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This parer summarized the clinical experience of Professor ZHANG Zhiyuan in treating stroke sequelae from the perspective of regulating qi and blood. It is believed that the basic pathogenesis of stroke sequelae is disharmony of qi and blood， and it is advocated that the basic treatment method is to regulate qi and blood. For the three major symptoms of stroke sequelae， including hemiplegia， cognitive dysfunction， and sluggish speech， the effective formulas have been summarized. Hemiplegia is often treated with Chongsu Qiju Decoction （重塑起居汤） to tonify the center and replenish qi， activate blood and dredge collaterals. Cognitive dysfunction is often treated with modified San Hua Decoction （三化汤） to resolve phlegm and purge heat， regulate qi and tonify blood. And sluggish speech is often treated with Zishou Jieyu Decoction （资寿解语汤） to warm and tonify yang qi， expel wind and remove phlegm. Meanwhile， the self-made Zhinao Huayu Decoction （治脑化瘀汤） is used to prevent the occurrence of stroke sequelae， and to regulate the blood and qi by using wind medicinals and the method of relaxing and purging bowels to cure the disease.
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Objective To observe the clinical efficacy of heat-sensitive moxibustion in preventing bedsores after ischemic stroke. Method A hundred ischemic stroke patients were randomized into a treatment group and a control group, 50 cases each. The control group was intervened by ordinary nursing care, while the treatment group additionally received heat-sensitive moxibustion. Norton scale and hemodynamics [whole blood viscosity (low-shear, mid-shear and high-shear), hematocrit and erythrocyte sedimentation rate (ESR)] of the two groups were observed before and after the treatment, and the occurrences of bedsores in the two groups were compared. Result After the intervention, Norton scale and hemodynamic indexes were significantly changed in both groups (P<0.05). Norton scale and hemodynamic indexes in the treatment group were significantly different from those in the control group after the intervention (P<0.05). The occurrence rate of bedsores was 8.0％ in the treatment group versus 24.0％ in the control group, and the between-group difference was statistically significant (P<0.05). Conclusion Heat-sensitive moxibustion can effectively reduce the risk and occurrence of bedsores in ischemic stroke patients, and its mechanism is possibly related to the improvement of hemodynamics.
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Objective To observe the clinical efficacy of warm needling plus Chinese medication for external application in treating post-stroke shoulder pain. Method Two hundred patients with post-stroke shoulder pain were randomized into a treatment group and a control group, 100 cases each. The two groups both received rehabilitation training for shoulder joint. In addition, the treatment group was given warm needling plus Chinese medication for external application, while the control group was given warm needling. Visual Analogue Scale (VAS) for pain, upper-limb Fugl-Mayer Assessment (FMA) and Modified Barthel Index (MBI) were adopted to evaluate the two groups before and after the treatment. The clinical efficacies of the two groups were also compared. Result The total effective rate was 100.0％ in the treatment group versus 87.0％ in the control group, and the between-group difference was statistically significant (P<0.01). The VAS, FMA and MBI scores were significantly changed after the treatment in both groups (P<0.01). After the treatment, the VAS, FMA and MBI scores of the treatment group were significantly different from those of the control group (P<0.05, P<0.01). Conclusion Warm needling plus Chinese medication for external application and rehabilitation training can obviously reduce post-stroke shoulder pain, and enhance the upper-limb motor function and activities of daily living.
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Objective To investigate the effect of acupuncture at Huatuo jiaji points plus virtual balancing game on balance function in stroke patients.Methods Fifty patients with poststroke balance dysfunction were randomly allocated: 25 cases to the treatment group and 25 cases to the control groups. The treatment group received acupuncture at Huatuo jiaji points plus virtual balancing game-based rehabilitation training and the control group, virtual balancing game-based rehabilitation training alone. The Berg Balance Scale (BBS) score, the Timed Up and Go Test (TUGT) score, the COP offset distance indices (EO2, EC2, EOTS and EO1) and the modified Barthel Index (MBI) score were recorded in the two groups before and after treatment.Results There were statistically significant pre-/post-treatment differences in the BBS score, the TUGT score, the COP offset distance indices and the MBI score in the two groups of patients (P<0.05). There were statistically significant post-treatment differences in the BBS score, the TUGT score, the COP offset distance indices and the MBI score between the treatment and control groups (P<0.05).Conclusion Acupuncture at Huatuo jiaji points plus virtual balancing game is an effective way to treat poststroke balance dysfunction.
