| Objective1.To compare the effects of two treatment methods on the NIHSS score, MESSS score and ADL score of the patients with stroke in Tong Du Tiao Shen acupuncture group and Routine acupuncture group and provide clinical evidence for improving the clinical therapeutic effect and optimizing the acupuncture treatment of ischemic stroke.2.In this experiment,The focal cerebral ischemia reperfusion model(MCAO/R model)was prepared by the improved Zea-Longa method. To observe and analyze the effects of three different treatments on VEGF and MMP-9 expression in the ischemic cortex of MCAO/R model rats, and the effects of the treatment methods, which are the Tong Du Tiao Shen acupuncture group, the routine acupuncture group and the Tong Xin Luo group. To explore the mechanism of acupuncture and moxibustion on cerebral protection in MCAO/R model rats and provide scientific basis for clinical research.Methods1.Clinical ResearchSelected 66 cases of hospitalized patients with CIS from October 2013 to December2014 in the Second Affiliated Hospital of Anhui University of traditional Chinese Medicine. The patients were divided into Tong Du Tiao Shen acupuncture group(A group) and the Routine acupuncture group(group B) with 33 cases in each group. Two groups of patients in drug treatment under the premise of the foundation, were given Tong Du Tiao Shen acupuncture group acupuncture and conventional acupuncture treatment. Guidelines for the prevention and treatment of brain vascular disease in China: a program for the prevention and treatment of cerebrovascular diseases in China(2005). The treatment method of Tong Du Tiao Shen acupuncture group is: Moxibusting Baihui,Pricking in Dazhui, acupuncture Fengchi, Hegu, Zusanli, Sanyinjiao and Quchi.Syndrome differentiation and distribution acupuncture, Hyperactivity of liver Yang close Taichong and Taixi, Wind phlegm Blocking Collaterals close Feng long and Wai guan, With the phlegm heat excess syndrome close Feng Long and Jian shi,Syndrome of qi deficiency and blood stasis close Qihai and Xuehai, Yinxu Fengdong syndrome close Taixi and Fuliu. The Routine acupuncture group acupuncture for Fengchi, Hegu, Quchi, Zusanli, Sanyinjiao Quchi, Zusanli, Sanyinjiao,Dialectical point of the same communication with the Tong Du Tiao Shen acupuncture group. The treatment in two groups is once a day, each time the needle for 30 minutes, every 15 minutes the line 1 times, a total of 14 days of treatment.minutes.NIHSS score, MESSS score and ADL score were detected before and after treatment and were analyzed with SPSS17.0 statistical analysis software.2.Experimental research2.1Experimental animals: 200 clean grade male SD rats, 1 weeks of adaptive feeding.2.2Preparation of cerebral ischemia reperfusion model: the model rats were prepared according to the modified Zea-Longa suture method.2.3Animal groups: 200 rats were randomly selected as Sham operation group, and the remaining 200 were made in 30 rats. After the model was made, the model was selected successfully and the neural function score was qualified. The computer random area group was divided into fourg roups, respectively, which were Tong Du Tiao Shen acupuncture group, Routine acupuncture group, Tong Xin Luo medicine group and Model group, 30 rats in each group.2.4The treatment methods: Du Tiao Shen acupuncture group: Moxibustion Baihui, once a day, 30 minutes each time, Dazhui acupoint needling blood letting, next time, each time phlebotomy 1-3 drops. Select pool, Hegu, Fengchi, Zusanli, Sanyinjiao acupuncture, once a day.Routine acupuncture group: select pool, Hegu, Fengchi,Zusanli, Sanyinjiao acupuncture, once a day.Tongxinluo group: treated with Tongxinluo Capsule by gavage, once a day, once every 0.2mg/kg.d. Each 4ml; Model group and Sham operation in addition to the given normal saline don't do any treatment. All the rats in each group were given normal saline, once a day, each time 4ml. Other treatment,once a day, 7 days a course of treatment, the end of the treatment of 4 courses.2.5Model rats behavioral function score: Before treatment and complete the course of treatment, respectively, according to the Bederson criteria of nerve function evaluation.2.6Immunohistochemical method detection: in the treatment of 7, 21, 28, 14 th days, In each group, 5 rats were randomly selected, and the rats were sacrificed, the brains were taken out, and the paraffin embedded sections were stained. The positive gray values of VEGF and MMP-9 in the ischemic cortex were detected by immunohistochemistry.2.7Statistical analysis: using SPSS17.0 statistical software for data processing. All data were expressed as mean plus or minus standard deviation, and P>0.05 showed no significant meaning. P<0.01 there is a very significant meaning, P<0.05,That there is a significant meaning,Results1. Clinical Research1.1The NIHSS score, MESSS score and ADL score of the patients with ischemic stroke were all intervened by both the Tong Du Tiao Shen acupuncture group and the Routine acupuncture group group.1.2 Before and after treatment, there was significant difference in Tong Du Tiao Shen acupuncture group group of patients with NIHSS score, MESSS score and ADL score(P<0.05), there was significant difference in Routine acupuncture group of patients with NIHSS score, MESSS score and ADL score(P<0.05).After treatment, between group A and B of NIHSS score,MESSS scores and ADL scores were significant difference(P<0.05) that Tong Du Tiao Shen acupuncture group of CIS patients NIHSS score,MESSS scores and ADL scores were intervention role, and Tong Du Tiao Shen acupuncture group for the treatment of ischemic