AIM: To explore the mechanism of acupuncture at the acupoints of Fengchi (GB20), Wangu (GB12) and Tianzhu (BL10) in treating acute cerebral infarction with quoting the theory of ischemic preconditioning. METHODS: (1) Eighty inpatients with acute cerebral infarction aged 35 to 70 years were selected from the Department of Acupuncture in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from February 2004 to June 2005. All the patients had signed the informed consent. The 80 patients were randomized into acupuncture group (n = 40, 28 males and 12 females) and control group (n = 40, 24 males and 16 females). (2) All the patients received routine treatment for cerebral infarction. Besides, those in the acupuncture group were treated with acupuncture at acupoints of Fengchi (GB20), Wangu (GB12) and Tianzhu (BL10), as well as electroacupuncture at bilateral Fengchi for 30 minutes, twice a day with an interval of 6 hours, two weeks as a course. (3) The neurological function was assessed with neurologic deficit score (NDS, the total score was 0 to 45 points, 0 to 15 points was taken as mild neurological impairment, 31 to 45 as severe neurological impairment). The score of NDS decreased by 50% to 100% was taken as significant effect, 20% to 49% as effective, < 20% as invalid. (4) The activities of daily life (ADL) and level of functional disability were evaluated assisted by Barthel Index (10 items, 0 to 15 points for each item, < 60 points as disorder of self-care) and Rankin scale (0 as fully recovered, 6 as dead). (5) The changes of mean blood flow rate and vascular resistant index of left and right vertebral arteries and basilar artery were detected with American transcranial Doppler detector before acupuncture, 20 minutes during acupuncture and 30 minutes after acupuncture respectively. 6 The differences of measurement data and enumeration data were compared with analysis of variance and Chi2 test. RESULTS: All the 80 cases of acute cerebral infarction were involved in the analysis of results. (1) NDS and Rankin scores: the scores were obviously lower after treatment than before treatment in both groups (p < 0.05 to 0.01). The scores after treatment were markedly lower in the acupuncture group than in the control group (p < 0.01, 0.05). Barthel Index: it was obviously higher after treatment than before treatment in both groups (p < 0.01, 0.05). It was markedly higher in the acupuncture group than in the control group after treatment (p < 0.01). (2) Total effective rate: It was obviously higher in the acupuncture group than in the control group after treatment (p < 0.05). (3) The mean blood flow rates of left and right vertebral arteries and basilar artery: In the acupuncture group, it was obviously lower at 20 minutes during acupuncture than before acupuncture (p < 0.01), but obviously higher at 30 minutes after acupuncture than before acupuncture (p < 0.05, 0.01). (4) The vascular resistant index of left and right vertebral arteries and basilar artery: In the acupuncture group, it was obviously higher at 20 minutes during acupuncture than before acupuncture (p < 0.05 to 0.01), but obviously lower at 30 minutes after acupuncture than before acupuncture (p < 0.01). CONCLUSION: Acupuncture at the acupoints of Fengchi (GB20), Wangu (GB12) and Tianzhu (BL10) can induce brain cell to be tolerant with ischemia, decrease peripheral vascular resistance, ameliorate microcirculation, so to promote to set up compensatory circulation and relieve impairment of brain tissue.

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