早期电针刺激局灶性脑缺血大鼠健侧肢体的康复效果

关键词：电针  单侧肢体  巨刺  交叉迁移  康复

Keywords:electroacupuncture  unilateral-limb  ju ci  cross-education  rehabilitation

摘要：

      摘要 目的：在SD大鼠实验性局灶性脑缺血早期,应用穴位电针刺激健侧肢体，评价健侧肢体的康复效果，探讨其在脑卒中患者早期康复中的应用价值。 方法：应用大脑中动脉栓塞法造模，将30只造模成功的SD大鼠，随机分为健肢治疗组（HT）、患肢治疗组(DT)、模型非治疗组(MC)，并另设假手术对照组(OC)，每组10只，共40只。术后24h开始电针刺激穴位曲池、内关、足三里、下巨虚，采用“巨刺法”，左右交叉行刺。治疗电流强度3mA，疏密波10Hz，50Hz/5s，10s。15min/次，1次/d，7d/周。分别在治疗第3d、7d、14d和21d进行神经行为学的评价。治疗21d后，冰生理盐水灌注取脑、切片、TTC染色，IPP分析计算脑梗死体积。 结果：①神经行为学（mNSS）评价：电针刺激治疗3d时， HT组mNSS评分低于MC组（P<0.05）；治疗7d和14d时，HT、DT组更显著低于MC组（P<0.01），HT组显著低于DT组（P<0.01）； 21d治疗后，HT组和DT组评分均恢复至接近正常水平，显著低于MC组（P<0.01），HT组与DT组之间没有差异（P>0.05）。②脑梗死体积： HT和DT组脑梗死体积均低于MC组（P＜0.05），而且HT组与DT组比较也显著下降（P＜0.05）。 结论：脑卒中后超早期健肢电针治疗较患肢治疗能够更早地促进MCAO大鼠神经功能恢复，减少患侧脑梗死体积，是一种有效的早期康复介入方式。

Abstract:

      Abstract Objective:To determine the effects of electroacupuncture(EA) treatment on unaffected limbs at very early stage of experiment local focus ischemic brain damage in rats. Method: Thirty SD rats with middle cerebral artery occlusion (MCAO) were randomly divided into EA on unaffected limbs group(HT) or affected limbs group(DT), and control group (MC) 10 rats in each group. Another 10rats was set as sham operation control group (OC). EA groups received EA on the accupoints of Quchi (LI 11) and Neiguan (PC6) on forelimb, and Zusanli (ST36) and Xiajuxu (ST39) on hindlimb. EA was given with opposing needle(ju ci) method, cross stimulation at left and right side, at 3mA, in cycles of (loose/dense)10Hz:50Hz/5s:10s, 15min per session, once a day, 7 sessions per week. Infarction volume of the brain was calculated by TTC dying and photoshop IPP analyses. Neurological scores were evaluated by modified neurological severity score(mNSS) method at day 3, 7, 14 and 21 post-MCAO. Result: The mNSS scores in HT group was lower than that of MC group at day 3 (P<0.05); At day 7 and 14, the scores in both EA groups were lower than that of MC group (P<0.01) and also significant differences were found between both EA groups(P<0.01). The mNSS scores in both EA groups were almost returned to the level of OC group at day 21 and much lower than that of MC group(P<0.01). The infarction volume in HT group was less than that in DT group, while that in both EA groups was lower than that in MC group(P<0.05). Conclusion: EA on unaffected limbs at very early stage after stroke had greater beneficial effect in facilitating neurological function recovery and allviating the infarction volume of brain, compared to that on affected limbs.