| Background With the development of perinatology and neonatal intensive care technology,the success rate of treatment of premature infants in China was significantly increased.However,these factors due to perinatal white matter damage caused by children also increased.White matter damage(WMD)is one of the most common forms of brain injury in premature infants.It is also a major cause of chronic neurological complications.WMD caused by the incidence of cerebral palsy is about 10%,and cognitive disorders,behavioral abnormalities such as the incidence of up to 50%,and may be associated with audio-visual disorders,so the white matter damage has received increasing attention.At present there is no specific treatment for premature infant white matter damage.This study was to be studied by means of clinical randomized controlled trials in combination with animal experiments.Clinical randomized controlled trials,based on conventional rehabilitation on the basis of acupunctur therapy of dredging governor vessel for awakening mentality,neurological assessment through the brain imaging and electrophysiology and other aspects of the check to see whether the difference in efficacy;animal experiments using intrauterine inflammation,to investigate the effect of acupuncture on neuropsychology and pathologic changes in rats with cerebral palsy caused by white matter damage.To investigate the therapeutic effect and possible mechanism of acupuncture therapy on the white matter damage in premature infants.This paper is divided into two parts,the summary is as follows:Part one Clinical study on acupunctur therapy of gredging governor vessel for awakening mentality in premature infant with white matter damageObjective In this study,randomized controlled clinical trials to select the white matter damage in preterm infants,in the conventional basis of rehabilitation,based on the increase acupunctur therapy of dredging governor vessel for awakening mentality,comparative analysis of neural motor development and head imaging changes,To understand the effect of acupuncture treatment on the white matter damage in premature infants,and to find a more effective treatment for preterm infants with white matter damage.Methods The infants with gestational age of less than 35 weeks and a history of white matter damage and age of 3 months to 12 months were randomly divided into acupuncture group and control group.The subjects were included in the routine basic rehabilitation therapy,on the basis of acupuncture group increased by the acupunctur therapy of dredging governor vessel for awakening mentality.At the beginning and the end of the study,the subjects were examined by head MRI and Diffusion Tensor Imaging(DTI).The Gesell developmental diagnostic scale,the gross motor function measure(GMFM)-88)assessment scale to understand the neural motor development.EEG examination,auditory and visual evoked potential examination,to understand the possible complications.To observe the effect of acupuncture on the nerves and nerves of the passers-by,to observe the effect of neuroimaging function and neurochemical function on the structure,intelligence,neuro-physiological function of preterm infants with white matter damage,and to study the repair effect of acupuncture on premature infants with white matter damage.Results1.There was no significant difference between the two groups after treatment(P> 0.05).The FA value between thalamus and frontal lobe of the two groups was statistically significant(P <0.05).The FA value between thalamus and frontal lobe of acupuncture group was statistically significant(P <0.05).Compared with the control group,the scores of hyperactivity,fine exercise and social adaptation DQ in the Gesell scale of the acupuncture group were significantly increased(P <0.05).After treatment,compared with the control group,the score of B in GMFM-88 was significantly increased(P <0.05).There was no significant difference in EEG,BAEP and VEP between the two groups(P> 0.05).There was no significant difference between the two groups in the diagnosis of cerebral palsy,epilepsy,hearing disorder,visual disorder,mental retardation and other comorbidities after treatment(P> 0.05).2.There was a significant correlation between birth weight,birth gestational age and age of acupuncture group,social adaptation of acupuncture group,DQ difference of large movement and fine action.There was a significant correlation between the head circumference and the social adaptation,large movement of the acupuncture group(P <0.05).Conclusion In this study,the white matter damage of the premature infants through the use of acupunctur therapy of dredging governor vessel for awakening mentality with conventional rehabilitation treatment of its neurological development and improvement of the situation and head imaging changes were observed and analyzed,the results show that: acupunctur therapy of dredging governor vessel for awakening mentality on the white matter damage in premature children infants have a good effect,the acupuncture therapy through the acupoints to stimulate and clear the governor vessel,and by the various levels of neuromodulation and integration,excitement of the activation of the brain,awakening resuscitation,promoting the repair of premature infants with impaired white matter function,improve the ability of large sports,especially the establishment of the balance of seats,improve the fine movement,improve social adaptability.Part two The effects of acupunctur therapy of dredging governor vessel for awakening mentality on preterm infant rats with brain damage induced by intrauterine infectionObjective To establish the animal model of premature brain damage caused by intrauterine infection and to explore the effect of acupunctur therapy of dredging governor vessel on the behavioral ability of premature brain injury and the expression of related protein.MethodsAnimal models were established by intraperitoneal injection of lipopolysaccharide(LPS)in pregnant rats to induce premature brain damage.The preterm rats were randomly divided into four groups: simple acupuncture group(group A),simple exercise intervention group(group B),comprehensive intervention group(group C)and non-intervention group(group D).The normal rats without premature delivery were set as the control group.The rats were sacrificed on the 7th day after birth,and serum Tau protein was detected.The rats were treated with acupuncture at the same time.At 28 th day,the rats were tested for behavioral ability,and then serum Tau protein was collected again.Histopathological changes of hippocampus were observed by HE staining and transmission electron microscopy.Expression of Tau protein was detected by immunohistochemical staining.Immunofluorescence staining was used to observe the expression of GFAP protein.Results Compared with the normal fetus,the motor behavior of the preterm rats with intrauterine infection was decreased,the neuron denaturation and necrosis,and the degree of mitochondrial damage were increased in the hippocampal CA1 region,The expression of Tau protein and GFAP protein were increased.Compared with the untreated group,the acupuncture group could significantly improve the motor behavior and the expression of Tau protein and GFAP protein,decrease the degeneration and necrosis of hippocampal neurons and mitochondria damage.Acupuncture combined with exercise training is better than acupuncture alone.Conclusion It can improve the behavioral ability and serological index of brain injury in premature rats caused by intrauterine infection.It has certain neuroprotective effect on the brain injury of preterm infants.It has a certain neuroprotective effect.And the acupuncture therapy inhibit the regulation of Tau hyperphosphorylation,reduce pathologic Tau protein in nerve cells and glial cells in the accumulation of inhibition of astrocyte reactive hyperplasia,thereby improving its brain histopathological structure,Promote the recovery of brain function,and then improve the motor behavior. |
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