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Objective To investigate the clinical therapeutic effect of different frequency electroacupuncture on poststroke hemidysesthesia.Methods Sixty patients with poststroke hemidysesthesia were randomly allocated to treatment and control groups, 30 cases each. Both groups received electroacupuncture at the same points. The electroacupuncture frequency was 100 Hz in the treatment group and 1 Hz in the control group. The clinical therapeutic effects were evaluated in the two groups at 30 days after treatment.Results The total efficacy rate and the cure and marked efficacy rate were 93.3 and 80.0, respectively, in the treatment group and 86.0% and 43.3%, respectively, in the control group. There was no significant difference in the total efficacy rate between the two groups (P<0.05).There was a statistically significant difference in the cure and marked efficacy rate between the two groups (P<0.05). There was a statistically significant pre-/post-treatment difference in the limb dysesthesia score in the two groups (P<0.05). There was a statistically significant post-treatment difference in the limb dysesthesia score between the treatment and control groups (P<0.05).Conclusions Electroacupuncture is an effective way to treat poststroke hemidyse- sthesia. High frequency electroacupuncture is more effective than low frequency electroacupuncture.
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Objective To analyze the clinical effect and application value of Dahuoluo capsule combined with acupuncture therapy in treating stroke sequelae. Methods 80 patients with brain stroke sequelae were enrolled in this study from January 2016 to January 2017, and were randomly divided into the observation group (n= 40) and the control group (n=40). The control group was given Dahuoluo capsule, and the observation group was treated with Dahuoluo capsule combined with acupuncture therapy. The therapeutic effects of the two groups were compared and analyzed. Results The total effective rates in the observation group (97.5%) was significantly higher than the control group (75.0%) with significant difference (P<0.05); the daily activity ability scores of the observation group 15d, 30d after treatment were significantly higher than the control group with statistical significance (P<0.05). There was no statistical significance in the incidence of adverse reactions between the observation group (2.5%) and the control group (5.0%). Conclusion Dahuoluo capsule combined with acupuncture therapy has significant clinical effect on the treatment of patients with stroke sequelae, and the efficacy of which is safe and reliable.
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Objective To analyze the clinical effect and application value of Dahuoluo capsule combined with acupuncture therapy in treating stroke sequelae. Methods 80 patients with brain stroke sequelae were enrolled in this study from January 2016 to January 2017, and were randomly divided into the observation group (n= 40) and the control group (n=40). The control group was given Dahuoluo capsule, and the observation group was treated with Dahuoluo capsule combined with acupuncture therapy. The therapeutic effects of the two groups were compared and analyzed. Results The total effective rates in the observation group (97.5%) was significantly higher than the control group (75.0%) with significant difference (P<0.05); the daily activity ability scores of the observation group 15d, 30d after treatment were significantly higher than the control group with statistical significance (P<0.05). There was no statistical significance in the incidence of adverse reactions between the observation group (2.5%) and the control group (5.0%). Conclusion Dahuoluo capsule combined with acupuncture therapy has significant clinical effect on the treatment of patients with stroke sequelae, and the efficacy of which is safe and reliable.
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Objective To explore the optimal acupuncture scheme in intervening hypermyotonia of the affected limbs in stroke.Method Eighty eligible stroke patients were randomly grouped by using the orthogonal experimental design, by adopting electroacupuncture (A), daily acupuncture frequency (B), and acupoint (C) as three factors, and two levels. A total of 20 treatment sessions were conducted. Each group was scored by using the Modified Ashworth Scale (MAS) before and after the treatment, and the safety was also evaluated.Result There was a significant difference in comparing the MAS score between the two different levels of factor A (P<0.05), while there were no significant differences in comparing the MAS scores between different levels of factor B and factor C (P<0.05). Concerning the improvement of the MAS scores of wrist, elbow, knee, and ankle joints, A2B1C1(i.e. electroacupuncture twice a day with acupoints from yin meridians) was the optimal treatment scheme.Conclusion Electroacupuncture twice a day is the optimal treatment scheme for hypermyotonia of the affected limbs in stroke, as it can effectively ease the hypermyotonia, improve the function and symptoms of the limbs, and has a satisfactory security evaluation.
