EFFECT ON TREATING ACUTE STROKE BY ACUPUNCTURE 

Jiang Dashu, Xie Yaofang*, Lu Yi** Song Chongshun***, Liu Jinlan, Gao Yuling, Liu Ai-hua, Zhao Jihui, Yuan Jige, Liu Jiaying, Wei Gongfen, Zhang Lixin

(Institute of Acpuncture, Academy of TCM, Beijing)

* Long Fu Hospital of Beijing ** Jishuitan Hospital of Beijing *** Dongzhimeng Hospital of Beijing College of TCM

Observation on Clinical Therapeutic Effect

1. We have observed 54 acute ischemic apoplexy patients who were treated in the hospital for 3 weeks. 59 patients were in acupuncture group, and 15 in niacin group.

2. Among the 39 cases treated by acupuncture, 6 were basically cured, 12 markedly improved, 18 improved and 3 failed. The markedly effective rate was 39.8%, the effective rate was 92.31%. Giving a mark in accordance with objective signs of the nervous system, the difference was very significant (P<0.001) before and after acupuncture,

3. Among the 15 cases treated by niacin with quantum routine, 2 cases were basically cured, 5 markedly improved, 6 improved and 2 failed. The markedly effective rate was 46.67% and the effective rate was 86.67%. Giving a mark in accordance with objective signs of nervous system, the difference was very significant (P<0.01) before and after niacin.

4. Comparing the acupuncture group and niacin group, there was no significant difference (P>0.2), indicating that the effects in acupuncture group and in niacin group were basically the same.

Observation on the Change of Hemorheology

1. Comparing the 50 normal subjects and the 54 cases of acute ischemic apoplexy of the same sex, it was found that rheological blood flow of patient was free of significant abnormalities, but the differences for specific viscosity of the whole blood, specific viscosity of blood plasma, specific viscosity of whole blood reduction, hematocrit, time electrophoresis of erythrocyte and Librinogen were significant or very significant (P<0.05, P<0.001) as compared with the normal subjects.

2. After the treatment of the 39 cases in acupuncture group, all the indices of hemo-rheology were improved, in which the specific viscosity of whole blood was prominently improved (P<0.01), and so was the hematocrit (P<0.05).

Method of Experimental Study

1. Studies were carried out on 44 acute experimental cerebral ischemia cats, which were divided into acupuncture group and control group, according to the random principle, by ligating some cerebral supply artery, such as the vertebral a, of both sides, the common carotid a. of the left side and the external carotid a- of the right side. Cerebral blood flow (C.B.F.) was measured to make use of model MF-27 electromagnetic flowmeter by means of the carotid artery of the right side. Mean arterial pressure was measured to make use of model BPM-1 electropressometer by means of the arteriae femoralis of the left side. Changes of the C.B.F and blood pressure (B.P) together were measured to make use of RIG-4000 model 2-meridian recorder.

2. 30 minutes after ligating some cerebral supply artery of cats in the acupuncture group, Quchi and Yanglingquan on the right side were needled with even movement by continuously rotating for 20 minutes. The operation and experimental procedures in the control group were all the same with the acupuncture group, except for acupuncture 17 normal cats without ligating cerebral supply artery but with acupuncture were observed by the changes of the C.B.F. and mean B.P., known as normal group.

3. The brain of cats were perfused with perfusate of ink immediately after experiment. The areas of cerebral ischemia could be seen by thick sections and microscopic of the brains.

Results:

1. Cerebral blood flow (CBF)

(1) In acupuncture group, CBF during needling was increased to 45.30±12.02 (average value+stan. error, the same before needling was 45.30±12.02 ml l00g brain/min more then that before acupuncture. After acupuncture CBF was 36.42±4.93, more than that before acupuncture. Compared with the control group, the increase of CBF during and after acupuncture was significant (P<0.001). The increase of CBF had lasted fro m the beginning of acupuncture until 35 minu-tes after withdrawal of the needle, showing that CBF of the cerebral ischemic cats may be increased by acupuncture.

(2) Comparing the changes of CBF in acupuncture group and in normal group, the increase of CBF of cerebral ischemic cats was more significant than that of the normal, no matter during acupuncture or after acupuncture. The normal cats were affected by acupuncture. CBF was not increasing but reducing (during acupuncture P<0.05, after acupuncture P>0.2). The cats in acupuncture groups and in normal group were marked with a difference in reaction which might be related to functional regulation of acupuncture.

2. Cerebral blood vessel resistance (CVR):

(1) During acupuncture, CVR was reduced to 1.18±0.38 (average value±Standard error, the same below) which was less than that before acupuncture in the acupuncture group. After acupuncture, CVR was reduced to 1.36±0.43 which was less than that before acupuncture. Compared with the control group, the decrease of CVR was significant ( P<0.05) during acupuncture, but not significant (P<0.02) after acupuncture.

(2) Compared between acupuncture group and normal group, the changes of CVR were not significant, no matter during acupuncture (P>0.05) or after needling (P>0.1).

3. Anatomical location:

The chief areas of cerebral ischemia were shown at the frontal, temporal and parietal lobe in the cortex layers on the left (on the ligating common carotid artery) by means of the perfusion of ink perfusate.

Conclusion:

1. We consider that the animal model of acute experimental cerebral ischemia may be performed by the method mentioned above.

2. Acupuncture of cerebral ischemic cats at Quchi and Yanglingquan may affect the hemodynamics of the brain, increase CBF and reduce CVR. After removing the needle, CBF may last for 35 minutes, but the CVR reduced not prominently. Normal cats were not markedly affected in hemodynamics of the brain by acupuncture.