目的：現今醫學對於出血性腦中風的照護固然降低了死亡率及罹病率，然而，其預後比起缺血性腦中風仍然較差，至今尚無有效藥物可以治療。電針(EA)已經被提出做為出血性腦中風之療法，然而需要更多的研究來證實其療效，本研究即以臨床前基礎研究探討此一問題。
方法：小鼠出血性腦中風(ICH)模式係利用立體定位儀將 collagenase VII 及 heparin 注射至紋狀體，動物分成3組：(1) 注射食鹽水組 ，(2) ICH 組，(3) ICH 加上EA 組(百會穴及大椎穴)；測量的指標是神經學 Clark’s 評分表 (CS)，瘀血體積及以西方墨點法評估紋狀體 heme oxygenase 1 (HO-1)，Bcl-2 associated X (BAX) 及 CD11b蛋白表現量。
結果：ICH組與ICH+EA組的Cs 值較腦內注射生理溶液組 (Saline)組顯著為高，ICH組與ICH+EA組的Cs 值相較，第5天ICH+EA組Cs顯著降低；有關出血體積，第5天時，ICH組與ICH+EA組沒有差異。有關紋狀體HO-1， BAX 表現量，第5天時，ICH組與ICH+EA組的Cs 值較腦內注射生理溶液組 (Saline)組顯著為高， ICH組與ICH+EA組沒有明顯差異。有關紋狀體CD11b表現量，第5天及第14天時，ICH組與ICH+EA組的Cs 值較腦內注射生理溶液組 (Saline)組顯著為高， ICH組與ICH+EA組沒有明顯差異。
Background: In patients with intracerebral hemorrhage (ICH) modern neuro-intensive care has reduced mortality and morbidity. However, the prognosis of this disease remains worse than it is for ischemic stroke. Electroacupuncture (EA) has been proposed effective in ICH, although more studies are needed to justify its use in the acute stage of the disease, which is the purpose of this preclinical study.
Methods: ICH was inducted in mice using a modified collagenase VII +heparin stereotaxic injection into the right striatum. We compared the outcomes of 3 groups: Saline injection (sham procedure), ICH-only and ICH+EA (on Baihui (GV20) and Dazhui (GV14)) by measuring the neurological deficit using the Clark’s Score (CS), the hematoma area (by macroscopy) and the expression of heme oxygenase 1 (HO-1), Bcl-2 associated X (BAX) and CD11b proteins in the striatum on different time points by using Western blot.
Results: CS values of the ICH-only group and ICH+EA group were significantly higher at all days of evaluation compared to the Saline group. CS values were reduced in the EA-treated mice on Day 5, compared to the ICH-only group (*p=0.026). There were no differences in the hematoma area between the ICH-only group and ICH+EA group on Day 5. HO-1 and BAX expression on Day 5 were significantly higher in the ICH-only group and ICH+EA group compared to the Saline group. The expression of CD11b on Day 5 and 14 was significantly higher in the ICH-only group and ICH+EA group compared to the Saline group. There were no significant differences of HO-1, BAX and CD11b levels between the ICH-only group and ICH+EA groups on Days 5 and 14.
Conclusions: Daily EA at GV20 and GV14 can improve clinical outcomes in the acute phase of experimental ICH, which was not related to a reduction of the hematoma area. No significant reduction of HO-1, BAX and CD11b expression exerted by EA was found.
