Clinical Observation And Dynamic Changes Of Neuron Apoptosis In Hippocampus Of Epileptic Rats Treated By The Acupoint Catgut Embedding Therapy

Epilepsy is very common in nervous system diseases.The seizure is so suddenly and complicatedly that make the disease a long course and hard to cure.It brings the patients much pressure on their lives,study and work,and often proves to be a tax upon the society.Early diagnosis and early treatment are very important to epilepsy.A successful treatment is based on controlling the seizure and reducing the frequency.Though the mechanism of epilepsy hasn't been totally confirmed,the using of anti-epilepsy drugs(AEDs)has obtained a lot of effects.But the routine and new AEDs still cannot entirely control all kinds of the seizure,also have many serious side-effects.It makes the patients suffer from the complications after the seizure.Since the other non-drug treatments are still under studying, and they all are very expensive,it' s very hard to promote now.The advantage of acupuncture treatment to epilepsy includes simplicity,with few side-effects.It coordinates the function of yinyang and tranquilizes by dredging the vital energy and blood,calming wind-syndrome and frightening, waking up the patient from unconsciousness.Acupoint catgut embedding therapy treats disease by utilizing persistence stimulating of the catgut to the acupoint.The therapy is efficient,safe,simple and cheap.Clinical Observation:Objective:To observe the effect of the acupoint catgut embedding therapy on epilepsy,study the effect on the quality of life(QOL).Method:60 patients were randomly divided into 2 groups:ACET(acupoint catgut embedding therapy)group and control group,30 patients in each group.Patients in ACET-group were treated by embedding a 1ml long #3-0 catgut into the acupoints,which was prescribed and combined as:A.DU14,DUB,ST40;B.BL15, BL18,GB34;C.BL15,BL18,LI14.The main point formula-A/B/C was used by turns, with an auxiliary point each time.They were treated once in 2 weeks,lasting for 3 months.The control group was treated by valproic acid(VPA),15mg/ (kg·d),p.o.The treatment also lasted for 3 months.Result:1.Total effect:Comparing with pretreatment,the general effective rate of the ACET-group being 76.7%,and the control group being 86.7%.This trial showed both treatment to be effective and there was no statistically significant difference between them in their effect(P=0.16＞0.05).2.Effect on the symptoms:Comparing with pretreatment,the symptomatic improvement of both groups were significantly obtained(P＜0.01)and there was no statistically significant difference between them in their effect (P=0.60＞0.05).3.Frequency of the seizure:3 months,half year and 1 year after the treatment, comparing with pretreatment,the seizure frequency of both group were significantly reduced.There was no statistically significant difference between them in their effect after 3 months or half year,but the statistical comparison after 1 year was significant.4.Improvement of QOL:3 months,half year and 1 year after the treatment, comparing with pretreatment,QOL improvement of ACET-group were significantly obtained.QOL of control group didn't improve after 3 months,since the improvement were significantly obtained after half year and 1 year.And at the time 3 months,half year and 1 year after the treatment,QOL improvement of ACET-group were significantly superior to control group.Conclusion:The effect of AECT and AEDs is similar on the total effect, including the effect on the epileptic symptoms,frequency of the seizure.the But AECT is significantly superior to AEDs on the improvement of QOL.Experimental Research:Objective:To investigate the dynamic changes of the neuron apoptosis and correlative genes in hippocampus of kindling epileptic rats treated by the catgut embedding therapy on epilepsy. Method:104 male SD rats are randomly divided into sham operation group,5 model groups(1d,4d,7d,10d,14d),5 ACET-groups(1d,4d,7d,10d,14d)and 2 twice-ACET-groups(10d,14d),8 rats in each group.Rats of model groups, ACET-groups and twice-ACET-groups were made the electric kindling epilepsy model,while sham operation group was received the implantation of the bipolar electrode only.ACET-groups and twice-ACET-groups were treated by ACET just after the kindling at DU14,BL15,BL17.twice-ACET-groups were treated again after 7 days.Common condition of the rats was observed.Rats of 1d-groups, 4d-groups,7d-groups,10d-groups and 14d-groups were killed respectively 1 day,4 days,7 days,10 days,14 days after the kindling and made the hippocampus sections.In all cases,the apoptosis,expression of P⁵³,Bax and Bcl-2 were detected by terminal dUTP-mediated nick end labeling(TUNEL)and immunohistochemistry.Result:1.Observed the dynamic changes of the common condition of the rats,it suggested that ACET can help the kindling model rats to get well,the effect was significant after 7 days.To treat again after 7 days can also enhance the effect.2.The dynamic changes of the the neuron apoptosis and correlative genes in hippocampus of model groups suggested that the neurons in contralateral hippocampus commenced apoptosis by the promotion of p⁵³in 4 days after kindling, then during 4 to 14 days,the apoptosis was inhibited by the coordination of Bcl-2 and Bax.3.The dynamic changes of the the neuron apoptosis and correlative genes in hippocampus of ACET-groups and twice-ACET-groups suggested that ACET can slower the apoptosis by inhibiting p⁵³and prolong the ascending period of p⁵³ in 4 days after the seizure,this effect would weaken after 4 days.ACET may inhibit the descending of Bax,prolong its descending period and then promote its expression,in order to weaken the inhibition of the apoptosis during 4 to 10 days after seizure and then promote the apoptosis during 10 to 14 days after.This effect of ACET can be enhanced after treating again within 7 to 14 days later.ACET had no significant effect on expression of Bcl-2 in hippocampus of the kindling model rats.Conclusion:1.the neurons in contralateral hippocampus of the kindling model rats commenced apoptosis by the promotion of p⁵³in 4 days after kindling,then during 4 to 14 days,the apoptosis was inhibited by the coordination of Bcl-2 and Bax.Neuron apoptosis early after the seizure will due to the decreasing of QOL and the interfering with the recovering.7 days after the seizure,the neuron apoptosis inhibited,so the encroached neuron bequeathed to become the cause of next seizure.In this way a vicious circle is set up which it is difficult to break.The seizure will occur frequently,the symptoms get worse, the QOL will decrease and decrease.2.ACET can slower the apoptosis by inhibiting p⁵³and prolong the ascending period of p⁵³in 4 days after the seizure.It helps to protect the neurons, avoid the losing of neurons,and improve the symptoms.3.ACET inhibit the descending of Bax,prolong its descending period andthen promote its expression,in order to weaken the inhibition of the apoptosis during 4 to 10 days after seizure and then promote the apoptosis during 10 to 14 days after.These effects may lead to the apoptosis of the encroached neuron,and set up a fine circle to reduce the seizure,decrease the frequency, improve the QOL finally.4.This effect of ACET can be enhanced after treating again within 7 to 14 days later.It follows that we should treat by ACET clinically once in 1 to 2 weeks.