Forty-six Cases of Acute Cerebral Infarction Treated with the Combined Use of Acupuncture and Drugs

Objective: To observe the clinical therapeutic effects of treatment for acute cerebral infarction with the combined use of acupuncture and drugs, and study the therapeutic mechanism. Methods: 88 cases of acute cerebral infarction were divided randomly into two groups, a treatment group of 46 cases treated with acupuncture, Danshen Zhushe Ye (丹参注射液 Saliva Injection) and routine western drugs and a control group of 42 cases treated simply with drugs. The therapeutic effects were evaluated based on the evaluation criteria for damage of the nerve function. Observation was also made on changes in the skull CT images, and in the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-px), and nitric oxide synthase (NOS) in serums, and levels of malondialdehyde (MDA) and nitric oxide (NO) in serums. Results: After treatment for 15 days, the total effective rate of the treatment group reached 80.43%, while that of the control group was 61.90%, showing significant differences. The effective rate shown by the skull CT images of the treatment group was 51.61%, while that of the control group was 45.16%, showing no significant differences. But as compared with the control group, the activities of SOD and GSH-px in serums were significantly enhanced, and the levels of MDA and NO, and activity of NOS in serums were significantly decreased in the treatment group. Conclusion: The prompt acupuncture treatment of acute cerebral infarction can markedly raise the clinical therapeutic effects, improve the activity of SOD and GSH-px in serums, lower down the level of MDA in serum, and markedly decrease NO level and NOS activity in serums.     

Clinical Observation on Influence of Chinese Medicines for Promoting Blood Circulation to Remove Blood Stasis on FIB and DD in Plasma of Patients with Cerebral Thrombosis

to study the influence of Chinese medicines for promoting blood circulation to removeblood stasis on fibrinogen(FIB)and D-dimer(DD)in plasma of patients with cerebral thrombosis.Method:73 inpatients with acute cerebral thrombosis were randomly divided into a control group of34 cases and a treatment group of 39 cases.The content of FIB and DD in plasma was detectedbefore treatment and on the 7th and 14th days after treatment.Result:FIB content in plasma aftertreatment was lower than that before treatment in the control group(P<0.01)and more remarkablein the treatment group(P<0.001).There was an obvious difference in DD content before and aftertreatment in both groups.DD content on the 7th and 14th days after treatment in the treatmentgroup was obviously higher than that in the control group(P<0.01 and P<0.05 respectively).Conclusion:Chinese medicines for promoting blood circulation to remove blood stasis can reducethe FIB content in plasma of patients with cerebral thrombosis,raise the DD content in plasma,cause the peak of DD content appear earlier and obviously improve hypercoagulability of blood inpatients with cerebral thrombosis.     

Effect of Electro-acupuncture on Vasomotor Symptoms in Rats with Acute Cerebral Infarction Based on Phosphatidylinositol System

Objective:To investigate the effect of electro-acupuncture(EA)on vasomotor symptoms in rats with acute cerebral infarction,by observing the changes in the expression of factors related to the phosphatidylinositol(PI)system.Methods:Forty-two Wistar rats were randomly divided into 3 groups by a random number table:the control group(n=6),the model group(n=18)and the EA group(n=18).The EA group was given EA treatment at Shuigou(GV 26)instantly after modeling with middle cerebral artery occlusion(MCAO)method,while the model and control groups were not given any treatment.The degrees of neurological deficiency were evaluated using neurological severity scores(NSS)and the brain blood flow was evaluated by a laser scanning confocal microscope.Western blot analysis was conducted to detect the expression levels of G-protein subtype(Gq)and calmodulin(CaM).Competition for protein binding was conducted to detect the expression level of inositol triphosphate(IP3).Thin layer quantitative analysis was conducted to detect the expression level of diacylglycerol(DAG).The expression level of intracellular concentration of free calcium ion([Ca²⁺]i)was detected by flow cytometry.Results:The NSS of the model group was significantly higher than the control group at 3 and 6 h after MCAO(P<0.01),while the EA group was significantly lower than the model group at 6 h(P<0.01).The cerebral blood flow in the model group was significantly lower than the control group at 1,3 and 6 h after MCAO(P<0.01),while for the EA group it was remarkably higher than the model group at the same time points(P<0.01).The expressions of Gq,CaM,IP3,DAG and[Ca²⁺]i in the model group were significantly higher than the control group(P<0.05 or P<0.01),and those in the EA group were significantly lower than the model group at the same time points(P<0.05 or P<0.01).Conclusion:EA treatment at GV 26 can effectively decrease the over-expression of related factors of PI system in rats with acute cerebral infarction,improve cerebral autonomy movement,and alleviate cerebral vascular spasm.     

