| Cerebral infarction is cerebral ischemia and necrosis that mainly result from the angiostegnosis of artery such as atherosclerosis, thrombosis and vasospasm. Some documents showed that the death number of cerebrovascular disease ranked the second among all the death number led by various causes in China. Cerebral infarction contains eighty percent of all cerebrovascular diseases, which hazards people's health seriously, bringing severe economic and mental burden to the patients, family members, society as well. It is the top priority for the medical servers to actively search for how to prevent and cure acute cerebral infarction which is also one of the most important tasks in the current medical field. As far as the treatment of cerebral infarction is concerned, acupuncture is being thought highly by people because of it's advantages of good effectiveness and low cost. Because of what mentioned above, acute cerebral infarcion was chosen in this study as the objective purposely followed by the related research that was carried on from the perspective of document and clinic.Section 1 The Documentary StudyObjectivesTo know the etiopathogenisis of TCM about wind stroke as well as the correlative treatment. To master the origin and theoretical basic of the Yin-Yang harmonizing acupuncture therapy. To get familiar with the pathogenesis of western medicine about cerebral infarction, the related hazards, the treatment as well.MethodsWriting summarizations by consulting TCM documents about wind stroke and the Yin-Yang harmonizing acupuncture therapy. Searching for the related material in the latest ten years about cerebral infarction.Results(1) The understanding of TCM etiopathogenisis about wind stroke was gradually developed from the exogenous factors to the endogenous factors, finally to the combinationof both of them. It was thought that the pathogenesis had something to do with deficiency, wind, phlem, stasis, fire, toxin etc. As far as the treatment was concerned, Some were the majority in the herbal treatment such as quickening the blood circulation to remove stasis, dredging the meridians by removing phlem and so on. While body acupoints, scalp acupoints, acupoints injection and the combination of acupoints and drugs were the main ways for the acupuncture treatment.(2) The Yin-Yang harmonizing acupuncture therapy had being developed step by step under the guidance of the theory that the keypoint of acupuncture therapy is the awareness of how to harmonize Yin and Yang. It was preliminarily thought that the Yin-Yang harmonizing acupuncture therapy was only a general term of a kind of theory instead of a specific acupoint choosing or needling method.(3) The research of western medicine about the pathogenesis of cerebral infarcion had been quite deepgoing already. Nowadays, the dominating treatments include thrombolysis, anti-blood coagulating, anti-blood platelet conglomerating, protecting neuron etc.Conclusions(1) The understanding of the etiopathogenisis about wind stroke in TCM theory had a process of being perfected gradually, so was the corresponding treatment. There was a long history for the treatment of wind stroke with acupuncture which is one part of TCM. A lot of clinical and experimental studys both domestic and abroad had also proven that acupuncture did improve the stroke patients' prognosis to some extent.(2) Most of related material showed that compared with the conventional acupuncture therapy in which the acupoints of yangming meridian are mainly chosen, the Yin-Yang harmonizing acupuncture therapy was more effective in treating wind stroke.(3) The understanding of western medicine about the pathogenesis of cerebral infarcion had been quite deepgoing already, which resulted in the comprehensiveeness of the treatment. In addition, the treatment was still on the process of being improved, in which thrombolysis and protecting neuron were the main two focuses.Section 2 The Clinical StudyObjectiveTo test the clinical curative effectiveness of acute cerebral infarction with the Yin-Yang harmonizing acupuncture therapy by making a comparision between the Yin-Yang harmonizing acupuncture therapy and the conventional one in which the acupoints of yangming meridian are mainly used, which will provide a new feasible thought and method for the treatment of acute cerebral infarction with acupuncture.Methods(1) All the cases were selected from the patients who had ever been hospitalized in the neurology department of Guangzhou general military hospital during the period from March 1st to September 30th. On the premise that all patients knew the study and agreed to receive it, a randomized controlled and single blind trial was conducted to the patients who met the western internalizing and depleting standards. All 60 patients were randomly allocated to two groups, namely the treating group treated by the Yin-Yang harmonizing acupuncture therapy combined with medicine, and the control group treated by the conventional acupuncture therapy combined with medicine.(2) The basic medicine was the same, which included the symptomatic treatment, the supporting treatment and the complication preventing treatment. Some medicine like Vite6, Vitei2, folic acid, DA, anti-epileptic drugs, blood lipid-lowering drugs and any drug that contains Mg + were all avoided being used Besides the basic medicine treatment, all the patients also received the acupuncture treatment once a day with two-day break in one week. For the treating group, the acupoints of yin meridian were used in the upper limbs and the acupoints of yang meridian were used in the lower limbs with strong stimulation and deep needling insertion at the stage of flaccid paralysis. Opposite way with light stimulation and shallow needling insertion were implemented at the stage of spastic paralysis. For the control group, the acupoints of yang meridian were used all along with mild stimulation and moderate needling insertion. In the treatment, five main acupoints were needled in the upper limbs and the lower limbs respectively every time. All the main acupoints were needled only in the affected side of the limbs. The choosing of the supplementary acupoints decided by the differentiation. The treatment lasted for three weeks. Three months later, a follow-up survey was carried on mainly through calling, supplemented by visiting.