Study On Acupuncture To Improve The Safety Of Thrombolytic Therapy For Cerebral Infarction By Promoting Angiogenesis

Objective:On the basis of observing the effect of acupuncture on improving the safety of thrombolysis in cerebral infarction,the mechanism of promoting angiogenesis in order to improve the safety of thrombolysis in cerebral infarction was discussed.Methods:Experiment 1:Ninty SD rats were randomly divided into sham group,model group,thrombolysis group(4.5h,6h),acupuncture+thrombolysis group(4.5h,6h),Fifteen rats in each group.Modified autologous thrombus method was used to make the rat model of cerebral infarction.In the thrombolysis group,rt-PA(10mg/kg)was injected into the tail vein at the corresponding time point.In the acupuncture+thrombolysis group,the rats were treated with acupuncture at Neiguan(both sides)and Shuigou at 2 hours after modeling(retain for 30 minutes),and then thrombolysis was performed at the corresponding time point.Cerebral blood flow(CBF)was monitored during modeling in each group,and neurobehavioral scores were scored according to Bederson method at 2 hours and 24 hours after modeling.24 hours after modeling,the rats were killed and sampled.To observe the effect of acupuncture intervention on neurobehavioral score,cerebral infarction volume,cerebral edema and thrombolytic hemorrhagic transformation of rats in each group,and to clarify the effect of acupuncture on improving the safety of thrombolysis in rats with cerebral infarction.Experiment 2:Forty-eight SD rats were randomly divided into sham group,model group,6h thrombolysis group and acupuncture+6h thrombolysis group,Twelve rats in each group.The modeling is the same as experiment 1.The expressions of VEGF,bFGF,ES protein and mRNA in the cortex of rats in each group were detected by Westernblot and Real-timePCR to clarify the mechanism of acupuncture promoting angiogenesis to improve the safety of thrombolysis in cerebral infarction.Results:(1)Comparison of neurobehavioral scores of rats in each group:The neurological function scores of the other groups were higher than those of the sham group.(P<0.01),and decreased in 4.5h thrombolysis group,4.5h acupuncture+4.5h thrombolysis group and 6h acupuncture+thrombolysis group compared with the model group(P<0.01).Compared with 4.5h thrombolysis group,there was no improvement in acupuncture+4.5h thrombolysis group(P>0.05).The neurological function in the thrombolysis group at 6 hours after acupuncture intervention was significantly better than that in the thrombolysis group at 6 hours after acupuncture intervention(P<0.05).It is suggested that early acupuncture can improve the nerve injury of thrombolytic rats outside the time window.(2)Comparison of cerebral infarction volume of rats in each group:The cerebral infarction volume in the model group was increased compared with the sham group(P<0.01),the cerebral infarction volume in the 4.5h thrombolysis group,acupuncture+4.5h thrombolysis group were decreased compared with the model group(P<0.01),as same as acupuncture+6h thrombolysis group(P<0.05).Compared with 4.5h thrombolysis group,there was no improvement in acupuncture+4.5h thrombolysis group(P>0.05).Compared with the 6h thrombolysis group,the acupuncture+6h thrombolysis group was significantly smaller(P<0.05).It is suggested that early acupuncture can reduce the cerebral infarction volume of thrombolytic rats outside the time window.(3)Comparison of brain water content in each group:The brain water content in the model group was higher than the sham one.Compared with the model group,it is decreased in the 4.5h thrombolysis group(P<0.05),decreased in the acupuncture+4.5h thrombolysis group(P<0.01),and increased in the 6h thrombolysis group(P<0.01).Compared with 4.5h thrombolysis group,there was no improvement in acupuncture+4.5h thrombolysis group(P>0.05).Compared with the 6h thrombolysis group,the brain water content in the acupuncture+6h thrombolysis group was significantly lower than that in the 6h thrombolysis group(P<0.01).It is suggested that early acupuncture can reduce the degree of brain edema in thrombolytic rats outside the time window.(4)Comparison of cerebral hemorrhagic transformation in each group:Compared with the model group,the hemoglobin content of brain tissue in 4.5h thrombolysis group and 6h thrombolysis group increased(P<0.01),and compared with 4.5h thrombolysis group,there was no improvement in acupuncture+4.5h thrombolysis group(P>0.05).Compared with 6h thrombolysis group,the content of hemoglobin in ischemic brain tissue in acupuncture+6h thrombolysis group decreased(P<0.01).It is suggested that acupuncture can significantly reduce the cerebral hemorrhagic transformation of thrombolytic rats outside the time window.(5)Comparison of protein expression of VEGF,bFGF and ES in cerebral cortex of each group:Compared with the sham group,all the protein expression levels of the model group were increased.In the acupuncture+6h thrombolysis group the expression of VEGF and bFGF were significantly higher than those in the model group and 6h thrombolysis group(P<0.01),while the ES expression decreased significantly(P<0.01).It is suggested that early acupuncture intervention can significantly increase the expression level of VEGF and bFGF in cerebral cortex of thrombolytic rats outside the time window,reduce the expression level of ES,and play a role in promoting angiogenesis.(6)Comparison of the expression of VEGF,bFGF and ESmRNA in cerebral cortex of rats in each group:Compared with the sham group,the expression of VEGF and ES in the model group increased(P<0.05),and there was no difference between the 6h thrombolysis group and the model group(P>0.05).Compared with the 6h thrombolysis group,the expression of VEGF and bFGF in the acupuncture+6h thrombolysis group increased(P<0.01),the expression of ES decreased(P<0.01).It is suggested that early acupuncture intervention can increase the mRNA expression level of VEGF and bFGF and decrease the mRNA expression level of ES in the cerebral cortex of thrombolytic rats outside the time window,which has a positive regulatory effect on angiogenesis.Conclusion:(1)Early acupuncture intervention can reduce the complications such as brain edema and hemorrhagic transformation after thrombolytic therapy of cerebral infarction,and improve the safety of thrombolytic therapy outside the time window.(2)Acupuncture can up-regulate the protein and mRNA expression of VEGF and bFGF and down-regulate the expression of Endostatin protein and mRNA in ischemic brain tissue of thrombolytic rats with cerebral infarction,suggesting that acupuncture can improve the safety of thrombolysis in cerebral infarction by promoting angiogenesis.