AIM: To observe the relationship between character and location of lesion and the changes of myocardial zymogram in patients with acute stroke, and analyze the effects of different acupunctures on the changes of myocardial zymogram of patients with impairment of heart caused by stroke. METHODS: (1) The experiment was completed in the Department of Acupuncture and Moxibustion, First Affiliated Hospital, Tianjin College of Traditional Chinese Medicine from November 2000 to February 2003. Among 126 patients with acute stroke, 108 patients had injury of heart, 72 had cerebral infarction, and 36 had cerebral hemorrhage. All patients were informed consent. Totally 108 patients with injury of heart were randomly divided into the acupuncture group and the control group with 54 in each group. Another 50 healthy subjects were selected as the healthy control group in the same hospital, and all subjects were also informed consent. (2) Patients in the two groups were treated with general treatment associated with acupuncture at the same time. The manipulation of acupuncture referred to 'activating brain and restoring consciousness, clearing heart-fire and dredging collaterals', and as the main acupunctures of yin meridians and Du meridian, other acupuncture points were selected in acupuncture group, such as Neiguan (PC6), Renzhong (DU26), Renying (ST9), Sanyinjiao (SP6), Fengchi (GB20), Jiquan (HT1), Chize (LU5), Hegu (LI4), and Weizhong (BL40). The manipulation of acupuncture referred to 'wind selecting from three positive point, treating flaccidity and selecting yangming meridian', acupuncture points were selected in control group, such as Shenmen (HT7), Tongli (HT5), Danzhong (RN17), Jianshi (PC5), Xuehai (SP1), Jianyu (LI15), Quchi (LI11), Huantiao (GB30), Yanghingquan (GB34), and Kunlun (BL60). Patients in the two groups were treated with acupuncture during the 7 days of administration, once a day, remaining the needles for 30 minutes after manipulation. (3) Activity of creatine enzyme, isoenzyme, lactate dehydrogenase and a-hydroxybutyric butyryl dehydrogenase were assayed in acupuncture group and control group after 1 course and in healthy control group with automatic biochemistry analyzer. (4) Measurement data were compared with one-way analysis of variance. RESULTS: Both 108 patients with injury of heart induced by stroke and 50 healthy subjects entered the final analysis. (1) Activity of myocardial enzyme of patients with cerebral hemorrhage was higher than that of healthy subjects (p < 0.01); activity of creatine kinase in myocardial zymogram of patients with cerebral infarction was higher than that of healthy subjects (p < 0.01); and activities of creatine kinase, isoenzyme and lactate dehydrogenase of patients with cerebral hemorrhage were higher than those of patients with cerebral infarction (p < 0.01). (2) Activities of creatine kinase and isoenzyme of patients with stroke on left side of basal ganglia and thalamus were higher than those on the right side (p < 0.01); and activities of creatine kinase an isoenzyme of patients with brain stem stroke were higher than those of other sides except on right side of basal ganglia and thalamus (p < 0.01). (3) Activity of myocardial enzyme was higher in acupuncture group and control group than that in healthy control group before treatment (p < 0.01). Activity of myocardial enzyme in acupuncture group after 1-course treatment was lower than that before treatment and also than that in control group after 1-course treatment (p < 0.05, 0.01), but only activity of creatine kinase isoenzyme was decreased in control group after 1-course treatment as compared with that before treatment (p < 0.01). CONCLUSION: (1) Acute stroke can cause abnormal myocardial zymogram, and degree of myocardial injury is severer of patients with cerebral hemorrhage than that of patients with cerebral infarction. Stroke in brain stem, left basal ganglia and thalamus can cause myocardial injury. (2) Acupuncture can protect myocardial injury induced by acute stroke, and acupuncture method based on 'activating brain and restoring consciousness, clearing heart-fire and dredging collaterals' and selecting yin meridians and Du meridian is superior to that based on 'wind selecting from three positive point, treating flaccidity and selecting yangming meridian'.

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