Objective: 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.
Methods: 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 (n=32 in each group). These 5 groups were further divided into 1, 3, 7 and 14 d subgroups(n=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.
Results: Compared with the normal group, the guinea pigs' neurological deficit scores in the model group were significantly increased at each time point (P<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 (P<0.01, P<0.05). Following modeling, the CCnt at each time point in the model group was significantly reduced (P<0.01), and the cough latency was significantly prolonged (P<0.01). After interventions, the CCnts were increased and the incubation periods of cough were shortened (P<0.05, P<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 (P<0.05, P<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 (P<0.05). There were no significant differences among the 3 groups in red blood cells counting, hemoglobin, myocardial enzymes, liver and kidney function (P>0.05). Compared with the normal group, the WBC counts in all the time points (except 1 d after operation) were significantly increased(P<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 (P<0.01, P<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 (P<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.
Conclusion: 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.
目的：观察交叉电项针对脑出血后咳嗽反射障碍豚鼠咳嗽反射次数(CCnt)、咳嗽潜伏期和血常规、肝功能、肾功能、心肌酶及心、肝、肾脏组织病理结构的影响，评价交叉电项针治疗脑出血后咳嗽反射障碍的有效性和安全性。方法：雄性纯白豚鼠随机分为空白组、模型组、针刺组、交叉电项针组和电项针组，每组又分为术后1、3、7、14 d 4个亚组，每个亚组各8只。采用自体血注入法复制豚鼠脑出血后咳嗽反射障碍模型。针刺组针刺双侧“风池”“翳风”；交叉电项针组在针刺组基础上电针正极连接“翳风”，负极连接对侧“风池”；电项针组在针刺组基础上电针正极连接“翳风”，负极连接同侧“风池”。电针频率2 Hz，强度0.5 mA，各组治疗每次均为20 min，每日1次。采用Longa评分法对脑出血后豚鼠神经功能进行评估；分析Buxco装置记录的CCnt和咳嗽潜伏期变化；采用全自动血液分析仪检测豚鼠血常规，全自动生化分析仪检测肝功能、肾功能、心肌酶等实验室指标变化；采用透射电镜观察各组豚鼠心脏、肝脏、肾脏组织病理结构变化。结果：与空白组比较，模型组豚鼠各时段神经功能缺损评分均显著升高(P<0.01)；与模型组比较，针刺组、交叉电项针组、电项针组神经功能缺损评分均降低(P<0.01，P<0.05)。与空白组比较，模型组各时段CCnt均显著减少(P<0.01)，咳嗽潜伏期均显著延长(P<0.01)；与模型组比较，3个治疗组术后7 d和14 d CCnt均增多(P<0.05，P<0.01)，咳嗽潜伏期均缩短(P<0.05，P<0.01)；7 d和14 d时，交叉电项针组较其他两治疗组CCnt明显增多（P<0.05,P<0.01），咳嗽潜伏期明显缩短(P<0.05，P<0.01)；电项针组14 d时这两个指标的改善程度优于针刺组(P<0.05)。与空白组比较，模型组白细胞(WBC)计数在术后3、7、14 d均明显升高(P<0.01)；与模型组比较，术后3 d时交叉电项针组WBC计数降低(P<0.05)，术后7 d和14 d时3个治疗组WBC计数均降低(P<0.01，P<0.05)；术后7 d和14 d时交叉电项针组的WBC计数均低于其他两治疗组(P<0.05)。透射电镜结果显示，各组豚鼠心脏、肝脏、肾脏的组织病理学结构无显著改变。结论：交叉电项针治疗脑出血后咳嗽反射障碍豚鼠安全有效。此外，脑出血后豚鼠会产生炎性反应，而交叉电项针可能具有一定的抗炎效果。.
Keywords: Cerebral hemorrhagea; Cough reflexa; Crossing nape electroacupuncturea; Safety.