Objectives: To investigate the repair effects of He's qiangtong method of acupuncture (involved bloodletting technique with strong action of unblocking) on the neurovascular unit of the patients with acute ischemic stroke (AIS) in terms of serological indicators so as to provide new ideas for the treatment of AIS.
Methods: Seventy subjects with AIS were randomly divided into an observation group (35 cases, 1 case dropped out) and a control group (35 cases , 4 cases dropped out). Patients in the control group were treated with conventional regimen. In the observation group, the bloodletting was operated, combined with the conventional treatment. Bloodletting was performed at Baihui (GV20), Sishencong (EX-HN1) and bilateral Erjian (EX-HN6), using He's qiangtong method of acupuncture, 3 times a week and for 2 weeks. Before and after treatment, the scores of the national institute of health stroke scale (NIHSS), the modified Rankin scale (MRS), and the Barthel index were evaluated；and the serological levels of the serum brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE) and blood-brain barrier permeability-associated protein (S100β protein) were detected in the two groups.
Results: After treatment, NIHSS score and MRS score were decreased (P<0.01), and Barthel score was increased (P<0.01) in both groups. NIHSS score of the observation group was lower than that of the control group (P<0.01). Compared with those before treatment, the content of BDNF in both groups increased (P<0.05), and VEGF content was elevated in the observation group (P<0.05) after treatment. The total effective rate was 100% (34/34) in the observation group, higher than that (67.74%, 21/31) in the control group (P<0.01).
Conclusions: He's qiangtong method of acupuncture can promote the recovery of neurological deficits in AIS patients and effectively improve their motor function and the activity of daily living, which may be related to the reconstruction of neurovascular unit in the brain of AIS patients by increasing the levels of serological repair factors.
目的: 观察贺氏强通法对急性缺血性脑卒中（AIS）患者神经血管单元（NVU）的修复作用，为治疗AIS提供新思路。方法: 将70例AIS受试者随机分为观察组（35例，脱落1例）和对照组（35例，脱落4例）。对照组给予常规治疗2周；观察组在百会、四神聪、双侧耳尖进行穴位放血联合常规治疗，每周治疗3次，共治疗2周。治疗前后评定两组患者美国国立卫生研究院卒中量表（NIHSS）评分、改良Rankin量表（MRS）评分、Barthel指数评分，采用ELISA法测定血清脑源性神经营养因子（BDNF）、血管内皮生长因子（VEGF）、胶质纤维酸性蛋白（GFAP）、神经元特异性烯醇化酶（NSE）、血脑屏障通透性相关蛋白（S100β蛋白）的含量。结果: 与治疗前比较，治疗后两组患者NIHSS评分、MRS评分均降低（P<0.01），Barthel评分均升高（P<0.01），观察组NIHSS评分低于对照组（P<0.01）。与本组治疗前比较，治疗后两组患者BDNF含量均升高（P<0.05），观察组VEGF含量升高（P<0.05）。治疗后观察组总有效率为100%（34/34），对照组总有效率为67.74%（21/31），观察组高于对照组（P<0.01）。结论: 贺氏强通法能促进AIS患者神经功能缺损症状的恢复，有效改善其运动功能及日常生活能力，可能与提高AIS患者血清中修复性因子的水平从而促进其脑内NVU的重构相关。.
Keywords: Acute ischemic stroke; Bloodletting; Cytokine; He’s qiangtong method of acupuncture.