| 1 Objective1.1 This study in our hospital(the Second Affiliated Hospital of Anhui University of TCM) during the period of 2013.9-2015.9 in 200 cases of clinical data of patients with cerebral infarction were retrospectively investigated, to analyze the clinical characteristics of cerebral infarction patients in our hospital, to improve the clinical symptoms and cerebral infarction acupuncture curative effect statistics, comparing the different methods of clinical therapeutic effect of acupuncture and moxibustion in the treatment of cerebral infarction. To summarize the optimization to provide an objective basis for clinical project of acupuncture and moxibustion in the treatment of cerebral infarction.1.2 through the establishment of focal cerebral ischemia reperfusion model(MCAO/R model), observe and compare the difference of Tongdu Tiaoshen acupuncture and conventional acupuncture, three methods for the treatment of Tongxinluo drug on hippocampal ischemic brain tissue of MCAO/R rat model of neurotransmitters in the Ach, the influence of 5-HT concentration, compared the effect of Tongdu Tiaoshen acupuncture and the conventional acupuncture and Tongxinluo treatment in MCAO/R rats. Objective: To explore the effect of brain protection Tongdu Tiaoshen acupuncture treatment of ischemic stroke model rats and promote angiogenesis, thus providing scientific basis for the clinical application of Tongdu Tiaoshen acupuncture.2 Method2.1 Our hospital medical record room computer randomly collected from our hospital(2013.9-2015.9) 200 cases were diagnosed as cerebral infarction within two years of hospital medical records, medical records of the general situation, risk factors, clinical symptoms, syndrome type, and different kinds and different acupuncture needle law etc.for retrospective statistical investigation and analysis, improve the incidence the characteristics of cerebral infarction after acupuncture treatment, clinical symptoms,clinical curative effect comparison of different methods of acupuncture treatment of cerebral infarction.2.2 Model with modified Zea-Longa suture method, and copy the MCAO/R model,reference weight and neurobehavior of rats were successfully modeled rats, a randomized group, respectively: model control group, Tongxinluo treatment group,routine acupuncture group, Tongdu Tiaoshen acupuncture group, and sham the surgery group, 24 rats in each group. The rats to the same feeding; in the treatment of sham operation group and model group were not given any treatment, Tongxinluo capsule and Tongxinluo treatment group. Each 2.0mg/kg.d[1] is dissolved in 4ml distilled water gavage; routine acupuncture group selected Fengchi, Hegu, Quchi, Zusanli, Sanyinjiao acupoint acupuncture; Tongdu Tiaoshen acupuncture group was treated with Moxibustion Baihui, 30 min once a day, the next day at Dazhui acupoint bloodletting,1-3 drops each time, and with the conventional acupuncture group acupuncture treatment group; more than once a day for 28 days. Before and after treatment respectively on a rat model of neurobehavioral scores by Bederson. The rats after twenty-eighth days of treatment 24 h and 72 h were decapitated, collecting specimens and immunohistochemical method to detect the index.3 Results3.1 clinical research3.1.1 analysis of general information: in 200 cases of CI, male is more than female,male(104 cases) and female(96 cases); age distribution between 36-89, with 60 years of age in the elderly, male age mean and standard deviation was 61.72±9.84 years old,female age and mean the standard deviation is 62.83±10.37 years; the distribution of the severity of severe(20 cases), medium(97 cases), mild(83 cases), the most common medium; in many CI risk factors, hypertension(158 cases), diabetes mellitus(87 cases),hyperlipidemia(56 cases) the common risk factors, at the same time and patients often accompanied by multiple risk factors; clinical manifestation of CI in hemiplegia(157cases), headache and dizziness(91 cases), barylalia(74 cases) and hydroposia(68 cases) and rare, and often a variety of clinical manifestations Symptoms at the same time. CI syndrome type of qi deficiency and blood stasis syndrome(41.4%), wind phlegm and blood stasis syndrome(32%),(9.5%), kidney yin deficiency, phlegm of God(6%), 200 cases of CI with Qi deficiency and blood stasis, wind phlegm and blood stasis syndrome is the most common symptom; in the needle selection of acupuncture in treating cerebral infarction. Body acupuncture, scalp acupuncture(92.5%),(91%), EA(9%),(6.5%) the plum blossom body, with body acupuncture and scalp acupuncture, clinical acupuncture often species in law application; acupuncture in the choice of xingnaokaiqiao(18 cases), Tongdu Tiaoshen method(166), Jin Sanzhen(7 so, our