Investigation On The Effect Of Acupuncture And Rehabilitation Therapy In Patients With Acute Cerebral Infarction Of Different Periods And The Study Of FMRI

Objective:To study the relation between the time of acupuncture and it's curative effect, and to survey the correlation between the recover of movement and the related region of brain, through the clinical survey of patients with acute cerebral infarction of different periods treated by acupuncture and observation of the related cortex of movement with the help of the technology of fMRI, so as to underlie the optimal opportunity of cure of patients with acute cerebral infarction of different periods treated by acupuncture, in order to enhances the clinical curative effect.Methods:Sixty-three patients with the disease of acute cerebral infarction were randomly divided into three groups, but there were sixty had complete material,21cases in group 1,19 cases in group 2, 20 cases in control group. All the three groups received the routine treatment of department of neurology and the control group received rehabilitation treatment only, once a day and 10 days a period, a total of 2 periods of treatment. On that basis, group 1 treated by acupuncture from the first day of admission, once a day,10 days a period with a total of 1 periods of treatment. But group 2 treated by acupuncture from the eleventh day of admission, once a day, and 10 days a period, a total of only 1 periods of treatment. With the nerve function deficit score, the Fugl-meyer motor function score and the modified Barthel index score, the three groups were evaluated respectively before and after the treatment, in order to estimate the condition of the recovery of the 3 groups of the neurologic impairment, motor function and daily living skills. Then we make a comparative study on the nerve function deficit, and the improvement of motor function and activities of daily living. Besides, we chose a part of patients (there were 5 subjects of group 1,6 subjects of group 2 and 5 subjects of control group) to take part in fMRI examination before and after treatment, and chose 5 healthy volunteers to participate in single-pass fMRI examination. Then we investigate the activatived volume of contralateral functional region of brain of patients and the rule of change with the same stimulation compared with healthy volunteers. Results:There were the significant difference among 3 groups before and after treatment in the scores of the nerve function deficit, the Fugl-meyer motor function and the modified Barthel index (P<0.01), and there were the significant difference among 3 groups after treatment(P<0.05). Moreover, the significant difference was obsevered between each other(P<0.05).16 subjects of patients with acute cerebral infarction taked part in fMRI examination, there were the significant difference in the activatived volume of contralateral functional region of brain among 3 groups before and after treatment(P<0.01) when they moved their ankle joints. After the treatment, the activatived volume of contralateral functional region of brain different significantly(P<0.05) when they moved ankle joint.Conclusion:The effect of acupuncture and rehabilitation therapy in patients with acute cerebral infarction is better than the single rehabilitation therapy. Acupuncture combined with rehabilitation therapy can effectively reduce the neurologic deficits degree and improve the skill of daily living of patients with acute cerebral'infarction,and the earlier acupuncture makes, the better the results are. The activatived situation of the cerebral motor cortex after acute cerebral infarction can be observed objectively by fMRI, it suggested that there are compensation and recombination of cerebral motor cortex in patients of acute cerebral infarction. And acupuncture and rehabilitation therapy in early patients with acute cerebral infarction may bring about changes of the activatived volume of contralateral functional region of brain, so as to accelerate recover of the function of limbs. As a useful tool to survey and study the recover of function of limbs of patients with acute cerebral infarction, fMRI can effectively assess the clinical outcomes of different treatment.