| Objective:1. Observe the collection of Jin three needle therapy rehabilitation exercise training, and for different periods of ischemic stroke in clinical outcomes, comparative early intervention to the effect of stroke treatment and late effects of treatment, come to acupuncture and rehabilitation training for interventional stroke therapy The best time for clinical evidence-based basis.2. Effect of acupuncture and rehabilitation MACO neurological score, and brain tissue level of apoptosis, growth factor GAP-43expression, compared to the acute and convalescent, the efficacy of acupuncture and rehabilitation of sequelae of difference for early clinical into the stroke treatment is to provide experimental basisMethods:1.90stroke patients were selected and divided into the early treatment group, the medium-term treatment group, late treatment group, according to their duration of, respectively, by acupuncture and rehabilitation training, each group of30cases, the treatment time is4weeks. Respectively, before treatment, treatment for14days,28days of treatment to be NIHSS score, the FUM score, Barthel score, and FIm ratings. After treatment, the various ratings to compare the control group and groups2. Select adaptive feeding of70male SD rats were randomly divided into blank group. Model group,3hours12hours of the treatment group, treatment group,24-hour treatment group, in addition to the blank group was treated with suture method to copy the MACO model. Model, respectively, after the success of in3hours,12hours,24hours by acupuncture and rehabilitation training, pre-treatment, treatment for7days,14days of treatment to be neurological score, treatment of rats in each group14days after perfusion the brain was conducted immunohistochemical method to detect apoptotic cells and GAP-43expression, and to be the data groups and the control groupResults:Clinical trials1. Acupuncture combined with rehabilitation training can effectively improve the neurological function of patients with stroke damage, and promote the recovery of neurological function in patients, acupuncture and rehabilitation training, early intervention for stroke treatment, better able to improve the patient's neurological function score, the more medium-term significant differences with the late group (P<0.05)2. Acupuncture combined with rehabilitation training can effectively improve the activities of daily living for stroke patients, acupuncture and rehabilitation training, early intervention for stroke treatment, better able to improve patients' Barthel score, significant difference compared with the mid-and late group (P<0.05)3. Improve patient function, the efficacy of the early group compared with the other two groups was statistically significant (P<0.05), although the efficacy of the mid-group and late group no statistically significant difference (P>0.05), but from the ratings trend map we can see that the mid-group to improve fasterAnimal experiments:1. Compared with the sham operation group, model group, penumbra apoptotic cells was significantly increased (P<0.05); Compared with model group treatment group can significantly reduce the penumbra, the number of apoptotic cells (P<0.05);12,24-hour treatment group compared with3hours of treatment group significantly reduce the penumbra, the number of apoptotic cells (P<0.05);12,24-hour treatment group on the penumbra between the impact of the number of apoptotic cells did not group difference (P>0.05)2. In this study, observed the cerebral ischemic penumbra surrounding tissue of GAP-43in3hours of treatment group was significantly increased while12hours and24hours group compared with model group, GAP-43expression tended to increase, but lower than3hours group there are still significant differences, indicating that acupuncture and rehabilitation early intervention treatment of ischemic stroke can be extended to the ischemic area penumbra of GAP-43expression, their symptoms improved, post-rehabilitation has a significant helpConclusions:1. Clinical studies have shown that acupuncture combined with rehabilitation therapy are effective for various periods of the stroke patients, but symptom improvement, quality of life improvement, limb motor function recovery and long-term efficacy of view, early in stroke patients be acupuncture and rehabilitation of patients more help than the recovery period, the sequelae of the patients, acupuncture rehabilitation are better able to improve patients' quality of life of patients with acute or subacute period to be deposited into the recovery of limb function in patients with right better long-term effects2. Experimental studies have shown that acupuncture and rehabilitation therapy can inhibit the degree of stroke ischemic area penumbra, apoptosis, and can effectively promote rat growth associated protein GAP-43expression, and promote the repair and regeneration of neurons. Compared to12hours and24hours group, three hours of group treatment in the improvement of neurological score, for the inhibition of the apoptotic cells, the expression of GAP-43is better than the first two groups, indicating an early stage of stroke in rats needle rehabilitation treatment is superior to the other two groups, and also provide an experimental basis for clinical acupuncture rehabilitation early intervention for stroke treatment... |
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