Sudden Change In Temperature-induced Stroke Mechanism Based On The Five Internal Organs Seasonal Incidence Based Study

Stroke,a frequent acute disease of cerebral vessels,has the characteristic of high attack rate, high fatality,high disability rate,complex complication and low cure rate.In our country,stoke threatens the health and life of people and influences the quality of individual and family life,with the incidence and fatality of 1.5‰and 1.2‰respectively.Stroke is a disease of meridian and vascular system,its core location of disease is the heart.Clinical data indicates that attack of stroke have seasonal characteristics,it usually attacks in winter and secondly in summer.It coincides with the theory of the attack of disease of five viscera proper to the season.1 ObjectiveAccording to the experimental study on changes of blood composition of stroke rat with hypertension induced by cataclysm of temperature in winter and summer and theoretical study of seasonal onset rule of disease of meridian and vascular system,to provide scientific instruction to seasonal preventive medication for stroke,to reveal the important role of changes of weather in attack of disease of meridian and vascular system and to provide an new way to modern study on theory of the attack of disease of five viscera proper to the season.2 Method2.1 Theoretical studyOn basis of literature data and logic analytic method,the study is to approach the effect of seasonal and climatic change on physiology and pathology of five viscera,and enrich the theoretical connotation of the attack of disease of five viscera proper to the season.2.2 Experimental study2.2.1 Establishing model and detecting indexesRHRSP model was established according to the modified method on basis of HUANG Ru-xun's, the model rats were placed in the artificial environment with sharp increase and..decrease of ambient temperature to induce cerebral infarction and cerebral hemorrhage respectively.The hemorrheology,radioimmunity,ELISA and NR were used to observe the dynamic changes of stroke RHRSP rat induced by sharp increase and decrease of temperature in summer and winter respectively from following aspects:â‘ the hemorrheologyâ‘¡the Fl+2 and D-dimer;â‘¢the ET-1,NO,Angâ…¡and AVP;â‘£the E,NE and DA;⑤the ACTH,CORT,TSH,T3 and T4.2.2.2 StatisticsData are presented as group mean values_S.E.M.The data analyzed with one-way ANOVA. The SPSS statistical package(version 11.5) was used in the analyses.The significance was set at pb0.05.3 Results 3.1 Theoretical results(1) Seasonal climatic changes had important influence on physiology and pathology of five viscera.The disease attacked in condition of deficiency of essence and qi of five viscera,with characteristic of attacked and aggravated seasonally.(2) Except wind evil,the other four kinds of evil,such as summer-heat,damp,dryness and cold,can act on corresponding zang and fu to induce special disease with obvious genius morbi and seasonal feature.(3) The onset and transmission had certain rule,and in accordance with inter-generation and inter-restriction among five elements in some extent.But other factors should be considered during the progress of disease,such as the cold,heat,excessive and deficient nature of disease,changes of physical environment,inter-regulation among zang and fu.(4) Heart was the core location of disease of meridian and vascular system;which usually attacked in winter and summer,especially in winter,and it correlated with the change of qi and blood of five viscera following the change of seasons.3.2 Experimental results3.2.1 Cerebral infarction was induced by sharp increase of temperature in summerâ‘ during and after the course of temperature increase,the viscosity of blood plasma,HCT, index of erythrocyte aggregation,ERI and ionophoresis in model group increased,especially the viscosity of WB,VPC and index of ionophoresis(P＜0.05;P0.01);â‘¡during the course of temperature increase,the level of Fl+2 and D-dimer in model group increased,after the course of temperature increase,the level of Fl+2 increased continually and the level of D-dimer decreased, but was still higher than that before the increase of temperature;â‘¢during the course of temperature increase,the level of ET-1,Angâ…¡and AVP decreased,but the NO increased;after the course of temperature increase,the level of ET-1 and AVP rebounded,but the level of Angâ…¡reduced and the NO increased persistently.The level of NO in model group after the increase of temperature was higher than that before and higher than that in normal group at the same time point.