| Thesis 1: Based on "Collateral Brain and Regulating Sprite" Exploring Eye Acupuncture Treating for Acute Cerebral Infarction and Its Effective-Time Relationship:A Clinical Study Purpose:This study is based on the theoretical basis of eye acupuncture " Collateral Brain and Regulating Sprite " to explore the theoretical basis of eye acupuncture for stroke.Through the self-control study before and after,the immediate effect and sustained effect of eye acupuncture treatment of ACI are further clarified,and the time-effect relationship of eye acupuncture is initially established.Aiming at the improvement and curative effect of patients after ACI on neurological function,motor function and daily living ability,the independent efficacy of eye acupuncture in ACI is further clarified,and evidence-based medical evidence is provided for clinical application of eye acupuncture in the treatment of ACI.Material and method:This study included a total of 120 patients with acute cerebral infarction who were hospitalized in the Department of Neurology,Northern Warfare General Hospital from September 2018 to December 2019,and were randomly divided into a treatment group of 60 cases and a control group of 60 cases according to the random number table method.The control group was treated with conventional Western medicine,including anti-platelet aggregation,statins for lipid-lowering,nutritional nerve drugs,primary disease contr-ol and related symptomatic treatment.The treatment group added eye acupuncture treatment on the basis of the control group.The bilateral liver,kidney,upper focal zone,and lower focal zone were taken with eye acupuncture once a day,and rested 5 days a week for 2 days.The total course of treatment was 2 weeks.The patients in the eye acupuncture group used the MMT evaluation method to observe the immediate acupuncture effect and the acupuncture continuous effect on the first day of treatment,the seventh day of treatment,and the 14 th day of treatment.The NHISS scale,MBI scale and HAMD scale were used to evaluate the limb movement,nerve function,daily life ability and mental and emotional conditions of patients in the eye acupuncture group and the control group before and after treatment.Results:1 After the eye acupuncture treatment,the muscle strength of the proximal upper extremity,distal upper extremity,proximal lower extremity,and distal lower extremity of the ACI patient was significantly improved before treatment(P <0.01);after the eye acupuncture treatment,the ACI patient immediately approached The effect of end muscle strength is obviously better than that of immediate distal muscle strength(P<0.01).2.The effect of different disease positions on the immediate effect of eye acupuncture is statistically different(P <0.05),in which the effective rate of the disease site in the basal ganglia is 76%,the effective rate of the disease site in the brain stem is 55%,and the disease site is The effective rate of cerebral cortex and multiple infarction is 100%;the effect of different courses on the immediate effect of eye acupuncture is statistically different(P <0.05),and the effective rate of early treatment of eye acupuncture(1d? course of disease <3d)is82% The effective rate of mid-term treatment(3d ? course <5d)was 83%,and the effective rate of late stage treatment(5d ? course ? 7d)was 33%;the severity of the disease did not have a statistically significant effect on the immediate effect of eye acupuncture(P > 0.05).3.Comparison of muscle strength at the proximal end of the upper extremity,distal end of the upper extremity,proximal end of the lower extremity,and distal end of the lower extremity before and immediately after eye acupuncture treatment,30 min after acupuncture,1 h after acupuncture,2 h after acupuncture and 4 h after acupuncture There are statistical differences(P <0.05).4.ACI patients on the 7th day before treatment,immediately,30 min after acupuncture,1h after acupuncture,2h after acupuncture and 4h after acupuncture muscle strength and before,immediately after treatment on the first day,30 min after acupuncture,acupuncture There was a statistically significant difference in the comparison of muscle strength 1h after acupuncture,2h after acupuncture and 4h after acupuncture(P <0.05).Before and immediately after treatment on day 14 of ACI patients,muscle strength before and after 30 minutes of acupuncture,1h after acupuncture,2h after acupuncture,and 4h after acupuncture and before and immediately after treatment on the 7th day,30 min after acupuncture,after acupuncture There was a statistically significant difference in the comparison of muscle strength at 1h,2hafter acupuncture and 4h after