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Objective To observe the clinical efficacy of acupuncture at the Foot Shaoyang Meridian and Yin Heel Vessel in treating post-stroke strephenopodia. Method Forty-two eligible subjects were divided into a treatment group of 21 cases and a control group of 21 cases by the random number table. The treatment group was intervened by acupuncture at Yanglingquan (GB34) and Zulinqi (GB41) from the Foot Shaoyang Meridian and Zhaohai (KI6) from the Yin Heel Vessel, while the control group was by acupuncture at conventional acupoints, once a day, 6 d as a treatment course, 5 courses in total. The Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS) and Modified Barthel Index (MBI) were adopted to evaluate the therapeutic efficacy. Result The treatment group was superior to the control group in improving strephenopodia, and recovering the lower-limb motor function and activities of daily living (ADL), and the intra-group and inter-group differences were statistically significant (P<0.05). Conclusion Compared to the conventional acupuncture, acupuncture by selecting acupoints from the Foot Shaoyang Meridian and Yin Heel Vessel has significant advantages in treating post-stroke strephenopodia.
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Objective To observe the therapeutic efficacy of low-frequency electrical stimulation (LFES) plus acupuncture in treating deglutition disorders after cerebral stroke. Method Seventy-six patients were randomized into two groups. The treatment group (38 cases) was intervened by LFES plus acupuncture;the control group (38 cases) was by LFES. Result The water drinking test scores were significantly changed after the treatment in both groups (P<0.05); after the intervention, there were significant differences in comparing the water drinking test score, improvement score, and therapeutic efficacy grading between the two groups (P<0.05). Conclusion LFES and acupuncture are both effective in treating deglutition disorders after cerebral stroke, and the combination of the two methods can enhance the clinical efficacy.
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Objective To observe the clinical efficacy of acupoint injection plus nerve electrical stimulation in treating deglutition disorders after cerebral stroke. Method Seventy-seven patients with deglutition disorders after cerebral stroke were randomized into an electrical stimulation group of 24 cases, a hydroacupuncture group of 26 cases, and a comprehensive group of 27 cases, to respectively receive Vitalstim electrical stimulation, acupoint injection of Mecobalamin, and both of the treatments, 5 d as a treatment course, with 2-day interval between two courses, for 4 courses in total. The modified water-drinking test and Standardized Swallowing Assessment (SSA) were adopted to evaluate the therapeutic efficacy before the intervention, after 20-day treatment, and after 60-day treatment, and the therapeutic efficacies were compared. Result The modified water-drinking test and SSA scores were significantly changed in the three groups after 20-day treatment compared with that before the intervention, and the scores in the comprehensive group were superior to that of the electrical stimulation group and hydroacupuncture group. However, on the 60th day, the scores were equivalent among the three groups. Conclusion The Vitalstim electrical stimulation and acupoint injection of Mecobalamin both can produce certain treatment effects for deglutition disorders after cerebral stroke;the two methods can work in a synergistic way and can boost the improvement of swallowing function.
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Objective To observe the effect of acupuncture at nape points plus nerve electrical stimulation on deglutition function and cerebral blood flow in pseudobulbar palsy after cerebral stroke. Method The eligible subjects were randomized into a control group of 35 cases and a treatment group of 33 cases. The control group was intervened by conventional Western medication, while the treatment group was by acupuncture at nape points plus nerve electrical stimulation in addition to the Western medication, once a day, 4 weeks as a treatment course. Result The total effective rates were respectively 93.9%and 80.0%in the two groups, and the treatment group was significantly superior to the control group; after the intervention, the high whole blood viscosity, low whole blood viscosity, hematocrit, and plasma viscosity all dropped markedly in the treatment group, and were significantly different from that in the control group (P0.05). After the intervention, there were significant differences in comparing the Vm, Vs, and PI of the left vertebral artery, right vertebral artery, and basilar artery between the two groups (P<0.05). Conclusion Acupuncture at nape points plus nerve electrical stimulation is effective in improving the deglutition function in pseudobulbar palsy after cerebral stroke, and its action mechanism is plausibly through improving the cerebral blood flow and promoting the recovery of brain function.
