ABSTRACT
Object:To analyze the effect of muscular tension injury in spasticity of cerebral apoplexy(SCA) rats with spasticity and the expression of γ-aminobutyric acid receptor (GABAα), γ-aminobutyric acid transporter (GAT-1) protein and mRNA expression in cerebral cortex modified Shaoyao Gancaotang, electroacupuncture Quchi, Yanglingquan and acupuncture combined with herb therapies alleviate the effect of SCA. Method:Randomly divided into two groups, divided into blank group, sham operation group, model group, modified Shaoyao Gancaotang group, acupuncture combined with herb group, electroacupuncture group, selected qualified SD rats into the group, 9 rats in each group. The modified Zea-Longa thread embolism method+internal capsule injection of NMDA receptor method was used to prepare a rat model. After the behavioral score confirms the success of the model,dispose of each group separately,electroacupuncture group (electroacupuncture on both sides of Yangling Spring and Quchi,1 time/d for 5 days), modified Shaoyao Gancaotang group (with Shaoyao Gancaotang 1 time/d,10 mL·kg-1 for 5 days),acupuncture combined with herb (modified Shaoyao Gancaotang was given, then electroacupuncture treatment was continued for 5 days). After treatment, the muscle tension was detected by behavioral analysis. Real-time fluorescent quantitative PCR（Real-time PCR） and Western blot were used to detect the expression of GABAα and GAT-1 related mRNA and protein in the cortex. Result:Compared with normal group, the muscle tension of the model group increased (P<0.01), the expression of GABAα mRNA and protein decreased (P<0.01), and the expression of GAT-1 mRNA and protein increased (P<0.01), compared with model group, the muscle tone score of the each treatment group decreased (P<0.05), the expression of GABAα mRNA and protein increased (P<0.05，P<0.01), and the expression of GAT-1 mRNA and protein decreased (P<0.05，P<0.01), of which the corresponding expression in the acupuncture combined with herb group was the most significant. Conclusion:Electroacupuncture Quchi, Yanglingquan,modified Shaoyao Gancaotang and acupuncture combined with three therapies can alleviate the muscle tension of limbs spasm of stroke,and the combination of acupuncture and medicine treatment on the cortical γ-aminobutyric acid receptor the highest expression efficiency suggests that it has the best effect on improving the excitatory spasticity of stroke limbs.
ABSTRACT
<p><b>OBJECTIVE</b>To observe the different clinical effects on the limb spasm after stroke among acupuncture mainly at governor vessel (GV) and Jiaji (EX-B 2) combined with rehabilitation training, simple acupuncture and simple rehabilitation training.</p><p><b>METHODS</b>Ninety patients according to admission sequence were randomized into a combination group, an acupuncture group and a rehabilitation group, 30 cases in each one. The comprehensive treatment was applied in the combination group. The same acupuncture was used in the acupuncture group; the same rehabilitation was used in the rehabilitation group. All the treatment was given for 4 courses with 1 d between the two courses, 10 times as one course, once a day. The modified Ashworth score (MAS), clinic spasticity index (CSI), Fugl-Meyer assessment (FMA), Barthel index (BI) were observed before and after treatment. The effects were compared among the three groups.</p><p><b>RESULTS</b>After treatment, the MAS, CSI score of the three groups significantly decreased in comparison with those before treatment (all<0.05), the FMA and BI score of the three groups increased in comparison with those before treatment (all<0.05). The improvements for MAS, CSI, FMA and BI of the combination group were better than those of the acupuncture group and the rehabilitation group (all<0.05). There were no statistical significance between the acupuncture group and the rehabilitation group (all>0.05). The total effective rate of 90.0% (27/30) in the combination group was better than 76.7% (23/30) in the acupuncture group and 73.3% (22/30) in the rehabilitation group (both<0.05).</p><p><b>CONCLUSIONS</b>Acupuncture mainly at GV and Jiaji (EX-B 2) combined with rehabilitation training are superior to simple acupuncture and simple rehabilitation training on reducing muscle tonus for stroke patients with limb spasm, which can more effectively improve the ability of daily life and motor function.</p>