(3) The primary outcome variables included Barthel Index (BI), Quality of life index (QLI) and the rate of case fatality/ long-term hospitalization. The secondary outcome variables included the Scandinavian Stroke Scale scores, the short-term clinical effectiveness, the muscular tension, the adverse events of acupuncture, the incidence of muscle convulsion, the level of homocysteine, lipoprotein(a) and magnesium of blood serum as well.Results(1) The basic data in two groups before the treatment were closely similar in all important prognostic variables includes gender, age, course of disease, accompanying deseases, past history etc(/?> 0.05).(2) There was no significant difference between two groups in the Scandinavian Stroke Scale scores before the treatment^ > 0.05). The scores of two groups were all increased remarkably after treatment(P < 0.01). But there was no significant difference between two groups in the change of the scores after treatment(/3> 0.05).(3) There was no significant defference between two groups in the short-term clinical effectiveness, namely the total effective rate (P> 0.05).(4) There was no significant difference between two groups in the classification of muscular tension before treatment^ > 0.05). The muscular tension was significant bettered in both two groups after treatment(P < 0.01). There was significant difference between two groups in the change of the classification of muscular tension after treatment, namely the percentage of normal muscular tension in the treating group was higher than that in the control group. While the percentage of high muscular tension in the treating group was lower than that in the control group(P < 0.05).(5) The incidence of muscle convulsion during the acupuncture treatment in the control group was remarkably higher than that in the treating group(P < 0.05).(6) The adverse events of acupuncture were relatively low in both two groups. Furthermore, some serious adverse events such as fainting, local infection etc never happened either.(7) There was no significant difference between two groups in the level of homocysteine, lipoprotein(a) and magnesium of blood serum before treatment(/>> 0.05). After treatment, the level of homocysteine and lipoprotein(a) in the treating group decreased remarkably at different degrees(P< 0.01, P < 0. 05). The level of homocysteine in the control group also decreased significantly (P < 0.01). Though the level of lipoprotein(a) in the control group decreased some, there was no significant difference between pre-treatment and post-treatment in the level of lipoprotein(a) (P> 0.05). The level of magnesium of both groups increased a little bit, but there was no significant difference between pre-treatment and post-treatment (P> 0. 05). There was no significant difference between two groups in the change of the level of homocysteine and magnesium after treatment (P> 0.05), but the level of lipoprotein(a) was an exception (P < 0.05).(8) There was no significant difference between two groups in BI score before treatment(/> > 0.05). After treatment, all items in the treating group were improved remarkably(P < 0.01, P < 0.05). All items except Bathing, Pluming and Sedes controlling in the control group were improved significantly at different degrees(P < 0.01, P < 0.05). As far as the change after treatment was concerned, there was no significant difference between two groups in most of items except Pluming and Sedes controlling.(9) There was no significant difference between two groups in QLI scores before treatment^ > 0.05). QLI scores were improved significantly in two groups after treatment(P < 0.01 ). As far as the change of QLI scores after treatment was concerned, there was no significant difference between two groups (P> 0.05).(10) There was no significant difference between two groups in the rate of case fatality/ long-term hospitalization though the rate of case fatality/ long-term hospitalization of treating group was a little bit lower than that of control group(vp> 0.05).Conclusions(1) The clinical research preliminarily proved that acupuncture was quite safe to patients.(2)The Yin-Yang harmonizing acupuncture therapy was more effective than the conventional one in regulating the muscular tension, which was significant to the recovery of patient's motor function.(3) The Yin-Yang harmonizing acupuncture therapy was better than the conventional one in decreasing the occurrence of muscle convulsion during the acupuncture treatment, which could alleviate the patients' pain and make the patients keep on receiving acupuncture treatment.(4) The Yin-Yang harmonizing acupuncture therapy was superior to the conventional one in decreasing the level of lipoprotein(a), which had a positive effect on preventing cerebral infarction from recurring.(5) The Yin-Yang harmonizing acupuncture therapy surpassed the conventional one in improving the patients' two items of BI scores, namely Pluming and Sedes controlling, which probably produced some effects to help the patient come back to the society healthier after cerebral infarction.
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