[Effect of Acupuncture Combined with Rehabilitation on Immune and Neural Functions in Elderly Patients with Stroke].

Objective: To investigate the therapeutic effect of acupuncture combined with rehabilitation and neuro-immune functional activities in elderly patients with stroke.

Methods: A total of 196 elderly stroke patients were randomly divided into control (rehabilitation exercise) and observation(acupuncture＋ rehabilitation exercise)groups (＝98 in each). Patients of the control group were treated by general healing treatment including good limb placement, timely conversion of body position, joint-motor exercise, sitting balance exercise, sitting-standing-walking, walking up and down stairs, daily life ability exercise, etc. and those of the observation group were treated by using the same methods mentioned in the control group and manual acupuncture stimulation of Sishencong (EX-HN 1), Xuanli (GB 6), the midpoint of EX-HN 1 and GB 6, Baihui (GV 20), Qubin (GB 7), and the midpoint between GV 20 and GB 7 on the affected side (once a day for three 10-day courses). Serum interleukin-2 (IL-2), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and high-sensitive C-reactive protein (hs-CRP) contents were assayed using ELISA, and serum CD 3， CD 4 and CD 8 contents assayed using flow cytometry. The disability severity was assessed by using National Institutes of Health Stroke Scale (NIHSS, for dysneuria), modified Rankin Scale，(mRS, stroke severity), and Barthel Index (BI, performance in activities of daily living), separately. The therapeutic effect was determined according to NIHSS score, clinical symptoms and daily activity ability.

Results: On day 30 after the treatment, serum IL-2, IL-6, TNF-α and hs-CRP contents were significantly decreased in the observation group in comparison with its own pre-treatment and day 10 after the treatment, and on day 10 and 30 after the treatment, the above were lower than the control group (<0.05). On day 30 after the treatment, serum CD 3， CD 4 and CD 4/CD 8 levels were significantly increased in both control and observation groups in comparison with their own pre-treatment and 10 days' treatment (<0.05), while CD 8 levels obviously decreased in both groups relevant to their own pre-treatment and 10 days' treatment (<0.05), and the increased CD 3， CD 4 and CD 4/CD 8 levels were significant higher in the observation group than in the control group (<0.05), and the CD 8 level was obviously lower in the control group than in the observation group (<0.05). On day 30 after the treatment, the NIHSS and mRS scores were significantly decreased in both groups (<0.05), and significantly lower in the observation group than in the control group (<0.05); the BI scores were evidently increased in both groups relevant to their own pre-treatment (<0.05), and the BI level was considerably higher in the observation group than in the control group (<0.05). The total effective rate was 72.4% (71/98) and 93.9% (92/98) respectively in the control and observation groups, being obviously higher in the latter group than in the former (<0.05).

Conclusion: Acupuncture combined with rehabilitation therapy is effective in promoting the recovery of neurological function and in regulating T lymphocyte subsets and the expression of inflammatory factors in elderly patients with stroke.