Clinical Study On The Effect Of Acupuncture Preconditioning On Cerebral Blood Flow In Patients With High Risk Of Ischemic Stroke

1 ObjectiveBy comparing different influence on the cerebral blood flow in patients with transient ischemic attack / ischemic stroke,who are taking acupuncture therapy of dredging governor vessel for regulating mentality pretreatment and conventional drug treatment separately,to explore the optimized scheme to reduce the rate that patients with high risk of ischemic stroke worsen to a dangerous level.2 Methods60 patients with TIA/MIS who satisfied the choosing condition were divided into acupuncture group(30 cases)and drug group(30 cases)randomly.Both the two groups took traditional medicine therapy.In addition,patients in acupuncture group took acupuncture therapy of dredging governor vessel for regulating mentality pretreatment with the main points: Yaoyangguan,Mingmen,Zhiyang,Shendao,Shenzhu,Dazhui,Yamen,Fengfu,Baihui,Jingjiaji.The acupuncture treatment were taken once daily.Meanwhile,patients in medicine group were given 30 mg of nimodipine three times daily.Both two groups' treatment kept uninterrupted and 4 weeks was a period of treatment.TCM syndrome scores of two groups were observed before and after a period of treatment.ASL technology was used to observe the change of blood flow of two groups before and after one period treatment,treatment for a period of treatment back.Qualitative and quantitative statistical analysis of cerebral blood flow were done respectively.The records of two groups' clinical end point event(stroke or death)after 6 months' treatment were followed.3 Results 3.1 TCM syndrome scoreAfter a period of treatment,each group's TCM syndrome score,when compared with before,decreased significantly(P < 0.01).It indicated that both two groups which were treated by acupuncture and medicine got observable curative effect.After acupuncture group's and drug group's treatment,the change of their TCM syndrome score was quite similar(P > 0.05),which suggested that the difference between two methods of treatment's improving patients' syndrome was not obvious and that they had similar curative effect.3.2 The qualitative comparison of ASL resultsAfter a period of treatment,acupuncture group had 23 cases converted to normal perfusion,with drug group 24 cases,in which there was no significant statistical difference(P > 0.05).It illustrated that acupuncture therapy of dredging governor vessel for regulating mentality could obviously improve the cerebral blood flow of TIA/MIS' brain tissue hypoperfusion area,and had no obvious difference with oral nimodipine in curative effect.3.3 ASL-rCBF valueAfter a period of treatment,each group's ASL-rCBF value,when compared with before,had statistically significant difference(P < 0.01),which suggested that both two methods could improve cerebral blood flow in patients with low perfusion.After acupuncture group's and drug group's treatment,the change of their ASL-rCBF value was quite similar(P > 0.05),which suggested that the difference between two methods of treatment's improving patients' syndrome was not obvious.3.4 Clinical curative effectAfter a period of treatment,acupuncture group's total effective rate was 86.7% and that of drug group was 90.0%.There was no statistically significant difference(P > 0.05).It indicated there was no big difference in curative effect between acupuncture and drug treatment.3.5 Ratio of end point eventAfter treatment,the two groups were followed-up 6 months later to record end event(stroke or death).There were 3 patients getting stroke in acupuncture group and 2 patients getting stroke in drug group.There were no patients dead in two groups.There was no statistically significant difference(P > 0.05)in the ratio of end point event between the two groups.It indicated that acupuncture and drug therapy had similar effects on the prognosis of patients with TIA/MIS.4 Conclusion 4.1 Acupuncture therapy of dredging governor vessel for regulating mentality pretreatment could effectively reduce the TCM syndrome score of patients with high risk of ischemic stroke and its clinical curative effect was positive.When compared with nimodipine treatment,the curative effect was about the same.4.2 Acupuncture therapy of dredging governor vessel for regulating mentality pretreatment could effectively improve the cerebral blood flow of brain tissue hypoperfusion area of patients with high risk of ischemic stroke.When compared with nimodipine treatment,the degree of improvement was about the same.4.3 Acupuncture therapy of dredging governor vessel for regulating mentality pretreatment had similar ratio of intervening in end point event with nimodipine treatment.It could be used as secondary prevention of ischemic stroke.4.4 Acupuncture therapy of dredging governor vessel for regulating mentality pretreatment was an effective method to lower the ratio of patients at high risk of ischemic stroke worsening to a dangerous level.The mechanism might be that it could effectively improve the cerebral blood flow of brain tissue hypoperfusion area of patients with high risk of ischemic stroke.