The effects of various forms of acupoint stimulation on cerebral ischemic rat model

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The effects of various forms of acupoint stimulation on cerebral ischemic rat model


Author: Yip, Ka Keung
Title: The effects of various forms of acupoint stimulation on cerebral ischemic rat model
Degree: M.Phil.
Year: 2012
Subject: Hong Kong Polytechnic University -- Dissertations
Cerebral ischemia -- Treatment.
Acupuncture points.
Acupressure -- Therapeutic use.
Department: Dept. of Rehabilitation Sciences
Pages: xi, 86 leaves : ill. ; 30 cm.
Language: English
InnoPac Record:
Abstract: Cerebrovascular stroke is the second leading cause of death in the world which account for 9.9% of the total number of death. There are two major types of cerebral stroke: ischemic and hemorrhagic. Ischemic stroke is the occlusion of cerebral arteries where hemorrhagic stroke is the accumulation of blood within the brain region. Nearly 80 % of the cerebral stroke cases are ischemia stroke. Acupuncture is traditional Chinese medicine (TCM) with the history over 2500 years. It treats patients by insertion and manipulation of needles in the specific points, acupoints, of the human body. Acupoints are the location to reflect the pathological changes and receive the stimulation for treatment of disease. Previous studies revealed that the use of acupuncture in cerebral ischemia provides favorable result. As acupuncture follows the theory of meridian, the current study hypothesizes that the critical factor of treatment is the acupoint stimulation whatever the forms of stimulation is. Therefore, the study aims at investigating the effectiveness of different forms of acupoint stimulation on providing neuroprotection under cerebral ischemic condition using rat model. Since the selection of acupoint is also the determining factor of treatment, different acupoint will be employed in the study to investigate the acupoint-specific effect. Three forms of acupoint stimulation were employed: electroacupuncture (EA), high voltage electrical stimulation (HVES) and laser irradiation. Multiple pre-ischemia EA stimulation at non-acupoint (NA), GB 20 and ST 36 were applied to examine the effect on cerebral ischemia by measuring two anti-apoptotic molecules: Bcl-2 and transforming growth factor beta-1 (TGFβ-1). Both Bcl-2 and TGFβ-1 were found to be significantly increased in the ST 36 groups. However in the GB 20 groups, significant increase was only observed in TGFβ-1. No significant elevation of the level of TGFβ-1 was observed in the NA groups, but a significant enhancement was indicated in the production of Bcl-2. The data suggest that multiple pre-ischemia EA at ST 36 was effective in conferring neuroprotective effect on the brain by means of upregulation of Bcl-2 and TGFβ-1. Stimulation group of GB 20 and NA provided less favorable result indicating acupoint specificity in the treatment of cerebral ischemia. In the second study, the effect of multiple pre-ischemia acupoint HVES on minimizing the cerebral neuronal damage was investigated by stimulating acupoints ST 36, LI 10 or ST 36 with LI 10. The production of inducible nitric oxide synthase (iNOS) and malondialdehyde (MDA) were attenuated at ST 36 group but not in LI 10 group. Combinational use of acupoint of ST 36 and LI 10 did not provide positive effect. The third study is laser irradiation. The effects of single low-energy laser irradiation (LLI) on the levels and activity of various anti- and pro-apoptotic factors following ischemia were investigated. After the induction of transient cerebral ischemia by unilateral occlusion of the middle cerebral artery for 1 hour followed by reperfusion, LLI was then directed on the ashi point for varying lengths of duration (1, 5 or 10 min at an energy density of 2.64 J/cm2, 13.2 J/cm2 and 24.6 J/cm2, respectively). Ashi point is traditional acupoint which is reported pain by patient when pressing. The expression levels of Akt, pAkt, BAD, pBAD, Bcl-2, caspase 9 and caspase 3 activity were measured 4 days post-injury. LLI was demonstrated to protect the brain by up-regulating Akt, pAkt, pBAD and Bcl-2 expression and down-regulating caspase 9 and caspase 3 expression following transient cerebral ischemia. In conclusion, the current study demonstrated that acupoint stimulation in various types may be effective in cerebral ischemia neuroprotection. However, the protective effect may be acupoint specific. Selection of acupoint is important in the efficacy of treatment. Clarification of individual and combined application of acupuncture point is needed in further research.

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