| Cerebralvascular disease is not only one of the most common diseases in the world, but also the main cause of human death. With the pace of modern life quickening and the increasing of social pressure, the incidence of cerebrovascular disease, especially Stroke has become higher and higher, which seriously endangers human life health. As the commonly used treatment, Acupuncture and Moxibustion is more and more valued and welcome due to its definite effect, cost and convenient operation. However, the approaches of acupuncture treatment for stroke are so numerous, most of which stress their respective features, that lack deep theoretical Investigation and mutual fusion penetration. Many people still constrained by the traditional "six-channel disease location theory", the old etiology and pathogenesis of stroke, think that stroke disease, no matter resulted from endogenous wind or exterior wind, bits in the meridians and collaterals. They divide stroke into meridian involved and viscera involved according to whether there is sane obstacles or not. As a result, the curative effect of acupuncture on stroke disease is inevitably restricted.Along with the progress of modern medicine, especially the development of clinical anatomy, people gradually realize that the real disease location of stroke is brain but meridians and collaterals. The National Emergency Encephalopathy teams of TCM clearly defined stroke as a disease resulted from a variety of reasons made 'blood stasis congesting brain vessel or blood spill over the pulses, which marks that the knowledge of people for stroke's etiology and pathogenesis reached a new height. Since stroke bits in the brain, the disease should be treated from brain. But the brain is one of extraordinary Fu-organs, which has no specific exclusive meridians. So how to treat stroke from brain is a theoretical conundrum before the Acupuncture and Moxibustion sessions. The author had tried to explain the necessity and feasibility of acupuncture treat stroke from brain according to the Four Seas' theory, and observated the treatment on the acute ischemic stroke patients by acupuncturing Four Seas' Shu, such further proved stroke from brain treatment is available.1. Research objectivesTo observe the therapeutic effect of acupuncture Four Seas' Shu on acute ischemic stroke, and compare the changes of some evaluating indicators before and after treatment, such as fibrinogen (FIB), lipoproteins (Lpa), c-reactive protein (Crp) and homocysteine (HCY), thus can verify the feasibility of stroke from brain treatment, and provide a new idea for clinical therapy and diagnosis on ischemic stroke by Chinese medicine.2. Research methods90 patients met clinical diagnosis standard of acute ischemic stroke were divided randomly into A, B and C three groups according to the random digits table. The patients of group A were acupunctured Four Seas' Shu, the group B treated by Resuscitating method and the group C is not acupunctured but just a based medicine control. All cases were gave usual treatment on the basis of western medicine. On that basis, the group A were acupunctured such acupoints as Baihui, Fengfu, Dazhui, Yamen, Renying, Qichong, Zusanli, Dazhu, Shangjuxu, and Xiajuxu. The Fengfu and Yamen points should be inserted slowly 0.5-1 cun toward the mandible, Baihui inserted horizontally 0.5-0.8 cun, Dazhui and Dazhu inserted perpendicularly 0.5 cun, Renying and Qichong inserted 0.5 cun to avoid the blood vessels, and Zusanli, Shangjuxu and Xiajuxu were just inserted directly 1.0-1.5 cun. The patients should feel sour, numb, bloated or heavy sensation while acupuncture, and then performed different strengthening or reducing acupuncture techniques according to the different physicals. Finally the needles except Fengfu, Yamen, Dazhui and Dazhu were retained 30min, and manipulated every 10mins. The group B were acupunctured by the Resuscitating method, which used acupoints as Neiguan, Shuigou, Sanyinjiao, Chize, Jiquan and Weizhong. The Neiguan was used reducing acupuncture techniques, Shuigou handled like sparrow pecking in order to make patients' eyes moist, Sanyinjiao used strengthening techniques, while Jiquan, Chize and Weizhong were manipulated by lifting and thrusting methods, so as to make the limbs move three times. Excerpt for these masterpoints there were other matching acupoints such as Taichong and Taixi with liver yang ascending syndromes, Fenglong and Hegu with obstruction of collateral due to wind-phlegm, Neiting and Fenglong with phlegm with heat and fu organ constipation, Xuehai and Qihai with qi-deficiency and blood-stasis type, Taixi and Fengchi with yin deficiency wind stirring type, according