acupuncture(P <0.05).5.The NIHSS scores of the two groups of patients were significantly higher than those before treatment(P <0.01);the NIHSS scores of the two groups after treatment were statistically different(P <0.05).6.The FMA scores of the two groups of patients were significantly higher than those before treatment(P <0.01);the FMA scores of the two groups after treatment were significantly different(P <0.01).7.The MBI score of the two groups of patients after treatment was significantly higher than that before treatment(P <0.01);the MBI score of the two groups after treatment was statistically different(P <0.05)8.The HAMD scores of the two groups of patients after treatment were significantly higher than before treatment(P <0.01);the HAMD scores of the two groups after treatment were significantly different(P <0.01)Conclusion:1 Based on the TMC theoretical basis of eye-acupuncture “Collateral Brain Regulated with Zang Organs and Fu Organs”,further collation and excavation of ancient literature,by exploring the relationship between “eye-brain” and “brain-sprite” and the whole of“eye-brain--sprite” with stroke The relationship between the etiology and pathogenesis has confirmed that the eye and brain pass the "eye system" to transfer qi,blood and essence,forming a mutually nourishing and synergistic network structure,and clarifying the theory of eye-acupuncture " Collateral Brain Regulate Sprite ".as the theoretical basis in stroke.2 Eye acupuncture had significant effects on immediate muscle strength of the proximal upper limb,distal upper limb,proximal lower limb,and distal lower limb,and the improvement of the proximal muscle strength was better than that of the distal muscle strength.3 The patient's infarct site and acupuncture intervention timing affected the immediate effect of the eye needle.Among them,the immediate effect of the lesion located in the basal ganglia and the brain stem was not good.The earlier the eye needle intervention,the better the immediate effect.4 The continuous action of the eye acupuncture has the time-effectiveness rule of onset,development,peak,attenuation and regression.5 Eye acupuncture therapy and basic Western medicine treatment can improve the nerve function and motor function of ACI patients,improve their daily life ability,adjust their mentality and mood,and thus improve the overall prognosis of ACI patients.And the effect of eye acupuncture is particularly prominent in improving the patient's motor function and regulating the patient's consciousness and emotion.Thesis 2: Based on Endoplasmic Reticulum Stress Exploring the Mechanism of Eye Acupuncture Intervention in CIRI Rats Purpose:Based on endoplasmic reticulum stress,to explore the mechanism of eye acupuncture to regulate cerebral ischemia-reperfusion injury,to further study the role and mechanism of eye protection against nerve function after CIRI,and to provide experimental theoretical basis for clinical application of eye acupuncture to ACI.Material and method:In this study,30 male SPF grade SD rats weighing approximately 220 g were randomly divided into the normal group,the sham operation group,the model group,the eye acupuncture group and the acupoints according to the random number table method.Outside the group.The model group,the eye acupuncture group and the extra-acupuncture group all used the modified suture method to replicate the MCAO rat model.The rats in the sham-operated group used the same procedure without inserting the suture.After operation,the Longa score and TTC staining were used to success-fully evaluate the model of CIRI rats,and the eye acupuncture group rats were intervened wit-h eye acupuncture.The eye acupuncture was used to take bilateral liver,kidney,upper focus and lower focus areas.Reperfusion begins immediately,once every 8 hours,for a total of 4times.The acupuncture site of the rats outside the acupoint area group was 3 mm outside the same area as the eye acupuncture area,and the rest operations were the same as the eye acupuncture group.Rats were sacrificed 24 hours after reperfusion.Longa score was used to evaluate the neurological function of the rats.HE staining was used to observe the pathological changes of the rat brain.TTC staining was used to observe the infarct volume.The average fluorescence of GRP78 and CHOP in the cerebral cortex was detected by immunofluorescen-ce Intensity,Western blot method was used to detect the expression levels of GRP78,CHOP,Caspase-12 and Caspase-3 in brain tissue.Results:1.The normal group and sham operation group had no neurological deficits.Compared with normal group and sham operation group,rats in model group and eye acupuncture group showed obvious