title: Combination treatment with Gua Sha and Blood-letting causes attenuation of systemic inflammation, activated coagulation, tissue ischemia and injury during heatstroke in rats.
abstract: OBJECTIVE
  Gua Sha and Blood-letting at the acupoints were Chinese traditional therapies for heatstroke. The purpose of present study was to assess the therapeutic effect of Gua Sha on the DU Meridian and Bladder Meridian combined with Blood-letting acupoints at Shixuan (EX-UE 11) and Weizhong (BL 40) on heatstroke.
  
  
  METHODS
  Anesthetized rats, immediately after the onset of heatstroke, were divided into four major groups: Gua Sha group, Blood-letting group, Gua Sha combined with Blood-letting group and model group. They were exposed to ambient temperature of 43 °C to induce heatstroke. Another group of rats were exposed to room temperature (26 °C) and used as normal control group. Their survival times were measured. In addition, their physiological and biochemical parameters were continuously monitored.
  
  
  RESULTS
  When rats underwent heatstroke, their survival time values were found to be 21-25 min. Treatment of Gua Sha combined with Bloodletting greatly improved the survival time (230±22 min) during heatstroke. All heatstoke animals displayed and activated coagulation evidenced by increased prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimer, and decreased platelet count, protein C. Furthermore, the animals displayed systemic inflammation evidenced by increased the serum levels of cytokines interleukin-1ß (IL-1ß), tumor necrosis factor α (TNF-α) and malondialdehyde (MDA). Biochemical markers evidenced by cellular ischemia and injury/dysfunction included increased plasma levels of blood urea nitrogen (BUN), creatinine, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), and alkaline phosphatase (ALP) were all elevated during heatstroke. Core temperatures (Tco) were also increased during heatstroke. In contrast, the values of mean arterial pressure were signifificantly lower during heatstroke. These heatstroke reactions were all signifificantly suppressed by treatment of Gua Sha and Blood-letting, especially the combination therapy.
  
  
  CONCLUSIONS
  Gua Sha combined with Blood-letting after heatstroke may improve survival by ameliorating systemic inflflammation, hypercoagulable state, and tissue ischemia and injury in multiple organs.
authors.affiliation: Department of Physical Medicine and Rehabilitation, the Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang Province, 325027, China.
authors.forename: Wen-zhan
authors.initials: WZ
authors.lastname: Tu
authors.forename: Rui-dong
authors.initials: RD
authors.lastname: Cheng
authors.forename: Jie
authors.initials: J
authors.lastname: Hu
authors.forename: Jie-zhi
authors.initials: JZ
authors.lastname: Wang
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Lin
authors.forename: En-miao
authors.initials: EM
authors.lastname: Zou
authors.forename: Wan-sheng
authors.initials: WS
authors.lastname: Wang
authors.forename: Xin-fa
authors.initials: XF
authors.lastname: Lou
authors.forename: Song-he
authors.initials: SH
authors.lastname: Jiang
mesh_terms: D000818:Animals; D001778:Blood Coagulation Disorders / Q000188:drug therapy / Q000628:therapy*; D001815:Bloodletting; D003131:Combined Modality Therapy; D000529:Complementary Therapies / Q000379:methods*; D016207:Cytokines / Q000097:blood; D018883:Heat Stroke / Q000503:physiopathology*; D007249:Inflammation / Q000188:drug therapy / Q000628:therapy*; D007511:Ischemia / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D015996:Survival Rate
chemical_list: D016207:Cytokines; D008315:Malondialdehyde
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