â‘£in the course of increase of temperature,the level of E,NE and DA increased;after the increase of temperature,the levels of NE and DA reduced and closed to those before the course of increase of temperature,but the level of E was still higher than that before increase of temperature (P＜0.05) and than that in normal group and sham-operation group respectively(P＜0.01);⑤during the course of temperature increase,the level of ACTH descended,but the levels of CORT, TSH,T₄ increased,the level of T₃ had no change;after the course of temperature increase,the level of ACTH descended persistently and was lower than that in normal and sham-operation groups respectively at the same time point(P＜0.01),the level of CORT was higher than that in sham-operation group(P＜0.05),the level of TSH increased continually,the level of T₄ decreased obviously and was lower than that in normal group and sham-operation before and during the course of temperature increase and at the same time point.3.2.2 Cerebral hemorrhage was induced by sharp decrease of temperatureâ‘ during the course of temperature decrease,the viscosity of blood plasma and WB,HCT, index of erythrocyte aggregation,ERIand ionophoresis in model group decreased,especially the viscosity of WB and blood plasma and index of erythrocyte aggregation(P＜0.05);and after the course of temperature decrease,the index of erythrocyte ionophoresis rebounded;â‘¡during the course of temperature decrease,the levels of F1+2 and D-dimer in model group decreased(P＜0.05), after the course of temperature decrease,the levels of F1+2 and D-dimer rebounded;â‘¢during the course of temperature decrease,the level of ET-1,Angâ…¡increased and the level of AVP in model group was higher than that before temperature decrease(P＜0.01);and higher than that in normal group at the same time point(P＜0.05),but the NO decreased;after the course of temperature decrease,the level of ET-1,Angâ…¡and AVP decreased,but the level of NO increased. The level of AVP in model group after the course of temperature decrease was higher than that before the course of temperature decrease and that in sham-operation group at the same time point (P＜0.01);â‘£in the course of decrease of temperature,the levels of E,NE in model group increased and were higher than those in normal group and sham-operation group respectively at the same time piont(P＜0.01);the level of DA had no significant change;after the decrease of temperature,the levels of NE reduced,but the level of E ascended continually and was higher than that before and during the course of temperature decrease and in sham-operation group(P＜0.01);⑤during the course of temperature decrease,the level of ACTH,CORT,TSH,T₄ and T₃ in model group increased;compared with before and during the course of temperature decrease,the level of ACTH and CORT after the course of temperature decrease ascended persistently(P＜0.05) and was higher than that in normal and sham-operation groups respectively at the same time point (P＜0.01);Compared with before the course of temperature decrease,level of TSH increased continually after the temperature decrease and was higher than that in normal group(P＜0.05 )4 Conclusion4.1 Possible mechanism of stroke attack in RHRSP rats induced by sharp change of temperature in winter and summer4.1.1 Hypertension lasted chronically can regulate up the level of entatic state,and result in disorder of self-regulation function and reduction of the self-recovery capability of the organism.4.1.2 Possible mechanism of cerebral infarction in RHRSP rats induced by sharp increase of temperature in summer was following circuit:stress was induced by high temperature;release of neurotransmitter acted on blood vessel and influenced the release of VEC;release of NO with a sudden increase;the blood vessel expanded obviously;blood pressure decreased and influenced the blood flow rate,and then the viscosity of blood increased;At the same time,the high temperature outside caused the organism to regulate self-temperature by sweating,the blood volume reduced,the blood flow step down,the blood viscocity ascended and then influenced the blood flow,the thrombus formed and the cerebral infarction attacked.4.1.3 Possible mechanism of cerebral hemorrhage in RHRSP rats induced by sharp decrease of temperature in winter was following circuit:the organism was sensitive to cold weather,the release of E,ACTH,CORT and TSH increased,those neurotransmitter acted on blood vessel and influenced the release of VEC;release of AVP with a sudden increase and bind with Vl,then PKC was activated to increase the vasoconstriction,the pressure of inner wall of blood vessel ascended and blood pressure increased;On the other hand,stimulation of cold weather decreased the blood viscosity,blood coagulation factor decreased,then cerebral hemorrhage attacked when the blood pressure exceeded the tension that vessel wall can bear.4.2 Stroke,a kind of disease of meridian and blood vascular system,attacked seasonally,the experiment results revealed that the environmental changes outside can influence the blood composition and provided scientific and material bases to theory of the attack of disease of five viscera proper to the season.