Effect of warming moxibustion on Shenque acupoint for the treatment of acute diarrhea in children with infantile cerebral palsy

Objective:To observe the effect of warming moxibustion on Shenque acupoint(RN8) for the treatment of acute diarrhea in children with infantile cerebral palsy(ICP).Methods:Clinical observation was performed on 60 ICP children suffering from acute diarrhea,who were randomly assigned to two groups equally.The Mox group was treated with warming moxibustion on Shenque acupoint(RN8) and the control group treated with Smecta.The efficacy was evaluated by markedly effective rate and total effective rate after a ...     

The Effect of Acupuncture on Plasma Endothelin Content in Cerebral Infarction Patients——A Clinical Study

Objective: To observe the effect of acupuncture on content of plasma endothelin in cerebral infarction patients. Methods: The plasma endothelin content in cerebral infarction patients was observed before and after acupuncture, which was compared with that of the medication group and the healthy subjects. Results: Before treatment, the content of plasma endothelin in cerebral infarction patients was significantly higher than that of the healthy subjects (P<0.01); after acupuncture treatment, the content greatly decreased (P<0.01), and there was a statistically significant difference between the acupuncture group and the medication group (P<0.05). Conclusion: Acupuncture may decrease the content of plasma endothelin in the cerebral infarction patients, improve the vascular elasticity, and improve the cerebral circulation of blood.     

Therapeutic Effects of Tongxinluo Capsule(通心络胶囊) on Patients with Acute Small Cerebral Infarction and Its Influence on SPECT Brain Perfusion Image

Objective: To investigate the influence of Tongxinluo capsule (TXL, 通心络胶囊) on regional cerebral blood flow (rCBF) with 99mTc-ECD single photon emission computed tomography ( SPECT) brain perfusion imaging, and to observe the therapeutic effects of TXL on acute small cerebral infarction (ASCI).Methods: Thirty-four patients with ASCI were enrolled and randomly divided into two groups: the control group ( n = 17) was treated with the conventional treatment, i.e. 1.0g of Citicoline added into 300 mi normal saline for intravenous dripping daily for 2 weeks and 0.8 g of Piracetam taken three times a day orally for 4 weeks, and the treatment group ( n = 17)was treated additionally with 4 TXL capsules three times a day for 4 weeks besides the conventional treatment. The 99mTc-ECD SPECT brain perfusion imaging was performed before and after treatment to observe the change of rCBF, and the neurological deficit was evaluated by Edinburgh-Scandinavia stroke scale (SSS) scores and Barthel index (BI) at the same time. Results: After treatment, the rCBF in the treatment group was significantly improved ( P＜0.01), while that in the control group remained unchanged, with the comparison of the rCBF in the two groups after treatment showing significant difference (P＜0.01). In addition, the SSS score was significantly lower and BI significantly higher in the treatment group than those in the control group respectively after treatment. Conclusion: TXL could effectively improve rCBF and lessen the neurological deficit symptoms in patients with ASCI.     

Clinical Observation on 30 Cases of Transient Cerebral Ischemia Attack Treated with Acupuncture and Medication

Objective: To probe the curative effect of acupuncture and medication on transient cerebral ischemia attack. Method: 30 patients with transient cerebral ischemia attack in the treatment group were acupunctured at Fengchi (GB 20), Wangu (GB 12) and Tianzhu (BL 10) and given orally leech capsules and centipede capsules. 30 patients with transient cerebral ischemia attack in the control group were given intravenous drip of compound Danshen injection and orally aspirin. At the end of two treatment courses, the curative effects were evaluated and the changes in blood rheology and in 3 indexes of blood coagulation were observed before and after treatment in the 2 groups. Results: The total effective rate in the treatment group was 86.7% with obvious difference as compared to the control group (P<0.05). There were remarkable differences in blood rheology and 3 indexes of blood coagulation before and after treatment in the treatment group (P<0.05, P<0.01). There were remarkable differences after treatment between the 2 groups (P<0.05). Conclusion: Acupuncture at Fengchi (GB 20), Wangu (GB 12) and Tianzhu (BL 10) and medication with leech capsules and centipede capsules are effective methods in treating transient cerebral ischemia attack.     

