早期电针阳明经穴对急性脑梗塞患者偏瘫下肢功能及PAC-1和CD62p表达的影响

Effect of early electric acupuncture with aeupoints of yansming meridians on functional recovery of the lower extremity and the expression of PAC-1 and CD62p in ACI patients

目的探讨早期电针阳明经穴对急性脑梗塞患者偏瘫下肢功能及PAC-1、CD62p和D—Dimer表达影响。方法将58例ACI患者，随机分为电针组和对照组，治疗前后用Barthel指数、NIHSS量表和Fugl—Meyer法评估，观察治疗前后PAC-1、CD62p和D—Dimer的变化。结果两组治疗后Barthel指数、NIHSS及简化的Fugl—Meyer评分较治疗前均有显著改变（P〈0．05），电针组简化Fugl-Meyer评分较对照组明显增高（P〈0．01）；两组治疗后CD62p水平均较同组治疗前明显下降（P〈0．05），但电针组和对照组在治疗后相比CD62p水平下降程度差异无显著性（P〉0．05）；电针组PAC-1水平较治疗前明显降低（P〈0．01），而对照组治疗前后PAC-1水平相比差异无显著性（P〉0．05）。两组D—Dimer水平较同组治疗前均有所升高（二者均P〈0．05），但电针组D—Dimer水平升高明显低于对照组（P〈0．05）。结论早期电针阳明经穴治疗能显著并改善ACI患者瘫痪的下肢功能，其作用机制可能与抑制血小板活化和减缓纤溶系统激活速度相关。

Objective To investigate the effects of early electric acupuncture with acupoints of yangming meridians on functional recovery of the lower extremity and the expression of PAC-1 and CD62p in ACI patients. Methods 58 cases of ACI patients were randomly divided into electric acupuncture group and control group.The neurology grade and recovery of lower limb function was evaluated with the method of Barthel index,NIH Stroke scale and simplify Fugl-Meyer. And the expression of PAC-1,CD62p and D-Dimer in 58 cases of ACI were respectively detect by flow cytometer, etc.Results The advance of neurology grades, which was evaluated with the method of Barthel index,NIH Stroke scale and simplify Fugl-Meyer in each group, have marked difference （ P〈0.5 ） between electric acupuncture group and control group after treatment. Compared with control group, Fugl-Meyer＇s grade was improved but no difference in Barthel index and NIH Stroke scale.The expression of CD62p after treatment in each group markedly decreased than its own prior treatment,being significantly different（P〈0.05, P〈0.05）.However, the expression of CD62p after post-treatment has no difference between two groups（ P〉0.05 ）. Contrasting to the control group, the expression of PAC-1 in electric acupuncture group markedly decreased after treatment（ P〈0.01 ）, but there was no significant difference between prior and post-treatment in control group. The expression of D-Dimer in each group increased after treatment. In comparison with control group, the increasing of D-Dimer in electric acupuncture group was significant lower （ P〈0.05 ）.Conclusions Early electric acupuncture treatment with acupoints of yangming meridians can make recovery of paralyzed lower extremity and reduce expression of PAC-1 in order to diminish thrombogenesis. Its action might be its suppressing the activation of platelet and decreasing the fibrolysis systems.