DWI评价针刺治疗家兔脑出血

DWI in evaluation of scalp-acupuncture in treatment of intracerebral hemorrhage in rabbit models

目的通过DWI及ADC值评价头穴针刺治疗家兔脑出血模型的疗效。方法将60只家兔随机分为空白组(10只)、模型组(10只)、针刺组(40只);针刺组再随机分为留针组(10只)、手法组(30只),手法组根据针刺方法不同再随机分为透刺补法亚组、透刺泻法亚组和透刺平补平泻法亚组(各10只)。对模型组和针刺组于造模后2h、3天、7天行DWI,测量血肿周围区域及对侧镜像区ADC值,并进行统计学分析;对部分家兔取脑组织进行病理检查。结果脑出血后,血肿周围区域ADC值高于对侧镜像区,2h、3天、7天ADC值差异有统计学意义。造模后2h模型组和针刺组血肿周围区域ADC值较空白组升高;3天时模型组增长幅度大于针刺组;7天时模型组和针刺组ADC值有所回落,针刺组较模型组回降更为显著,手法组ADC值较留针组低,手法组各亚组间差异无统计学意义。对侧镜像区3天、7天的ADC值模型组与针刺组差异有统计学意义,而手法组各亚组间差异无统计学意义。结论DWI可动态活体监测脑出血后脑组织水肿变化情况;头穴针刺治疗有助于缓解兔脑出血后脑水肿。

Objective To explore the efficacy of scalp-acupuncture in treating experimental encephalorrhagia in rabbit models with DWI and ADC. Methods Sixty rabbits were randomly divided into control group （n=10）, model group （n=10） and acupuncture group （n=40）. The acupuncture group was divided into needle retaining group （n=10） and manipulation group （n=30）, and the latter were averagely divided into transdermal needling reinforcing method subgroup, reducing method subgroup, moderate reinforcing and reducing subgroup （each n=10）. Rabbits in model and acupuncture group underwent DWI 2 h, 3 days and 7 days after establishment of encephalorrhagia models. ADC values around the hematoma and at the contralateral mirror area were measured and analyzed statistically. Results After the models were made, ADC values around hematoma were higher than that of the contralateral area. There was statistical difference of ADC values among 2 h, 3 days and 7 days. Two hours after establishment of models, ADC values of model and acupuncture group around hematoma were higher than those of control group, and the increasing range of model group was larger than that of acupuncture group 3 days later. ADC values of model and acupuncture group around hematoma decreased 7 days later, and in acupuncture group decreased more than in model group. ADC values of manipulation group were lower than those of needle retaining group, and there was no statistical difference among acupuncture subgroups. There was statistical difference of ADC values between model group and acupuncture group at the mirror areas 3 days and 7 days later, but not among acupuncture subgroups. Conclusion DWI and ADC value can dynamically and lively monitor the changes of edema in encephalorrhagia rabbit models. Scalp-acupuncture is helpful to relieve the edema of encephalorrhagia in rabbit models.