Jia Kun-Ping, Pei Si-Ying, Wang Hong, Wang Xin, Cai Guo-Feng
Internal Medicine, Hanan Branch of the Se-cond Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150060, China; Graduate School of Heilongjiang University of Chinese Medicine, Harbin 150040.
Internal Medicine, Hanan Branch of the Se-cond Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150060, China.
Zhen Ci Yan Jiu. 2020 Dec 25;45(12):954-60. doi: 10.13702/j.1000-0607.200279.
To observe the effect of crossing nape electroacupuncture(EA) on cough count (CCnt), cough incubation period and blood routine, liver function, renal function, myocardial enzymology, and heart, liver and kidney pathological structure in guinea pig with cough reflex disorder after cerebral hemorrhage, so as to evaluate the efficacy and safety of crossing nape EA in the treatment of cough reflex disorder after cerebral hemorrhage.
A total of 160 male pure white guinea pigs were randomly divided into normal group, model group, acupuncture group, crossing nape EA group and nape EA group (=32 in each group). These 5 groups were further divided into 1, 3, 7 and 14 d subgroups(=8 in each subgroup). The model of cough reflex disorder after cerebral hemorrhage was established by injection of the guinea pigs' autoblood (50 μL) into the basal ganglia region confirmed by Longa's neurologic examination grading system(0-4 points). Acupuncture was applied to bilateral "Fengchi" (GB20) and "Yifeng" (SJ17) in the acupuncture group. In the crossing nape EA group, the positive pole of the needle is connected to SJ17, while the negative pole is connected to the opposite side of GB20(2 Hz, 0.5 mA). In the nape EA group, the positive pole of the needle is connected to SJ17, while the negative pole is connected to the same side of GB20(2 Hz, 0.5 mA). All treatments were applied 20 min each time, once a day. The changes of CCnt and cough incubation period were recorded by Buxco device. The changes of blood routine, liver function, kidney function, myocardial enzyme and other laboratory indexes were monitored by automatic analyzer instrument. The pathological changes of heart, liver and kidney of guinea pigs were observed by transmission electron microscopy.
Compared with the normal group, the guinea pigs' neurological deficit scores in the model group were significantly increased at each time point (<0.01). Compared with the model group, the neurological deficit scores of the acupuncture group, crossing nape EA group and nape EA group at 3 d, 7 d and 14 d all decreased (<0.01, <0.05). Following modeling, the CCnt at each time point in the model group was significantly reduced (<0.01), and the cough latency was significantly prolonged (<0.01). After interventions, the CCnts were increased and the incubation periods of cough were shortened (<0.05, <0.01) at 7 d and 14 d in the 3 intervention groups, and were superior in the crossing nape EA group than those of acupuncture group and nape EA group (<0.05, <0.01). The improvement degrees of these 2 indexes in the nape EA group at 14 d were better than those of the acupuncture group (<0.05). There were no significant differences among the 3 groups in red blood cells counting, hemoglobin, myocardial enzymes, liver and kidney function (>0.05). Compared with the normal group, the WBC counts in all the time points (except 1 d after operation) were significantly increased(<0.01) in the model group. In comparison with the model group, the WBC counts at 3 d in crossing nape EA group, and at 7 d and 14 d in the 3 intervention groups decreased (<0.01, <0.05). Meanwhile, the WBC counts were lower in the crossing nape EA group at 7 d and 14 d than those of acupuncture group and nape EA group (<0.05). The results of transmission electron microscopy showed that the histopathological structure of heart, liver and kidney of guinea pigs in each group had no significant changes.
Crossing nape EA is safe and effective in the treatment of cough reflex disorder after cerebral hemorrhage in guinea pigs. In addition, guinea pigs will have an inflammatory response after cerebral hemorrhage, and crossing nape EA may have a certain anti-inflammatory effect.
观察项部交叉电针(EA)对脑出血后咳嗽反射紊乱豚鼠咳嗽次数(CCnt)、咳嗽潜伏期及血常规、肝功能、肾功能、心肌酶学以及心、肝、肾病理结构的影响,以评价项部交叉电针对脑出血后咳嗽反射紊乱的疗效及安全性。
将160只雄性纯白豚鼠随机分为正常组、模型组、针刺组、项部交叉电针组和项部电针组(每组32只)。这5组又进一步分为1、3、7和14天亚组(每组8只)。采用Longa神经功能检查评分系统(0 - 4分)确定基底节区,向豚鼠基底节区注射自体血(50 μL)建立脑出血后咳嗽反射紊乱模型。针刺组针刺双侧“风池”(GB20)和“翳风”(SJ17)。项部交叉电针组,针的正极连接SJ17,负极连接对侧GB20(2 Hz,0.5 mA)。项部电针组,针的正极连接SJ17,负极连接同侧GB20(2 Hz,0.5 mA)。每次治疗20分钟,每天1次。用Buxco装置记录CCnt和咳嗽潜伏期的变化。用自动分析仪监测血常规、肝功能、肾功能、心肌酶等实验室指标的变化。通过透射电子显微镜观察豚鼠心、肝、肾的病理变化。
与正常组比较,模型组豚鼠各时间点神经功能缺损评分均显著升高(<0.01)。与模型组比较,针刺组、项部交叉电针组和项部电针组在3天、7天和14天的神经功能缺损评分均降低(<0.01,<0.05)。造模后,模型组各时间点CCnt显著降低(<0.01),咳嗽潜伏期显著延长(<0.01)。干预后,3个干预组在7天和14天时CCnt升高,咳嗽潜伏期缩短(<0.05,<0.01),且项部交叉电针组优于针刺组和项部电针组(<0.05,<0.01)。项部电针组在14天时这2项指标的改善程度优于针刺组(<0.05)。3组在红细胞计数、血红蛋白、心肌酶、肝肾功能方面差异无统计学意义(>0.05)。与正常组比较,模型组各时间点(术后1天除外)白细胞计数均显著升高(<0.01)。与模型组比较,项部交叉电针组3天时、3个干预组7天和14天时白细胞计数降低(<0.01,<0.05)。同时,项部交叉电针组7天和14天时白细胞计数低于针刺组和项部电针组(<0.05)。透射电子显微镜结果显示,各组豚鼠心、肝、肾组织病理结构无明显变化。
项部交叉电针治疗豚鼠脑出血后咳嗽反射紊乱安全有效。此外,豚鼠脑出血后会出现炎症反应,项部交叉电针可能具有一定的抗炎作用。