| OBJECTIVE: To observe the therapeutic effect of acupuncture associated with language training treating early-stage aphasia from ischemic apoplexy, meanwhile to investigate the acupuncture therapy mechanism. Methods: Fifty-eight cases with early-stage aphasia from ischemic apoplexy were randomly divided into the treatment group (acupuncture associated with language training) and the control group (language training). The two groups were treated by "Xing Nao Kai Qiao"(XNKQ) acupuncture therapy and Schuell' stimulating method respectively, and given language examination evaluation before and after course of treatment according to (CRRCAE), the treatment group were given cerebral blood flow examination before and after acupuncture treatment instantly by transcranial Doppler (TCD) and given accident correlated electric potential (P300) examination before and after the course of treatment, and further the correlation and regression relationship was analyzed between cerebral blood flow examination results and language examination results. In order to study the acupuncture's therapeutic mechanism, we applied rats of middle cerebral artery obstruction (MCACO) reperfusion and in situ hybridization methods, and observed BDNF mRAN expression and time change after cerebral ischemic reperfusion. Through electro-acupuncture stimulating rat's brachial plexus nerve trunk (acupoints and their neighboring), we observed the function of acupuncture regulating the BDNF mRNA expression after cerebral ischemic reperfusion.RESULT: According to language examination evaluation, the scores of each language function in two groups increased in different degrees. Both the scores of each language function (except writing function) and the curative effect in treatment group were superior to those in control group(P<0.05). After acupuncture, the treatment group had instantly remarkable improvement in the mean blood velocity (Vm) of middle cerebral artery (MCA) and posterior cerebral artery (PCA) in the left hemisphere (P<0.05), but there were no significant difference in pulsation index (PI) and resistance index (RI). It appeared highly positive correlated relationship between the improvement of the mean blood flow velocity in the left hemisphere and the elevation ratio of language function scores(r=0.883). After course of treatment, the incubation period of accident correlated electric potential (P300) had been markedly shortened (P<0.01), but the wave amplitude had no significant change. The time change of the BDNF mRNA expression in cortex and corpus striatum was different in different groups: BDNF mRNA expression in normal control rat brain was at basal level, sham-operation had no effect on BDNF mRNA expression, and after the MCAO rats had been in the state of cerebral ischemia for an hour, at reperfusion 2h, 6h, 12h, 24h, 2d and 3d, BDNF mRNA expression increased significantly, which appeared double-hump rising. BDNF mRNA expression in cortex was notably higher than that in corpus striatum, the peak in cortex was at 2h and 24h, the latter peak value was higher and lasted for a longer time, then decreased gradually. The amount of positive cells was still at higher level at reperfusion 7d,and at 14d BDNF mRNA expression decreased to basal level. The peak of BDNF mRNA expression in corpus striatum was at 2h and 2d to 3d, and then decreased gradually. The amount of positive cells was still significantly less than that of cortex at reperfusion 7d. and at 14d BDNF mRNA expression decreased to basal level. Electro-acupuncture had an effect on BDNF mRNA expression, which began to rise at reperfusion 6h and kept at high level at 24h, 2d, 3d, 7d and 14d, and had significant difference compared to the control group. CONCLUSION: The therapeutic effect of acupuncture associated with language training was obviously superior to the control group (simple language training) in five items of language function improvement and clinical effect. Acupuncture could instantly improve the patient's left...
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