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Objective:To evaluate the effect of Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine on ischemic stroke.Methods:Prospective cohort study. According to random number table method, 120 patients with ischemic stroke who met inclusion criteria in the hospital were divided into control group and treatment group, 60 in each group. The control group was given routine western medicine, while the treatment group was additionally given Banxia Baizhu Tianma Decoction and modified Buyang Huanwu Decoction. All were treated for 4 weeks. The severity of neurological deficits was evaluated by National Institute of Health Stroke Scale (NIHSS). The activities of daily living were evaluated by Barthel index. The high blood shear viscosity (HWBV), low blood shear viscosity (LWBV), plasma fibrinogen (FIB) and plasma viscosity (PV) were detected by full-automatic blood rheometer. The levels of MDA, SOD and NO were detected by ELISA. The clinical responsive rate was assessed.Results:The differences in total response rate between treatment group and control group were statistically significant [93.3% (56/60) vs. 75.0% (45/60), χ2=7.56, P=0.006]. After treatment, NIHSS score in treatment group was significantly lower than that in control group ( t=2.38, P=0.019), while Barthel index was significantly higher than that in control group ( t=13.28, P<0.01). After treatment, HWBV [(5.02±0.13) mPa?s vs. (6.18±0.28) mPa?s, t=29.11], LWBV [(1.18±0.21) mPa?s vs. (1.73±0.32) mPa?s, t=11.13], FIB [(2.26±0.28) g/L vs. (3.13±0.39) g/L, t=14.04] and PV [(8.87±1.44) mPa?s vs. (10.34±1.31) mPa?s, t=5.85] in treatment group were significantly lower than those in control group ( P<0.01), and the MDA [(4.14±1.23) mmol/L vs. (5.23±1.35) mmol/L, t=204.30] in treatment group was significantly lower than that in control group ( P<0.01), and levels of SOD [(113.34±0.28) mg/L vs. (96.59±0.57) mg/L, t=4.62] and NO [(26.01±3.26) μmol/L vs. (20.84±3.74) μmol/L, t=8.07] in treatment group were significantly higher than those in control group ( P<0.01). Conclusion:The Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine can repair nerve function, improve hemorheology, oxidative stress indexes, clinical curative effect and activities of daily living in patients with ischemic stroke.
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Objective:To evaluate the efficacy of Zhongfeng Xingnao liquid combined with conventional treatment for acute ischemic stroke (AIS).Methods:A total of 92 patients with AIS in our hospital from May 2020 to March 2021 who met the inclusion criteria were selected and divided into 2 groups according to the end number of the medical records, with 46 cases in each group. Both groups were given conventional western medicine therapy, and the control group added intravenous drip of edaravone injection, and the study group added Zhongfeng Xingnao liquid on the basis of the control group. Both groups were treated continuously for 2 weeks. Before and after treatment, the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) were used to evaluate the degree of neurological deficit and prognosis. The whole blood high-shear viscosity, hematocrit, whole blood low-shear viscosity, fibrinogen were detected by automatic blood rheometer, and the levels of high-sensitivity C-reactive protein (hs-CRP), IL-6 and endothelin-1 (ET-1) were detected by ELISA. Adverse events were recorded, and clinical effect rate was evaluated.Results:After treatment, the mRS score (2.06±0.18 vs. 2.73±0.23, t=15.56) and NIHSS score (5.25±2.36 vs. 10.61±2.48, t=14.58) of the study group were significantly lower than those in the control group ( P<0.01). The total clinical effective rate was 89.1% (41/46) in the study group and 69.6% (32/46) in the control group, with a statistically significant difference between the two groups ( χ2=5.37, P=0.020). After treatment, the serum levels of hs-CRP [(9.04±1.98)mg/L vs. (14.36±2.09)mg/L, t=12.57], IL-6 [(23.14±1.46)ng/L vs. (39.37±2.51)ng/L, t=12.39] and ET-1[(67.18±13.22)ng/L vs. (98.14±22.29)ng/L, t=19.37] in the study group were significantly lower than those in the control group ( P<0.01). The whole blood high shear viscosity [(7.53± 1.37)mPa·s vs. (9.24±1.42)mPa·s, t=5.89], hematocrit [(0.27±0.06)% vs. (0.39±0.08)%, t=8.14], whole blood low shear viscosity [(5.92±1.09)mPa·s vs. (8.35±1.24)mPa·s, t=9.98] and fibrinogen [(1.63±0.42) g/L vs. (2.47±0.58) g/L, t=7.96] were significantly lower than those in the control group ( P<0.01). During the treatment period, the incidence of adverse events was 8.70% (4/46) in the control group and 15.22% (7/46) in the study group, and there was no significant difference between the two groups ( χ2=0.93, P=0.335). After treatment, the good outcome rate was 73.9% (34/46) in the control group and 93.5% (43/46) in the study group, with a statistically significant difference between the two groups ( χ2=6.45, P=0.011). Conclusion:The Zhongfeng Xingnao liquid combined with edaravone injection can reduce the level of inflammatory cytokines in patients with AIS, improve hemorheological indicators, and play a role in brain protection.
