急性脑出血家兔针刺即刻效应的PWI和MRS研究

目的:探讨针刺对脑出血家兔脑组织血流动力学和神经物质代谢的即刻效应。方法:20只新西兰兔随机分为模型组和针刺组,每组10例。自体血二次注血法复制急性脑出血模型。针刺组造模成功后进行头针治疗(位置相当于人体"百会"透"太阳"穴)。两组分别在造模前、造模后即刻和针刺后即刻通过磁共振波谱分析(MRS)和磁共振灌注加权成像(PWI)观察N-乙酰基天门冬氨酸(NAA)、平均通过时间(MTT)、相对脑血容量(rCBV)和相对脑血流量(rCBF)的变化。结果:与本组造模前比较,造模后两组血肿周围脑组织NAA/肌酸(Cr)降低,MTT延长,rCBV和rCBF降低(P0.05),两组间同期比较差异无统计学意义。疗后针刺组MTT缩短(P0.05),rCBV和rCBF回升,且与模型组同期比较差异显著(P0.05),而NAA/Cr无显著变化。结论:头穴透刺法对改善急性脑出血局部脑组织血流动力学改变具有显著的即刻效应,这可能是针刺对脑出血即刻效应产生的机制之一。

Instant effect of acupuncture to acute intracerebral hemorrhage rabbits studied by PWI and MRS

Objective: To observe the regularity for immediate change of hemodynamics and neural material metabolism on brain tissues of intracerebral hemorrhage rabbit after acupuncture treatment,exploring the mechanism of the instant effects of acupuncture.Methods: A total of 20 New Zealand rabbits were randomly divided into model group and acupuncture group,with 10 cases in each group.Self-arterial injection method had been used to copy the ICH rabbit model.After the ICH rabbit model was successfully established,the acupuncture group was treated on scalp acupoint of hemorrhage side,equivalent to Baihui(GV20) through Taiyang(EX-HN5) in human body.Quantitative analysis of 1H-MRS(Magnetic Resonance Spectroscopy) and PWI(Perfusion Weigted Imaging) were used to observe the MTT,rCBV,rCBF and content of NAA and Cr in perihematoma tissues before,instantly and 1 hour after ICH model was successfully established.Results: After the ICH model was established,NAA/Cr level decreased markedly,MTT extended,and rCBV and rCBF reduced significantly(P<0.05) in both groups,and there was no difference between them.After acupuncture therapy,MTT shortened,and rCBV and rCBF increased(P<0.05),with no significant change in NAA/Cr.No obvious change in all those indexes for model group,whose MTT,rCBV and rCBF had statistically significant difference compared with acupuncture group(P<0.05).Conclusion: Point-through-point scalp acupunture method has instant effect on ICH by improving hemodynamic changes of the brain,and it probably could be one important mechanism of acupuncture’s instant effect on ICH.