中医大脑-人工智能在中医临床中的创新性应用

中医临床在发展过程中始终面临有效性与安全性的问题,如医师辨病辨证不准确、药物配伍不当等。提升中医临床的有效性与安全性,是促进中医临床发展与创新的关键环节。人工智能是研究、开发用于模拟、延伸和扩展人的智能的理论、方法、技术及应用系统的一门新的技术科学。若将人工智能技术应用于中医临床,模拟中医临床思维方法,进行辨病辨证及处方用药,同时智能审核药物“十八反”“十九畏”等配伍禁忌,辅助医师进行诊疗决策,将会在一定程度上解决药物有效性与安全性的问题。因此,如何最大程度地融合信息化、智能化的人工智能技术,为中医临床诊疗提供辅助决策,是目前亟须探究的问题。

Treatment of 140 cerebral palsied children with a combined method based on traditional Chinese medicine(TCM)and western medicine

Objective:To observe and evaluate a method that is effective and practical for treatment of cerebral palsied(CP)children in China.Method:The patient's age and disease type and individual specific conditions were considered in choosingtherapy methods accordingly:Chinese herbs,acupuncture,auricnlar seed pressure,point finger pressing,massage,orthopedichand manipulation,physiotherapy,occupational therapy,language therapy,etc.Meanwhile we created a new CP treatment modelthat combines hospitalized treatment with family therapy.Results:The majority of CP patients improved greatly in motor andsocial adaptation capacities after treatment.Wilcoxon paired rank sum test analysis showed that there were significant differencesbetween the data before and after treatment(P<0.01).Conclusion:This combined therapy method,based on traditional Chinesemedicine and western medicine plus family supplemental therapy,is an effective and practical treatment strategy for CP children inChina.

INFLUENCE OF DIFFERENT NEEDLE-RETAINING DURATION ON CEREBRAL HEMODYNAMICS OF CEREBRAL PARALYSIS CHILDREN

Objective: To investigate the effects of different needle-retaining duration on cerebral hemodynamics in cerebral paralysis (CP) children. Methods: A total of 20 cases of CP children were subjected into this study. Changes of systolic peak value (Vs), blood flow velocity at the end-diastolic phase (Ved), mean velocity (Vm), pulsation index (PI) and resistance index (RI) of the cerebral hemodynamics before and after performing JIN’s Three-Needling Therapy with the needles retained for 30 min (group A) and 5 min (group B) were observed by using transcranial Doppler ultrasonography (TCD). Results: After acupuncture, the blood flow in the middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) was accelerated, and the resistance of blood vessels decreased. The effect of needle-retaining-30 min was better than that of needle-retaining-5 min. Conclusion: In treating cerebral paralysis by using JIN’s Three-Needling Therapy, sufficient stimulation provided by needle remaining is an important factor for achieving satisfactory therapeutic effects.

EFFECT OF ELECTROACUPUNCTURE ON NOREPINEPHRINE LEVEL AND APOPTOSIS IN CEREBRAL CORTEX TISSUE IN RATS WITH CEREBRAL ISCHEMIA-REPERFUSION

Objective: To investigate the underlying neurobiological mechanism of the protective effect of electroacupuncture (EA) during cerebral ischemia-reperfusion (CI-R). Methods: In the first part of the study, 15 SD rats were evenly randomized into control group, CI-R-48h model group and CI-R-48h+EA group. The cortical apoptosis and expression of Bcl-2 and Bax proteins in each group were detected by flow cytometer (FCM). In the second part of the study, 75 SD rats were evenly randomized into control, CI-R-3min, CI-R-3min+EA, CI-R-48h and CI-R-48h+EA groups. Cortical norepinephrine (NE) concentration was detected by fluorescence spectrometer. CI-R model was established by occlusion of the bilateral common carotid arteries and reperfusion. EA (4～16 Hz, 1～3 V) was applied to “Shuigou”(水沟 GV 26) and “Chengjiang”(承浆 CV 24) for 30 min before CI and after reperfusion respectively. Results: In the first part of this study, results indicated that the number of the apoptotic neurons and the apoptosis rate of CI-R-48h group were significantly higher than those of control group; while comparison between CI-R-48h+EA and CI-R-48h groups showed that the number of the apoptotic neurons and the apoptosis rate of the former group were significantly lower than those of the later group (P<0.05). In comparison with control group, after CI-48h, Bax expression was up-regulated significantly and Bcl-2 down-regulated markedly (P<0.05). Comparison between CI-R-48h and CI-R-48h+EA group indicated that Bax expression of the later group was significantly lower than that of the former group, while Bcl-2 expression of CI-R-48h+EA group was significantly higher than that of CI-R-48h group (P<0.05), suggesting that EA could reverse CI induced reactions of these two indexes. In the second part of the study, in comparison with control group, NE concentration in cerebral cortex of CI-R-3min group increased significantly (P<0.05); while NE content of CI-R-3min+EA group was significantly lower than that of CI-R-3min group (P<0.05). No significant difference was found between CI-R-3min group and control group in cortical NE levels; and no significant changes were found about NE levels in CI-R-48h and CI-R-48h+EA groups, suggesting that EA could inhibit the increase of cortical NE level in the early stage of CI. Conclusion: Changes of NE concentration in the cerebral cortex during the earlier period of CI-R is possibly related to the incidence of cortical apoptosis. EA can reduce the increase of NE due to CI and thus may inhibit CI-induced cortical apoptosis.

EFFECT OF ELECTROACUPUNCTURE OF SCALP-POINTS ON ABNORMAL DISCHARGES OF NEURONS AROUND THE CEREBRAL HEMORRHAGE FOCUS IN THE RAT

Objective: To study the mechanism of electroacupuncture (EA) of scalp-points for regulating abnormal discharges of neurons in different regions around the cerebral hemorrhage focus by using neuro-electrophysiological methods. Methods: 80 Wistar rats (anesthetized with 20% urethane 1 g/kg, i.p.) were randomly divided into normal, saline, model and EA groups, with 20 cases in each group. Cerebral hemorrhage model was established by intracerebral injection of the rat’s own arterial blood sample (40 uL). In rats of saline group, the same volume of saline was given for intracerebral injection. Extracellular electrical activity of neurons of the caudate nucleus and parafascicular nucleus and Tail flicking latency (TFL) were used as the indexes. “Baihui”(百会 GV 20) and “Taiyang”(太阳 EX-HN 5) were punctured from GV 20 towards EX-HN 5 with filiform needles and stimulated electrically with stimulating parameters of strength of 1 V, frequency of 15 Hz and duration of 15 min. Results: Compared with normal group, TFL values of model group and EA group increased significantly (P<0.01); and compared with model group, those of EA group decreased significantly (P<0.01), suggesting that the pain threshold increased significantly in cerebral hemorrhage rats while after acupuncture stimulation, it lowered strikingly. Compared with normal and saline groups, the latency values of the pain excitement and inhibitory responses of the cellular discharges of the caudate and parafascicular nuclei in model and EA groups increased significantly (P<0.05～0.01), while after EA, it recovered apparently (P<0.01), showing an apparent regulative effect of EA on the abnormal changes of discharges of neurons around the cerebral hemorrhage focus. Conclusion: Scalp-acupuncture possesses an apparent regulatory effect on the abnormal electrical activity of neurons around the cerebral hemorrhage focus which may favor the early recovery of functional activity of neurons near the focus tissues.