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Objective:To explore the influence of acupoint catgut embedding combined with exercise therapy on the rehabilitation effect of patients with upper limb spasticity after stroke and qi deficiency and blood stasis type.Methods:A total of 76 patients with qi deficiency and blood stasis type of upper limb spasticity after stroke who met the inclusion criteria in the hospital were enrolled between May 2018 and May 2020, and they were divided into two groups according to the random number table method, with 38 in each group. The control group was given conventional rehabilitation treatment, while the observation group was combined with acupoint catgut embedding and exercise therapy intervention on the basis of the control group. The degree of elbow spasm was assessed by Modified Ashworth Scale and hemiplegic hand function was evaluated by Hemiplegic Hand Function Classification Scale. Simplified Fugl-Meyer Scale was used to evaluate the limb motor ability and Modified Barthel Index was used for ability of daily living, and the adverse events during treatment were recorded.Results:After treatment, the improvement degree of elbow spasm in observation group was significantly better than that in control group ( Z=2.29, P=0.022), and the hemiplegic hand function classification was significantly better than that in control group ( Z=2.08, P=0.038). After treatment, the scores of upper and lower extremities and total score of Fugl-Meyer Scale in observation group were significantly higher than those in control group ( t=7.17, 7.40, 11.39, all Ps<0.001). While the scores of hemiplegia, faintness, shortness of breath and sallow complexion in observation group were significantly lower than those in control group ( t=7.82, 12.87, 12.55, 7.95, all Ps<0.001). The Barthel index in observation group was significantly higher than that in control group at 6 and 12 months of follow-up ( t=4.82. 6.45, all Ps<0.001). Conclusion:Acupoint catgut embedding combined with exercise therapy for intervention can improve the hemiplegic hand function, and enhance the limb motor function and daily living ability of patients with qi deficiency and blood stasis type of upper limb spasticity after stroke.
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Chinese medicine is effective in treating wind-phlegm obstructing collateral type in acute stroke. In order to explore the modern molecular basis of wind-phlegm obstructing collateral type of acute stroke, the correlation with genetics, blood rheology and imaging, and the effect of clinical treatment, this paper summarizes the research progress on the wind-phlegm obstructing collatera type in acute stroke.
