| Objective:To establish the new stitch to treat the cerebral hemorrhage patients after tracheostomy—"cross electro-nape-acupuncture".To evaluate the effect of cough reflex remodeling of cerebral hemorrhage patients after tracheostomy,swallowing function recovery effect of intubation.According to different puncture depth of guinea pig skull,autologous blood injection is different,the estalishment of basal ganglia hemorrhage after the model of cough reflex disorder in guinea pig.Methods:1.Using randomized,single blind method,we observe the "cross electro-nape-acupuncture" treatment of cerebral hemorrhage after tracheotomy and indwelling gastric tube with 60 cases,were randomly divided into three groups,respectively cross electro-nape-acupuncture group,electro acupuncture group,acupuncture group,20 cases in each group.Scalp acupuncture,body acupuncture,Western medicine of anti-inflammatory,phlegm,nerve nutrition and other basic treatment in the three groups were given the same acupoints.cross electro-nape-acupuncture group:the basic treatment and cross electro-nape-acupuncture which cross the ipsilateral Yifeng connected with the positive electrode and the contralateral Fengchi acupuncture group is connected to the negative;electro acupuncture group:the same side of Yifeng connected with the positive electrode and the same side Fengchi is connected to the negative;acupuncture group only given the same acupuncture with electro acupuncture.The three groups were 30 minutes each time the needle,2 times a day,Saturday,Sunday 1 times daily for 4 weeks.Before and after treatment,the standard swallowing function scale SSA,GFC cough reflex score,Glasgow GCS score and NISS score of neurological impairment score were evaluated.2.According to different anatomical depth of basal ganglia of guinea pigs,the depth of skull puncture was determined,10 SPF guinea pigs,weighing between 285 gram and 315 gram.Sodium pentobarbital(40 mg/kg)was used for abdominal anesthesia,the sudden death of the wound,the skull was cut along the sagittal suture,and the left cerebral hemisphere puncture was taken as an example to observe the relationship between the anatomical depth of basal ganglia and the depth needle penetration:4 mm,5 mm,6 mm,7 mm,8 mm and 9 mm.3.On the basis of the depth of needle penetration,the amount of blood injection was sdudied.According to the difference of the blood volume of femoral artery injection,70 male SPF guinea pigs weighing between 285 gram and 315 gram were randomly divided into 7 groups:Black control group,20?L,30 ?L,40 ?L,50 ?L,60 ?L and 70 ?L.The nonheparinized autologous arterial blood promote the basal ganglia with 20?L/min for 10 min,slowly out of the needle.4.To observe cough reflex,the capsaicin induced cough,testing began second days after modeling basal ganglia hemorrhage,count 10 min in cough frequency detection for 7 days,once a day after modeling for 14 days,21 days and 28 days respectively once,and observe the cough reflex changes.Results:1.Standard swallowing function scale(SSA scale)There was no statistical difference between the three groups before treatment(p>0.05).(1)The three groups were analyzed by analysis of variance,the difference was statistically significant(p<0.05).(2)Comparison of cross electro-nape-acupuncture group before and after treatment by paired t test,the difference was statistically significant(p<0.05),acupuncture group compared with before treatment,the paired t test,the difference was statistically significant(p<0.05).(3)The three groups were analyzed by analysis of variance,the difference was statistically significant(p<0.05).2.GFC cough reflex score(GFC score)in patients with tracheostomy(1)There was no statistical difference between the three groups before treatment(p>0.05).After treatment,GFC scores were reduced,the three groups were analyzed by variance analysis,there was a significant difference(p<0.05).cross electro-nape-acupuncture group compared with before treatment,the paired t test,the difference was statistically significant(p<0.05).(2)Of the three groups by X2 test,the recovery rate of cross electro-nape-acupuncture group was 90 percent,the recovery rate of electro acupuncture group was 50 percent,the recovery rate of cross acupuncture group was 40 percent,the difference was statistically significent(p<0.05).3.Glasgow consciousness impairment score(GCS score)(1)The three groups before treatment by variance analysis,no significant difference(p>0.05),after treatment,GFC scores were increased,the three groups were analyzed by variance analysis,there was a significant difference(p<0.05).(2)The comparison of cross electro-nape-acupuncture group before and after treatment by paired t test,the difference was statistically significant(p<0.05),acupuncture group before and after treatment by paired t test,the difference was statistically significant(p<0.05).(3)The treatment of electro acupuncture group and acupuncture group compared with the two sample t test,there was no statistically significant difference(p>0.05).4.Neurological dedicit score(NISS score)(1)The three groups before treatment by variance analysis,no significant difference(p>0.05),after treatment,GFC scores were increased,the three groups were analyzed by variance analysis,there was no significant difference(p>0.05).(2)The comparison of cross electro-nape-acupuncture group before and after treatment by paired t test,the difference was statistically significant(p<0.05),acupuncture group before and after treatment by paired t test,the difference was statistically significant(p<0.05).5.The penetration depth and the volume of injection in guinea pig model of basal ganglia hemorrhage.The depth of needle insertion in 5 mm-6 mm was just in the basal ganglia area,which was consistent with the requirement of modeling.When the injection volume was 50 ?L,the degree of cough reflex was not significantly difference(p>0.05).Conclusion:1.Cross electro-nape-acupuncture was established to effectively treat the patients after cerebral hemorrhage,i.e.Ipsilateral Yifeng connected with the positive electrode and the contralateral Fengchi connecting the negative elctrode.2.Cross electro-nape-acupuncture can effectively promote the recovery of swallowing function;3.Cross electro-nape-acupuncture can effectively promote the recovery of cough reflex in patients with cerebral hemorrhage after tracheotomy;4.Cross electro-nape-acupuncture can effectively improve the level of consciousness;5.Cross electro-nape-acupuncture can effectively improve the neurological deficit symptoms;6.The depth of needle penetration in the model of cough reflex disorder after basal ganglia hemorrhage was 5.5 mm,and the injection volume should be 50 ?L. |
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