[Comparative study on effects between electroacupuncture and acupuncture for spastic paralysis after stroke]
To observe the differences of therapeutic effect of spastic paralysis after stroke between electroacupuncture and acupuncture and explore the mechanism.
Sixty-four cases were randomly divided into an electroacupuncture group (n = 33) and an acupuncture group (n = 31). Both groups were treated with Bobath facilitation techniques and medicine treatments. Quchi (LI 11), Hegu (LI 4), Yanglingquan (GB 34), Sanyinjiao (SP 6), et al. on the affected side were selected in each group. The needle was retained for 30 min, and the manipulation was applied for 1 min in the acupuncture group, and electroacupuncture was added in the electroacupuncture group. Stroke Impairment Assessment Set (SIAS) was adopted to assess the whole function status after sroke, and the contents of glutamate (Glu) and gamma-aminobutyric acid (GABA) in serum and clinical efficacy were observed in the two groups.
The SIAS score increased after treatment as compared with that before treatment in either group (both P < 0.01), and the electroacupuncture group was superior to the acupuncture group (P < 0.01); the content of Glu in blood serum and ratio of Glu/GABA reduced, while the content of GABA in serum increased after treatment as compared with those before treatment in either group (all P < 0.01), but the improvement of above indices were much more apparently in the electroacupuncture group as compared with those in the acupuncture group (P < 0.01, P < 0.05); the total effective rate of 90.9% (30/33) in the electroacupuncture group was superior to that of 83.9% (26/31) in the acupuncture group (P < 0.05).
Electroacupuncture can improve therapeutic effect of spastic paralysis after stroke, it's mechanism may be ralated to ajusting the contents of Glu and GABA in serum.
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ABSTRACT: Acupuncture and electroacupuncture have been used to improve the brain and motor functions of poststroke patients, and aspirin is used for the prevention of stroke recurrence. Our hypothesis is that acupuncture and electroacupuncture treatments may interact with aspirin in terms of pharmacokinetics via affecting the brain blood flow. The aim of this study is to investigate the potential interactions of acupuncture and electroacupuncture on the pharmacokinetics of aspirin. The effects of acupuncture treatments on brain blood flow were measured by the laser Doppler blood flow imager. The parallel pharmacokinetic study design included three groups: control, acupuncture, and electroacupuncture groups. Two acupoints, namely, Quchi (LI 11) and Zusanli (ST 36), were needled and stimulated electronically in anaesthetized rats. The concentrations of aspirin and its metabolite, salicylic acid were determined by microdialysis and HPLC analysis after aspirin administration (30 mg/kg, i.v.). The brain blood flow responded to electroacupuncture treatments, but the pharmacokinetic parameters of aspirin and salicylic acid in blood and brain were not significantly changed by acupuncture and electroacupuncture treatments. This study may, in part, offer some evidence to support the contention that there is no significant interaction for the combination of aspirin with acupuncture or electroacupuncture.
Available from: Hua Zhang
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ABSTRACT: Functional disability of stroke patients, especially limb motor function, seriously impacts the quality of life. Although acupuncture at GB34 (Yang-ling-quan) has been shown to be effective on the recovery of motor function, the underlying mechanism has not been well explored.
To explore the central mechanisms of immediate effect of acupuncture at GB34 on motor-related network of stroke patients with hemiplegia.
A repeated measures ANOVA method was employed to investigate the effect of acupuncture at GB34 on functional connectivity of motor-related network. Six stroke patients with left hemiplegia were recruited. A left hand motor task fMRI experiment was performed before and right after acupuncture. Sham point acupuncture was taken as control. The most significant fMRI signal changes during motor task in the right precentral gyrus were identified, which was selected as a seed point for connectivity analysis. Then the functional connectivity of this seed point was compared between verum and sham point acupuncture.
Compared to sham, acupuncture at GB34 showed positive interaction effect at right temporal pole, left lingual gyrus, and left cerebellum. While negative interaction effect mainly occurred at contralateral motor cortex and ipsilateral motor cortex of lower limb.
Acupuncture at GB34 may increase motor-cognition connectivity meanwhile decrease compensation of unaffected motor cortex and homolateral synkinesis, which can definitely promote the rehabilitation of hemiplegia and spasm.
Copyright © 2015. Published by Elsevier B.V.
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