increased while the serum level of Ang-II decreased statistically after treatment(P<0.05).(2)The acupuncture treatment group: Compared with before treatment,ESCA,ADL,MBI score increased while NIHSS score decreased statistically after treatment(P<0.05).The serum levels NO,SYP-p38,GAP-43 level increased while the serum level of AngII level decreased statistically after treatment(P<0.05).(3)After treatment,the muscle strength of the upper and lower limbs in the acupuncture treatment group was significantly improved compared with the conventional treatment group,and the difference was statistically significant(P<0.05).The self-care ability,ADL score,NIHSS score,and FMA score of patients in the acupuncture treatment group were better than those in the conventional treatment group,and the difference was statistically significant(P<0.01).The serum level of NO in the acupuncture treatment group was higher than that in the conventional treatment group,while the serum level of Ang-II was lower than that in the conventional treatment group,the difference was statistically significant(P<0.01);the serum levels of SYP-p38 and GAP-43 in the acupuncture treatment group were significantly higher than those in the conventional treatment group(P<0.01).The improvement of whole blood viscosity(high-cut,lowcut),plasma viscosity,hematocrit and platelet adhesion rate in the acupuncture treatment group was better than that in the conventional treatment group,and the difference was statistically significant(P<0.05).Conclusion: "Xingnao Kaiqiao" acupuncture could improve the motor function of hemiplegic limbs.Its mechanism might be related to regulating the balance of vasoactive factors NO and Ang-II,improving peripheral blood circulation,and increasing the serum levels of neuroplasticity-related factors SYP-p38 and GAP-43.