hospital patients) in the treatment of CI on the selection and application of Tongdu Tiaoshen method3.1.2 The research found that, not related to the severity and age of onset of CI; Tongdu Tiaoshen method is widely used in our hospital, the effective rate of Tongdu Tiaoshen improve the clinical symptoms of patients with CI were more than 80% found in this study, the clinical effect is clear.3.2 experimental study3.2.1compared with the model group, Tongdu Tiaoshen acupuncture and conventional acupuncture and drug Tongxinluo can reduce the nerve MCAO/R rat model behavior score(P<0.01), and Tongdu Tiaoshen acupuncture is better than routine acupuncture and drug Tongxinluo(P<0.05)3.2.2 drug Tongxinluo and conventional acupuncture, ischemic hippocampus 5-HT content in brain tissue of MCAO/R rat model and regulating acupuncture can be reduced in different degrees. After the end of treatment 24 h, conventional acupuncture group, reduce the efficacy of 5-HT in hippocampus of brain tissue in ischemic rat model is better than that of Tongxinluo drug group(P<0.05); and the effect of Tongdu Tiaoshen acupuncture group decreased the content of 5-HT in hippocampus of cerebral ischemia is better than that of Tongxinluo group and routine acupuncture group(P<0.01, P<0.05); after the treatment of 72 h, content of each group can be continuously adjusted in brain tissue of model rats with ischemic hippocampus 5-HT, conventional acupuncture group and Tongxinluo drug groups have no difference(P>0.05), through the effect of Du regulating acupuncture group than Tongxinluo group, conventional acupuncture and drugs group(P<0.05).3.2.3 drug Tongxinluo and conventional acupuncture, Tongdu Tiaoshen acupuncture can increased the content of Ach E in hippocampus of cerebral ischemia rats MCAO/R model. After the end of treatment 24 h, conventional acupuncture group increase the efficacy of Ach E in hippocampus of cerebral ischemia in rats is superior to Tongxinluo drug group(P<0.05), and the effect of Tongdu Tiaoshen acupuncture is better than that of Tongxinluo group and routine acupuncture group(P<0.05); after the treatment of 72 h,content of each can be adjusted in brain tissue of model rats with ischemic hippocampal Ach E, better than the routine acupuncture group Tongxinluo drug group(P>0.05),through the effect of Du regulating acupuncture group than Tongxinluo drug group and routine acupuncture group(P<0.05).4 Conclusion4.1 clinical study4.1.1 analysis of general information: in 200 cases of CI, more men than women; over60 years of age in the elderly, male age mean and standard deviation was 61.72±9.84 years old, female age mean and standard deviation of 62.83 ± 10.37 years; the distribution of severity, with the most common medium; in many of the CI risk factors,hypertension, diabetes, hyperlipidemia is the common risk factors, at the same time and patients often accompanied by multiple risk factors; clinical manifestation of CI in hemiplegia, headache, dizziness, slurred speech, hydroposia wait to see more, and often in various clinical symptoms at the same time. In 200 CI patients with Qi deficiency and blood stasis, wind phlegm and blood stasis syndrome is the most common symptom; in the choice of needle acupuncture in the treatment of cerebral infarction, with body acupuncture and scalp acupuncture, clinical acupuncture often species application;acupuncture in the choice of law, in our hospital in the treatment of CI selection and application of Tongdu Tiaoshen method.The research found that4.1.2 not related to the severity and age of onset of CI; Tongdu Tiaoshen was treated in our hospital in CI applications, effect of Tongdu Tiaoshen treatment CI clear.4.2 experimental study4.2.1 drug Tongxinluo and conventional acupuncture, Tongdu Tiaoshen acupuncture can reduce the neurological behavior of model rats with MCAO/R scores. Comparison of the efficacy of the three methods, the conventional acupuncture is better than Tongxinluo drug; Tongdu Tiaoshen acupuncture is superior to conventional acupuncture and drug tongxinluo.4.2.2 drug Tongxinluo and conventional acupuncture, acupuncture of Tongdu Tiaoshen MCAO/R model rat hippocampus neurotransmitter 5-HT and Ach E concentrations have different moderating effects. Tongdu Tiaoshen acupuncture curative effect on reducing MCAO/R in rat model of cerebral ischemia hippocampus neurotransmitter 5-HT content and the increase of the content of Ach E is better than that of conventional acupuncture and drug tongxinluo.Brain injury.4.2.3 Tongdu Tiaoshen acupuncture can improve the cerebral ischemia reperfusion model in rats, and could reduce the content of neurotransmitter serotonin 5-, increased acetylcholinesterase content. |
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