neurological deficits.Compared with the model group,the performance of neurological deficits in the eye acupuncture group was statistically different(P <0.05).Com-pared with the model group,there was no statistically significant difference in neurological deficits in the extra-acupoint group(P > 0.05).2.Histopathology of the brain of each group: visible by HE staining,the gray and cortical boundaries of the brain tissue of the normal group and the sham-operated group are clear,the structure of nerve cells is complete,neatly arranged,no edema and necrosis,the level of nerve cells is clear and distributed Uniform,rich in cytoplasm of neurons,clear and complete nucle-us and membrane.The brain tissue of the model group and the extra-acupuncture group show-ed changes in the reticular necrotic foci of typical cerebral infarction,the edges of the necro-tic foci were unclear,the remaining neurons in the core area of ??the infarct were disorderred,and nuclear condensation,nuclear fragmentation,and cytoplasmic staining occurred.Atrophy,loose cytoplasm,edema,lightening of staining,interstitial edema,dilated capillary inflamma-tion and infiltration of sex cells can be seen.In the eye-acupuncture group,there were fewer reticular necrotic foci in the brain tissue,the edges of the necrotic tissue were clearer,and a large number of glial cells proliferated,and telangiectasia and inflammatory cell infiltration were still visible.3.Comparison of infarcts of brain tissue of rats in each group: After TTC staining,the brain tissues of normal group and sham operation group are red,and the brain tissues of noninfarction area of ??model group and eye acupuncture group are red.The brain tissues in the infarcted focus area of ??the group and the eye acupuncture group were pale.Compared with the sham operation group and the normal group,the increase in cerebral infarction volume in the model group was statistically significant(P <0.05).Compared with the model group,the volume of cerebral infarction in the eye acupuncture group was significantlyreduced,with statistical difference(P <0.05).Compared with the model group,there was no statistically significant difference in the volume of cerebral infarction in rats outside the acupoint group(P >0.05)4 Immunofluorescence results showed that,compared with the normal group(579.80 ±120.73)and the sham operation group(621.85 ± 111.21),the average fluorescence intensity of cortical CHOP in the model group was significantly increased(9133.71 ± 849.25),with statistical differences(P < 0.01);Compared with the model group,the intensity of the fluorescence intensity difference in the eye acupuncture group decreased(2080.29 ± 125.99),with a statistical difference(P <0.01).Compared with the model group,the difference in the fluorescence intensity of the group outside the acupoint area was(9441.74 ± 1590.11),and there was no statistical difference(P > 0.05).5 Immunofluorescence results showed that,compared with the normal group(762.22 ±129.06)and sham operation group(726.76 ± 117.45),the average fluorescence intensity of cortical GRP78 in the model group was significantly increased(5470.48 ± 479.12),with statistical differences(P < 0.01);Compared with the model group,the fluorescence intensity of the eye acupuncture group decreased significantly(1181.72 ± 219.60),with a statistically significant difference(P <0.01).Compared with the model group,the difference in fluorescence intensity of the outside-acupuncture group was(5154.48 ± 328.89),and there was no statistical difference(P > 0.05).6 Compared with the normal group and the sham operation group,the model group GRP78,CHOP,Caspase-12,Caspase-3 were significantly up-regulated,with statistical differences(P<0.05).Compared with the model group,GRP78,CHOP,Caspase-12,and Caspase-3 in the brain tissue of the eye-acupuncture group were significantly down-regulated,with significant statistical differences(P <0.05).Compared with the model group,the expressions of GRP78,CHOP,Caspase-12,and Caspase-3 in the brain tissue of rats outside the acupoint group were not statistically different(P > 0.05).Conclusion:1.Eye acupuncture can improve the symptoms of neurological deficits in MCAO rats,reduce the area of cerebral infarction,reduce CIRI,and play a neuroprotective role.2.CIRI can induce endoplasmic reticulum stress to up-regulate GRP78,CHOP,Caspase-12,and Caspase-3 protein.The mechanism of eye acupuncture on CIRI may be by up-regulating GRP78 and inhibiting the related factors of CHOP and CHOP protein downstream:Caspase-12 and Caspase-3 expression levels can interfere with endoplasmic reticulum stress and improve CIRI. |
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