瑞舒伐他汀对急性脑梗死患者疗效及脑梗死体积变化的影响

目的 观察瑞舒伐他汀对急性脑梗死患者疗效及脑梗死体积变化的影响.方法 将100例急性脑梗死患者随机分为观察组52例和对照组48例,对照组患者入院后均给予常规治疗方法,观察组在对照组治疗的基础上加服瑞舒伐他汀20 mg/d.两组均连续治疗30 d.检测两组患者神经功能缺损程度评分和脑梗死灶体积.结果 治疗后观察组梗死灶体积显著低于治疗前及对照组(P均＜0.05);观察组患者神经功能缺损程度评分低于对照组(P＜0.01),Barthel指数高于对照组(P＜0.01);观察组总有效率显著高于对照组(P＜0.05).瑞舒伐他汀不良反应轻微.结论 瑞舒伐他汀能加速脑梗死患者神经功能的恢复,可缩小脑梗死体积,有保护神经的作用. Abstract： Objective To observe the effect of rosuvastatin on efficacy and volume changes of cerebral infarction in patients with acute cerebral infarction. Methods One hundred patients with acute cerebral infarction were randomly divided into observe group (52 cases) and control group (48 cases). The control group were given conventional treatment after admission, the observe group were given rosuvastatin(20 mg/day) treatment on the basis of conventional treatment.Both groups were treated for 30 days. Neurological deficit scores and infarct volumes of two groups were recorded. Results After treatment, the infarct volume of the observe group was significantly lower than before treatment and the control group(P all＜0.05),the neurologic impairment score of the observe group was lower than the control group(P＜0.01),the Barthel index of the observe group was higher than the control group(P＜0.01),the total effective rate of the observe group was significantly higher than the control group (P＜0.05). The side effects of rosuvast were minor. Conclusions Rosuvastatin can accelerate the recovery of neurological function in patients with cerebral infarction, can reduce infarct size and has the effect of nerve protection.     

Effects of Minimally Invasive Puncture and Drainage of Intracranial Hematoma on the Blood-brain Barrier in Patients with Cerebral Hemorrhage

The effects of minimally invasive surgery on the blood-brain barrier (BBB) of 30 patients with cerebral hemorrhage were investigated. Difference of the BBB index and serum MBP concentra-tion were assessed in 15 cases of conservative treatment group and 15 cases of minimally invasive surgery group. The BBB index in minimally invasive surgery group was significantly lower than in conservative treatment group (P<0.05), and the BBB index in the two treatment groups was signifi-cantly higher than in control group (P<0.01). Serum MBP concentration in minimally invasive sur-gery group was significantly lower than in conservative treatment group (P<0.05), and that in the two treatment groups was significantly higher than in control group (P<0.01). It was suggested the per-meability of BBB in patients with cerebral hemorrhage was increased, and BBB index and serum MBP concentration in patients with cerebral hemorrhage were increased. Minimally invasive surgery can reduce the lesion of cytotoxicity to BBB and cerebral edema.     

Therapeutic Effects of Tongxinluo Capsule(通心络胶囊) on Patients with Acute Small Oerebral Infarction and Its Influence on SPECT Brain Periusion Image

Objective: To investigate the influence of Tongxinluo capsule (TXL,通心络胶囊) on regional cerebral blood flow (rCBF) with 99mTc-ECD single photon emission computed tomography (SPECT) brain perfusion imaging, and to observe the therapeutic effects of TXL on acute small cerebral infarction (ASCI). Methods: Thirty-four patients with ASCI were enrolled and randomly divided into two groups: the control group (n = 17) was treated with the conventional treatment, i.e. 1. Og of Citicoline added into 300 ml normal saline for intravenous dripping daily for 2 weeks and 0. 8 g of Piracetam taken three times a day orally for 4 weeks, and the treatment group (n = 17) was treated additionally with 4 TXL capsules three times a day for 4 weeks besides the conventional treatment. The 99mTc-ECD SPECT brain perfusion imaging was performed before and after treatment to observe the change of rCBF, and the neurological deficit was evaluated by Edinburgh-Scandinavia stroke scale (SSS) scores and Barthel index (Bl) at the same     

高压氧附加药物治疗急性脑梗死42例临床观察

目的：探讨高压氧治疗急性脑梗死的效果。方法：将７２例急性脑梗死患者随机分成两组：高压氧疗组４２例,对照组３０例,两组均给予常规药物治疗,高压氧疗组同时给予高压氧辅助治疗,１０次为一疗程,共３个疗程。治疗后评价疗效,检测血液流变学进行对比分析。结果：高压氧疗组显效率显著高于对照组,全血粘度、血浆粘度、纤维蛋白原等指标明显降低（Ｐ〈０．０５）。结论：高压氧治疗急性脑梗死疗效显著,起效快。     