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ObjectiveTo observe the clinical efficacy of relaxing needling plus joint needling from the Internal Medicine in treating post-stroke spastic hemiplegia.MethodTotally 121 eligible subjects were randomized intoan ordinary acupuncture group (61 cases) and a relaxing-joint needling group (60 cases). The two groups were treated for 2 weeks, 5 sessions each week. The spasm of the lower limb was evaluated by using Fugl-Meyer Assessment Scale (FMA), modified AshworthScale (MAS), Tardieu Scale, and Activities of Daily Living (ADL) before and after treatment. Besides, 4 patients from each group were randomly selected for the three-dimensional gait analysis, and the dorsi-extension, range of motion (ROM) of ankle, strephenopodia, and heel-raising height were observed.Result and ConclusionRelaxing-joint needling and ordinary acupuncture both can produce significant efficacies in treating post-stroke spastic hemiplegia. The relaxing-joint needling produced more significant efficacies in improving the body balance, ROM, muscular tension, and lower limb spasticity compared to ordinary acupuncture. It’s plausible that relaxing-joint needling improves the strephenopodia and hemiplagia gait through renovating body balance, ROM, muscular tension, and lower limb spasticity. Since the three-dimensional gait analysis can analyze the dorsi-extension, strephenopodia, and heel-raising height, thus it can be used to evaluate the change of the spastic gait of post-stroke hemiplegia in amore objective, elaborate, and correct way.
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ObjectiveTo evaluate the clinical efficacy of acupuncture at Waiguan (TE5) and Zhigou (TE6) in treating post-stroke hand spasm.MethodSixty patients with post-stroke hand spasm graded≥Ⅰand≤Ⅲby the Modified Ashworth Scale (MAS) were randomized into a treatment group (30 cases) and a control group (30 cases). The treatment group was intervened by acupuncture at Waiguan and Zhigou plus rehabilitation training, while the control group was by dry rehabilitation training alone. The acupuncture and rehabilitation were performed once a day, 5 sessions a week, totally for 3 months. The change of hand spasm degree was observed by using MAS; the Fugl-Meyer Assessment (FMA) was adopted to observe the change of hand function; the Modified Barthel Index (MBI) was used to observe the change of the activities of daily living (ADL).ResultAfter treatment, there was a significant difference in comparing the MAS score between the two groups (P<0.05); there was a significant difference in comparing the FMA score between the two groups after treatment (P<0.05); after intervention, there was a significant difference in comparing the MBI score between the two groups (P<0.05).ConclusionAcupuncture at Waiguan and Zhigou can significantly improve the hand spasm sate after stroke; acupuncture plus rehabilitation can substantially improve the hand function and ADL of the patients, and can produce a more significant efficacy compared to dry rehabilitation training.
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Objective To observe the clinical efficacy ofXing Nao Kai Qiao (brain awakening and orifice opening) Needling plus mountain-burning fire manipulation in treating post-stroke limb numbness.Method Eighty patients with post-stroke limb numbness were randomized into a treatment group and a control group, 40 cases in each group. The treatment group was intervened byXing Nao Kai Qiao needling plus mountain-burning fire manipulation, while the control group was byXing Nao Kai Qiao needling alone. The sensory function and motor function (Fugl-Meyer Assessment, FMA), National Institute of Health Stroke Scale (NIHSS), and Barthel Index (BI) were observed before and after intervention.Result The component scores of FMA (motor function, sensory function, range of motion, and joint pain intensity), NIHSS scores, and BI scores were significantly changed respectively after 1 and 2 treatment courses in both groups (P<0.05). The component scores of FMA, NIHSS scores, and BI scores after 2 treatment course were significantly different from that after 1 treatment course in both groups (P<0.05). After 2 treatment courses, the sensory function score, joint pain intensity in the treatment group were significantly different from that in the control group (P<0.05).ConclusionXing Nao Kai Qiaoneedling plus mountain-burning fire manipulation is an effective method in treating post-stroke limb numbness.