stroke in improving neural function defect, improve clinical curative effect has more advantages.2. Experimental Research2.1 Before treatment, Model group, Tongxinluo group, Routine acupuncture group,Tong Du Tiao Shen acupuncture group between neurobehavioral score difference was not statistically significant(P>0.05); All courses of treatment, Tongxinluo group,Routine acupuncture group, Tong Du Tiao Shen acupuncture group, Model group rats group rats neurobehavioral evaluation points are reduced. Compared compared after treatment, compared with the Sham operation group, Model group of nerve behavioral score difference was statistically significant(P<0.01), Tongxinluo group, Routine acupuncture group, Tong Du Tiao Shen acupuncture group of nerve behavioral score difference wasstatistically significant(P<0.05); and the Model group, Tongxinluo group,Routine acupuncture group of nerve behavioral score is significant difference(P<0.05),Tong Du Tiao Shen acupuncture group of nerve behavioral score difference was statistically significant(P<0.01); and Tong Xin Luo group compared with Routine acupuncture group rats neurobehavioral score differences statistically significant difference(P<0.05), the Tong Du Tiao Shen acupuncture group neurobehavioral score difference is very significant(P<0.01). That pass Tongxinluo drugs and Common acupuncture method, Tong Du Tiao Shen acupuncture group can make the Model rats neurological behavior score decreased, and Tongdu Tiaoshen acupuncture effect is better than through Tongxinluo drugs and routine needling method.2.2 The positive gray value of VEGF and MMP-9 in ischemic area of rats in each groupat 7th day, 14 th day, 21 th day and 28 th day of Treatment was as follows:(1)The change of Model group and Sham operation group had no statistical significance(P>0.05).Compared Tong Du Tiao Shen acupuncture group, Routine acupuncture group, Tong Xin Luo group and Model group,in the 7th, 14 th, 21 th,28th day of four time points respectively:The 7thd:Compared with Sham operation group,there was statistically significant difference in Tong Du Tiao Shen acupuncture group, Routine acupuncture group, Tong Xin Luo group(P<0.01);Compared with Model group,there was statistically significant differenceingroup Tong Du Tiao Shen acupuncturegroup,and Routineacupuncturegroup,(P<0.01,P<0.05);Compared with Routineacupuncturegroup,there was statistically significant difference in Tong Du Tiao Shen acupuncture group(P<0.05);The 14thd:Compared with Sham operation group,there was statistically significant difference in Tong Du Tiao Shen acupuncture group, Routine acupuncture group, Tong Xin Luo group(P<0.01);Compared with Model group,there was statistically significant differenceingroup Tong Du Tiao Shen acupuncturegroup,and Routineacupuncturegroup,(P<0.01,P<0.05);Compared with Routineacupuncturegroup,there was statistically significant difference in Tong Du Tiao Shen acupuncture group(P<0.05);The 21thd:Compared with Sham operation group,there was statistically significant difference in Tong Du Tiao Shen acupuncture group, Routine acupuncture group, Tong Xin Luo group(P<0.01);Compared with Model group,there was statistically significant differenceingroup Tong Du Tiao Shen acupuncturegroup,and Routineacupuncturegroup,(P<0.01,P<0.05);Comparedwith Routineacupuncturegroup,there was statistically significant difference in Tong Du Tiao Shen acupuncture group(P<0.05);The 28thd:Compared with Sham operation group,there was statistically significant difference in Tong Du Tiao Shen acupuncture group, Routine acupuncture group, Tong Xin Luo group(P<0.01);Compared with Model group,there was statistically significant differenceingroup Tong Du Tiao Shen acupuncturegroup,and Routineacupuncturegroup,(P<0.01,P<0.05);Compared with Routineacupuncturegroup,there was statistically significant difference in Tong Du Tiao Shen acupuncture group(P<0.05);Conclusion1. Clinical Research1.1Tong Du Tiao Shen acupuncture group and Routine acupuncture group were of ischemic stroke patients NIHSS score, MESSS scores and ADL scores with intervention effect.1.2In the improvement of NIHSS score, MESSS score and ADL score,Tong Du Tiao Shen acupuncture group is better than Routine acupuncture group.That pass Tongdu Tiao shen acupuncture can reduce the defect of nerve function in patients with and improve the quality of life of patients, strongly in the clinic.2.Experimental Study2.1There was a significant effect of the Tong Du Tiao Shen acupuncture group, the Routine acupuncture group and the heart meridian on the MCAO/R model rats.Tong Du Tiao Shen acupuncture group is better than the Routine acupuncture group and Routine acupuncture group is better than that of Tong Xinluo drug, Du Tiao Shen acupuncture can restore neural function in rat with.MCAO/R models.2.2The relative expression levels of VEGF and MMP-9 in the ischemic cortex area of MCAO/R model rats were intervened by three kinds of treatment methods, which were through the Tongxinluo group, the Routine acupuncture group and the Tong Du Tiao Shen acupuncture group. Tong Du Tiao Shen acupuncture group is superior to the group, and the group is superior to the Tongxinluo drugs.2.3Tong Du Tiao Shen acupuncture group can effectively contribute to the restoration MCAO/R model of nerve function, possibly by upregulating the expression of VEGF in the ischemic area of ??its mechanism, promote angiogenesis improve cerebral blood flow, inhibit the expression of MMP-9 worked by reducing inflammation, protecting the blood-brain barrier, cerebral edema and protecting neurons. |
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