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Objective To evaluate the effect of acupuncture for the stroke patients with tinnitus, hearing loss by using the twirling reinforcing method. Methods A total of 92 tinnitus, hearing loss patients with stroke were included and divided into the observation group and control group by random number table method, 47 in the observation group and 45 in the control group. Patients in both groups were needled at Tinggong, Tinghui, Yifeng in the affected side, and Zhongzhu, Waiguan, Sanyinjiao, Taichong and Taixi in both sides. Patients in the observation group were needled at Taixi and Sanyinjiao using the twirling reinforcing method, but those in the control group needled at Taixi and Sanyinjiao using the needle retention method. Patients in both groups were also treated with semiconductor laser therapy and ultrashort wave therapy. All patients were treated for 20 days. The Tinnitus Severity Scale and the clinical effect were evaluated. Results After the treatment, the Tinnitus Severity Scale scores in the observation group were significantly lower than that in the control group (5.04 ± 3.24 vs. 5.67 ± 3.55; t=-0.880, P>0.05). The improvement rate in tinnitus in the observation group was significantly higher than that in the control group (38.3%vs.17.8%;χ2=17.391, P=0.000). The improvement rate in hearing loss showed no significant difference between two groups (38.3%vs. 31.1%;χ2=8.522, P=0.004). Conclusions Acupuncture using the twirling reinforcing method may relieve tinnitus of the stroke patients with tinnitus, hearing loss.
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Objective To investigate the effects of Yindan-Xinnaotong combined with aspirin on lipidemia levels and hemorrheology in patients with stroke. Methods A total of 62 patients with stroke were randomized into a treatment group (31 cases) and a control group (31 cases). The patients in the control group were treated with aspirin and those in the treatment group were treated with aspirin and Yindan-Xinnaotong capsule (4 capsules each time, 3 times/d) for 30 days. The lipidemia levels and hemorrheology were evaluated before and after the treatment. Results After the treatment, whole blood viscosity (4.15 ± 0.14 mPa?s vs. 5.25 ± 0.40 mPa?s;t=14.452, P0.05). Conclusion Yindan-Xinnaotong combined with aspirin can improve the lipidemia and hemorrheology in stroke patients.
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This paper reports the situation of the treatment for stroke and introduces stroke unit (SU) in overseas hospitals : its important role in the emergency treatment and rehabilitation, the characteristics, advantages and managing modes. Moreover,it discusses the possibility and necessity of establishing SU with characteristics of traditional Chinese medicine.
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Up to now, advantages and disadvantages in the treatment of hypertensive middle_ and large_amount cerebral hemorrhage (HMLCH) by western medicine or traditional Chinese medicine,or by medical treatment or surgical treatment still exist. Mortality and disablement rate remain high. Western medicine combined with Chinese herbal medicine shows better effect in treating HMLCH, but the related research is preliminary. Therefore, thoughts of establishing comprehensive therapeutic protocols for HMLCH are presented as follows. Western medicine combined with Chinese herbal medicine is the fundamental therapeutic principle. Proper surgical operation should be employed promptly to clear away hemotoma and relieve the symptoms first according to the situation of the patient, hospital and the surgeon. Clearing heat and calming the liver, removing blood stasis and phlegm, relaxing the bowels and restoring consciousness are the fundamental therapeutic methods for HMLCH with yang_excess syndrome, and reinforcing Qi and activating blood circulation, removing phlegm and dredging channels, relaxing the bowels and restoring consciousness for yin_excess syndrome. Routine treatment and symptomatic treatment also should be taken into account.
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82 cases were treated with acu—moxibustion and tra-ditional materia medica,while 42 cases were treatedwith routine western drugs.Results revealed that theamelioration of clinical symptoms,signs and total ef-fectiverate in the traditional modality group was betterthan the western drug group.
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Objective:To observe changes of cerebral nerve cell apoptosis of the rat after acute stroke and the preventive and treating effect of Jiannao Decoction on the apoptosis.Methods:SHRsp rats were used to establish the model of acute stroke,which were treated with Jiannao Decoction.Symptoms and signs of the nervous system and changes of pathological structures of the hipocampus were investigated before and after establishment of the model,and changes of cerebral nerve cell apoptosis before and after establishment of the model and medication were investigated with TUNEL,immunohistochamical and Western blot methods. Results:The incidence rate of stroke in the prevention group was significantly lower than that of the model group(P0.05).Conclusion:Jiannao Decoction has significant protective action on brain in the rat with stroke,which is related with inhibiting the effect of nerve cell apoptosis and conduction of apoptosis-related signals.