Effect Of Electroacupuncture On Motor Function In Acute Infarction Patients By Triple Stimulation Technique

BackgroundCerebral Vascular Disease(CVD), presently one of the three leading causes of death, has become the first reason of disability and death on urban and rural population in China, and the incidence of this disease is increasing annually. In our country there are about 7 million CVD patients (more than 70 percent for ischemic strokes), which seriously impacts on the life quality of people. Limb motor dyfunction, dysphagia, aphasia of CVD patients are therapeutically difficulty, that increases socioeconomy burden and places mental,economic pressure on the family. Electroacupuncture has been regarded as an effective therapy for Acute Cerebral Infarction(ACI);it can significantly improve the clinical symptoms and promote motor functional recovery, But the mechanism is not clear yet. Evaluation of motor function by scale have certain subjectivity and easily occur windage. Triple stimulating technique (TST), which can be used to objectively and quantitatively analysis the early part transmission dysfunction of corticospinal tract,makes direct quantitative evaluation motor neuron loss to be possible. Recent studies show that quantitative detection cortical spinal cord transmission is possible in ACI period, and TST can be considered as an accurate and objective quantitative index in evaluation of motor function and follow-up study ACI patients. At present, there are very few researches on objective and quantitative evaluation of ectroacupuncture on motor function in ACI Patients. Therefore, it will has an important significance to discuss the action mechanism of promoting motor function recovery in treating ACI patients with electroacupuncture from the Angle of cortical spinal cord transmission. ObjectiveUsing TST to assess effect of Electroacupuncture on motor function in ACI Patients objectively and quantitatively.Methods ①61 cases of ACI patients attacked within 72 hours, admitted to the Foshan Hospital of TCM from June 2010 to March 2011, confirmed by CT or MRI, were randomly divided into treatment group(31 cases) and control group(30 cases), gather baseline data;②Before treatment and after 14-day, the neurology grade in two groups were separately evaluated with the method of NIH Stroke scale(NIHSS),Barthel index(BI) and Fugl-Meyer motor function scale(F-M);③Before treatment and after 14-day, the TSTtest in two groups were respectively detected, meanwhile choose 20 healthy cases for reference to contrast;④To assess clinical curative effect of treating the ACI patients with electroacupunctue;⑤Before treatment and after 14-day, to analyze the correlation of TSTtses and NIHSS, BI and F-M.Results①Before treatment, there were no statistical difference between treatment group and control group in NIHSS,BI and F-M(*t=-0.277, @t=0.506, #t=0.531,*P=0.782, @P=0.615,*P=0.597);after 14-day, the NIHSS of the treatment group was significantly lower than the control group (*t=-2.344,*P=0.022<0.05), but higher in BI and F-M(@t=2.530,#t=2.099, @P=0.015, #P=0.040).②For the difference of the scale betwen before treatment and after 14-day, there were significant difference between treatment group and control group in NIHSS, BI and F-M (*t=-2.881,@t=2.738,#t=2.479,*P=0.006,@P=0.008, #P=0.016);③Before treatment, ACI patients'TSTtest was significantly higher than healthy people (t=3.546, P=0.007<0.05); there is no significant difference between two groups in TSTtest (t=-0.174, P=0.863> 0.05); but after 14-day, the treatment group's TSTtest is lower than the control group (t=-2.042, P=0.046<0.05);④For the difference of the TSTtest betwen before treatment and after 14-day, there is significant difference between two groups (t=-3.705, P=0.000<0.05);⑤There were significant differences on excellence rate and total effective rate between two groups (*X2=3.92,@X2=5.72,*P=0.047,@P=0.016);⑥Before treatment, TSTtest was positively correlated with NIHSS (r=0.646,P=0.000<0.05); while TSTtest were respectively negatively correlated with BI and F-M (@r=-0.680,#r=-0.770, @P=0.000,#P=0.000);⑦After 14-day, there was no correlation between TSTtest and NIHSS(*r=0.191,*P=0.141＞0.05); while TSTtest were still respectively negatively correlated with BI and F-M (@r=-0.672,#r=-0.725, @P=0.000,#P=0.000);⑧Before treatment and after 14-day, there is no significant difference between tow groups in safety indexes (ALT, Scr), (P>0.05)Conclusions①Electroacupuncture can relieve brain tissue damage and promote the recovery of neurological function after ACI;its mechanism may be to improve the transmission of corticospinal tract function.②TST is an effective method to objectively assess the motor function in ACI patients treated with electroacupuncture;it can quantitatively analyze the damage and repair level of corticospinal tract.③TSTtest can assess motor function and the prognosis in patients with brain injuried, so it is very important to determine the damage of motor nerve and may have broad application prospects.