依达拉奉联合羟乙基淀粉治疗急性脑分水岭梗死临床疗效观察

目的:观察依达拉奉联合羟乙基淀粉治疗脑分水岭梗死临床疗效。方法:将86例急性脑分水岭梗死的患者随机分为治疗组44例和对照组42例,对照组常规活血,抗血小板聚集药物同时予羟乙基淀粉500ml静点治疗,治疗组在对照组基础上加用依达拉奉治疗,治疗前及治疗10天行神经功能缺损程度评分并判断疗效。结果:治疗10天后两组患者神经功能缺损评分较治疗前均有好转(P<0.01),治疗组神经功能缺损评分明显低于对照组(p<0.01);治疗组患者神经功能缺损评分减少值明显高于对照组(P<0.01)。两组患者均未出现明显不良反应。结论:依达拉奉联合羟乙基淀粉治疗急性脑分水岭梗死临床疗效安全有效。     

降纤酶治疗急、慢性脑梗死的临床观察

目的:观察降纤酶治疗不同时期脑梗死的疗效.方法:注射用降纤酶(国产力源精纯溶栓酶)治疗发病＞24 h～30天的脑梗死73例,并随机选择同期住院的脑梗死40例,予川芎嗪治疗为对照组.进行疗效评定,并观察用药前后血纤维蛋白原(FIB)、凝血酶原时间(PT)、凝血酶时间(TT)、肝肾功能变化.结果:治疗前、后脑梗死急性期与慢性期组神经功能缺损程度评分及日常生活能力状态(Barthel指数)评分差异均有显著性(P＜0.001),降纤酶组疗效优于对照组(P＜0.05).治疗后血FIB显著降低(P＜0.01),而PT、TT、肝肾功能无明显变化(P＞0.05).结论:降纤酶对发病＞24 h～30天左右的急、慢性脑梗死仍有较好的疗效,且副作用少.     

阿司匹林、双嘧达莫、川芎嗪联合治疗急性脑梗死效果评估

目的:观察阿司匹林、双嘧达莫及川芎嗪联合治疗对急性脑梗死患者血小板功能的影响,并对联合治疗的临床疗效和安全性作一简单评估。方法:将急性脑梗死患者66例随机分为观察组和对照组。对照组采用常规治疗加用阿司匹林,观察组在常规治疗基础上行阿司匹林、双嘧达莫及川芎嗪联合治疗。治疗前及治疗后14天分别评定神经功能缺损评分及血小板功能的变化。结果:观察组总有效率84.8%(28/33),对照组63.6%(21/33),两组比较差异有统计学意义(P<0.05);观察组较对照组神经功能缺损评分、血小板功能均有明显的改善(P<0.05)。结论:阿司匹林、双嘧达莫及川芎嗪联合应用治疗急性脑梗死可明显改善血小板功能,提高临床疗效,且与常规治疗有协同作用,无明显副反应。     

神经节苷脂治疗急性脑梗死的临床疗效观察

目的:观察神经节苷脂( GM1)注射液治疗急性脑梗死的临床疗效.方法:64例急性脑梗死患者,随机分成治疗组和对照组,每组32例,在给予相同的常规治疗基础上,治疗组加用神经节苷脂(GM1)注射液60 mg溶于250 ml生理盐水中静脉滴注,每日1次,2周为1个疗程,观察两组患者治疗前后神经功能缺损程度评分的变化,评价其临床疗效.结果:疗程结束后,治疗组神经功能缺损评分与对照组相比明显改善,差异有统计学意义(P＜0.05),治疗组临床疗效明显优于对照组(P＜0.05),其神经功能障碍明显改善,未出现毒副作用.结论:神经节苷脂(GM1)应用于急性脑梗死早期治疗可以获得良好的治疗效果.     

通心络胶囊对急性脑梗死患者临床与脑血流影响

目的　观察通心络胶囊对急性脑梗死治疗效果及对患者脑血流的影响。方法　选择 90例急性脑梗死患者随机分为 2组 ,通心络胶囊加常规药物治疗组 (治疗组 ) 4 5例 ,常规药物治疗组 (对照组 ) 4 5例。观察 2组患者治疗后有效率、治疗前后神经功能缺损评分及脑血流变化。结果　治疗组总有效率为 86 .7% ,明显优于对照组的 73.3% (P <0 .0 5 )。治疗后 2组神经功能缺损评分均较治疗前有明显降低 (均为P <0 .0 1) ,但治疗组 (8.4 2± 2 .2 8)下降明显优于对照组 (12 .4 5± 2 .6 4 ) ,有非常显著性差异(P <0 .0 1) ;治疗后 2组脑血管搏动指数和血管阻力指数明显改善 (P <0 .0 1) ,但治疗组改善更为明显 ,与对照组比较有显著性差异 (P <0 .0 5 )。 2组均未出现明显副作用。结论　通心络胶囊治疗急性脑梗死可明显提高临床疗效 ,改善脑血流量 ,且用药是安全的。     