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Objective To systematically review the therapeutic efficacy of acupuncture plus rehabilitation in treating post-stroke spasm and to summarize the commonly-used acupoints.Method The randomized controlled trials and quasi-randomized trials of acupuncture plus rehabilitation for post-stroke spasm published from January 1 of 2005 to December 31 of 2014 in China were retrieved from CNKI, WanFang database, and VIP database, etc. by using computer. The eligible studies were recruited for review. Result Totally 15 studies were enrolled. The Meta-analysis showed that the most commonly used acupoints in acupuncture treatment for post-stroke spasm were Quchi (LI 11), Jianyu (LI 15), Hegu (LI 4), Tianjing (TE 10), Waiguan (TE 5), Zusanli (ST 36), Sanyinjiao (SP 6), Chize (LU 5), and so on. Compared to the controls, acupuncture plus rehabilitation had significantly better effective rate [OR=3.13, 95%CI (2.00,4.89),P<0.00001], recovery rate [OR=2.42, 95%CI (1.53,3.83),P=0.0002], MAS score [MD=﹣0.48, 95%CI (﹣0.62,﹣0.35),P<0.00001], FMA score [MD=5.58, 95%CI (4.96,6.20),P<0.00001], and NDS score [SMD=﹣0.68,95%CI (﹣0.91,﹣0.44),P<0.00001].Conclusion Acupuncture plus rehabilitation can effectively mitigate the post-stroke spasm and is worth promoting in clinic; more high-quality researches are expected as the quality of the currently recruited trials is not so satisfactory.
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This paper aimed to review the recent literature on the TCM treatment for stroke sequelae. The content summarized and discussed the definition of stroke sequelae, herbalmedicine, TCM patents, acupuncture and so on. Sequelae of stroke’s pathogenesis was mainly caused by deficiency generating stasis, so the treatment principles were to tonifying Qi and blood and promote circulation and remove stasis with the common prescriptions, such asBuyang-Huanwudecoction,Xuefu-Zhuyu decoction andDihuang-Yinzi. Meanwhile, Chinese medicine patents and acupuncture treatment canimprove the brain function and ADL.
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ObjectiveTo observe the clinical efficacyand safety of the point-toward-point needling respectively from Qiuxu (GB40) to Shenmai (BL62) and from Qiuxu to Zhaohai (KI6) in treating post-stroke ankle joint dysfunction.MethodThirty-six patients with post-stroke ankle dysfunction were randomizedinto a treatment group of 18 cases and a control group of 18 cases. The treatment group was majorly treated with point-toward-point needling from Qiuxu to Shenmai, while the control group was by needling from Qiuxu to Zhaohai.ResultRegarding the spasm intensity of the triceps surae, the change of the Modified Ashworth Scale (MAS) score in the treatment group after treatment was significantly different from that in the control group (P<0.05), and the treatment group was superior to the control group.ConclusionPoint-toward-point needling from Qiuxu to Shenmai is better than that from Qiuxu to Zhaohai in relieving the spasm of triceps surae, and it’s an safe and effective needling method.
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Objective To investigate the clinical efficacy of acupuncture plus bloodletting therapy for post-stroke limb sensory disturbance.Methods Ninety patients with post-stroke limb sensory disturbance were randomly allocated to treatment and control groups, 45 cases each. The treatment group received acupuncture plus bloodletting therapy and the control group, acupuncture alone. The disease and motor function were scored in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There were statistically significant pre-/post-treatment differences in the disease score and the motor function score in the two groups (P<0.05). There were statistically significant post-treatment differences in the disease score and the motor function score between the treatment and control groups (P<0.05). The total efficacy rate was 91.1% in the treatment group and 66.7% in the control group; there was a statistically significant difference between the two groups (P<0.01). Conclusions Acupuncture plus bloodletting therapy is an effective way to treat post-stroke sensory disturbance. It can improve the clinical symptoms and motor function in the patients.
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Objective To observe the clinical efficacy of heat-sensitive moxibustion in treating post-stroke urinary incontinence. Method Ninety patients with post-stroke urinary incontinence were randomized into a treatment group and a control group, 45 cases in each group. The treatment group was intervened by heat-sensitive moxibustion at Qihai (CV 6), Guanyuan (CV 4), and Sanyinjiao (SP 6), while the control group was by moxa-box moxibustion. After 4-week treatment, the two groups were compared with each in the incontinence grading and Activities of Daily Living (ADL).Result After treatment, the incontinence grading and ADL scores were significantly changed in both groups (P<0.05). The incontinence grading and ADL scores of the treatment group were significantly different from that of the control group after treatment (P<0.05).Conclusion Heat-sensitive moxibustion can improve the post-stroke urinary incontinence and ADL.