to different TCM syndrome types. The group C was not acupunctured just to be regarded as based medicine control. The treatment was operated once a day, seven days for a course and lasted two courses.Before and after the treatment, clinical nerve function damage degree of all cases was respectively marked, which make curative effect assessed consulting the efficacy standards from the fourth national cerebrovascular disease conference in 1995. The standards include recovery with the marks reduced by 91～100% and invalid degree for 0 level; marked effect with the nerve function defect scale reduce by 46～90% and invalid degree for 1-3 level, common effect with the marks reduced by 18～45%, and no effect with the marks reduced by less than 17%. At the same time, the changes of objective indexes such as fibrinogen (FIB), lipoprotein (Lpa), c-reactive protein (Crp) and homocysteine (HCY) were compared among the three groups. The data collected was processed by SPSS 13.0 statistical software. The measuring data was expressed by mean±standard deviations (x±s), and analyzed by T-test of independent sampler between two groups, ANOVA among three groups and Paired Sample T test when compared itself, and Rank sum test when the data belongs to Categorical variable.3. Research results(1) The general information Of 90 patients exclude the missing,86 cases were collected, including 29 patients with 17 men and 12 women from Four Seas'Shu group, whose ages range from 32 to 77 (60.17±12.66) years old. The Resuscitating group had 27 cases, including 16 male and 11 female, whose ages range from 39 to 76 (61.56±9.42) years old. And the nonacupuncture group had 30 patients, including 14 male and 16 female, whose ages range from 40 to 80 (60.89±10.25). There was no statistically difference in aspects of sex and age of three group cases analyzed by chi-square test and ANOVA(P>0.05).(2) Before the treatment, there were no statistically differences in the neurological defect among the three groups, while the score of each group decreased with obvious degrees, especially for A and B group after the treatment(P<0.05). But there was no statistically difference between the Four Seas' Shu and the Resuscitating group.(3) It displayed that there were 3 cases healed,10 cases marked effective,11 ordinary effective and 5 invalid in the Four Seas' Shu group. The Resuscitating group included 2 cases healed,13 marked effective,8 ordinary effective and 4 invalid. While the nonacupuncture group had 0 cases healed,14marked effective,16 ordinary effective and 10 invalid. There was statistically difference on clinical effect of three groups analyzed by multiple independent sample non-parameter test(P=0.004), and the effects of Four Seas' Shu and the Resuscitating were the same(P'=0.595), which better than the nonacupuncture group(P'<0.0167).(4) On one hand, after treatment all the objective indicators of Four Seas' Shu group, such as fibrinogen (FIB), lipoproteins (Lpa), c-reactive protein (Crp) and homocysteine (HCY), dropped into different levels(P<0.05). The Crp and HCY of the Resuscitating group decreased after treatment while FIB and Lpa didn't changed. The nonacupuncture group had hardly changes except the C-reactive protein (Crp). On the other hand, the Crp of three groups had decreased after treatment, while the Four Seas' Shu and the Resuscitating had more significantly changes than the nonacupuncture group(P<0.05). The declines of Crp and HCY between the Four Seas' Shu and the Resuscitating had no statistically significant(P>0.05).4. Research conclusion(1) The same as Resuscitating method, acupuncture Four Seas' Shu can significantly decreased the neural function defect scale of patients with acute ischemic stroke, which emphasised that the Acupuncture Four Seas' Shu had definite clinical effect on acute ischemic stroke and also effectively reduced the level of risk factors for stroke. The Four Seas' Shu acupuncture had less noxious stimulation and more tolerabilities, which can improve the compliance.(2) Compared with resuscitating method, acupuncturing Four Seas' Shu reduced more comprehensively and efficiently the risk factors of stroke, such as fibrinogen (FIB) and lipoproteins (Lpa), which maybe partly explain the curative effect mechanism of Four Seas' Shu.(3) Due to the number of patients suffered from acute ischemic stroke is small, the conclusions interpretate only the clinical observation data. The observations of hemorrhagic stroke, recovery and sequela period of stroke patients, and the experimental researchs for curative effect mechanism of Four Seas' Shu, need to be furtherly discussed thoroughly. |
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