卒中单元对急性脑梗死患者神经功能缺损程度的影响

目的:观察卒中单元模式急性脑梗死患者神经功能缺损程度的影响。方法:30例急性脑梗死患者随机分成A、B组。在进行常规治疗的基础上,A组给予神经内科常规药物治疗,B组在给予神经内科常规药物治疗时,在患者神经症状、生命体征平稳后48 h内进行规范的康复训练。治疗前及治疗后第15天、第30天、第75天,依据欧洲卒中评分量表(ESS)评定患者神经功能缺损程度。结果:2组患者第30天和第75天的ESS均较治疗前改善,其中B组治疗后ESS评分明显高于A组(P<0.05)。结论:卒中单元能够明显提高急性脑梗死患者神经功能。     

阿托伐他汀钙治疗急性脑梗死的疗效及对血清 IL-6水平的影响

目的：观察阿托伐他汀钙治疗急性脑梗死的临床疗效及对血清白细胞介素-6(IL-6)水平的影响。方法将三台县人民医院100例发病72 h 内收治的急性脑梗死患者随机分为治疗组和对照组各50例。两组均给予常规治疗,治疗组在此基础上加用阿托伐他汀钙10 mg/d 口服,连用14 d。于治疗前、治疗后14 d 检测两组患者血清 IL-6水平,并比较两组神经功能缺损评分。结果两组治疗14 d 后神经功能缺损评分较治疗前明显改善,且治疗组改善程度较对照组更明显,差异有统计学意义(P <0.05)。治疗组治疗后血清 IL-6水平较治疗前明显降低(P <0.05),且低于对照组,差异有统计学意义(P <0.05)。对照组治疗后血清 IL-6降低不明显(P >0.05)。结论阿托伐他汀钙能降低急性脑梗死患者的 IL-6水平,从而改善其神经功能。     

急性脑梗死早期降纤治疗的临床研究

目的研究急性早期降纤治疗的疗效。方法将114例急性脑梗死患者随机分为治疗组(57例)和对照组(57例),治疗组早期应用东菱克栓酶,对照组应用血栓通,两组均应用CDPC,肠溶阿司匹林,维生素B6,尼莫地平。两组治疗前后均进行血浆纤维蛋白原及血液粘度的测定,并以神经功能缺损评分标准评价疗效。结果10天后治疗组血纤维蛋白原浆纤维蛋白原及血液粘度明显降低,神经功能恢复明显优于对照组,总有效率94.7%,明显高于对照组77.2%(P<0.01)。结论急性脑梗死早期降纤治疗安全有效。     

普罗布考对脑梗死患者急性期血清oxLDL-Ab及MMP-9水平的影响

目的:观察普罗布考对脑梗死患者急性期血清氧化型低密度脂蛋白自身抗体(oxLDL-Ab)和基质金属蛋白酶9(MMP-9)水平的影响。方法:采用自身对照和组间对照,将62例急性期脑梗死患者分为两组,其中普罗布考组(32例),常规组(30例)。治疗2周后,用酶联免疫吸附法和酶谱法分别测定治疗前后血清oxLDL-Ab及MMP-9水平的变化。以神经功能评分为标准,分别观察治疗7 d和14 d后两组的疗效。结果:①普罗布考组治疗2周后,血清oxLDL-Ab及MMP-9水平均较治疗前明显降低(均P<0.05),神经功能明显改善(P<0.05)。②治疗2周后,普罗布考组血清oxLDL-Ab及MMP-9水平均较常规组明显降低(均P<0.05),神经功能明显改善(P<0.05)。③普罗布考组治疗前后,血清oxLDL-Ab及MMP-9水平降低无相关性(P>0.05)。结论:普罗布考能降低脑梗死患者急性期血清oxLDL-Ab及MMP-9水平,可能通过稳定动脉粥样硬化斑块,抑制了血-脑屏障的早期开放和脑水肿,从而减轻缺血性脑损伤,防止脑梗死出血转化和再发,并同时提高了患者的近期疗效。