Aphasia is an impairment of language use following brain damage. There is no consensual definition of aphasia beyond this general description （Code and Petheram, 2011）. In a more restricted defini- tion, however, ap...Aphasia is an impairment of language use following brain damage. There is no consensual definition of aphasia beyond this general description （Code and Petheram, 2011）. In a more restricted defini- tion, however, aphasia is an impairment of linguistic processing at the phonological, morphological, lexical semantic or syntactic level which is usually caused by lesions of the left cerebral hemisphere. This impairment can affect language reception and expression depending on the various aphasic syndromes （McNeil and Pratt, 2001）. Aphasia results in restrictions in those activities of daily living which rely on communication.展开更多
Objective To investigate the clinical application value of Loewenstein Occupational Therapy Cognitive Assessment （LOTCA） battery in Chinese patients with post-stroke aphasia. Methods Cognitive fimctions of 59 Chine...Objective To investigate the clinical application value of Loewenstein Occupational Therapy Cognitive Assessment （LOTCA） battery in Chinese patients with post-stroke aphasia. Methods Cognitive fimctions of 59 Chinese patients with aphasia following a stroke were assessed with the Chinese version of the second edition of LOTCA battery and their linguistic functions were tested with the Western Aphasia Battery （WAB） Scale, respectively. The results of LOTCA were analyzed and compared across different groups, in the light of gender, age, educational background, the length of illness, and the degree of aphasia.展开更多
BACKGROUND Neuropsychiatric symptoms(NPS)have been insufficiently examined in persons with aphasia(PWA)because most previous studies exclude participants with language and communication disorders.AIM To report a two-p...BACKGROUND Neuropsychiatric symptoms(NPS)have been insufficiently examined in persons with aphasia(PWA)because most previous studies exclude participants with language and communication disorders.AIM To report a two-part study consisting of a literature review and an observational study on NPS in post-stroke aphasia.METHODS Study 1 reviewed articles obtained from PubMed,PsycINFO,Google Scholar and Cochrane databases after cross-referencing key words of post-stroke aphasia to NPS and disorders.Study 2 examined language deficits and activities of daily living in 20 PWA(median age:58,range:28-65 years;13 men)with the Western Aphasia Battery-Revised and the Barthel Index,respectively.Informants of these 20 PWA were proxy-evaluated with the Neuropsychiatric Inventory and domain-specific scales,including the Stroke Aphasia Depression Questionnaire-10 item version and the Starkstein Apathy Scale.In addition,an adapted version of the Hospital Anxiety and Depression Scale was directly administered to the PWA themselves.This observational study is based on the baseline assessment of an intervention clinical trial(EudraCT:2017-002858-36;ClinicalTrials.gov identifier:NCT04134416).RESULTS The literature review revealed a broad spectrum of NPS in PWA,including depression,anxiety,apathy,agitation/aggression,eating and sleep disorders,psychosis,and hypomania/mania.These findings alert to the need for improving assessment and treatment approaches of NPS taking into consideration their frequent occurrence in PWA.Study 2 showed that the 20 participants had mild-to-moderate aphasia severity and were functionally independent.A wide range of comorbid NPS was found in the post-stroke aphasic population(median number of NPS:5,range:1-8).The majority of PWA(75%)had depressive symptoms,followed by agitation/aggression(70%),irritability(70%),anxiety(65%)and appetite/eating symptoms(65%).Half of them also presented symptoms of apathy,whereas euphoria and psychotic symptoms were rare(5%).Domain-specific scales revealed that 45%of participants had apathy and 30%were diagnosed with depression and anxiety.CONCLUSION Concurrent NPS are frequent in the chronic period of post-stroke aphasia.Therefore,further research on reliable and valid assessment tools and treatment for this aphasic population is strongly warranted.展开更多
Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but...Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but the neuropsychiatric sequelae in the chronic stage have become increasingly prominent.Post-stroke depression is one of the very important manifestations.This article conducts a further discussion on this issue.展开更多
BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their effi...BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their efficacy is limited.This study investigated whether combining SSRIs with traditional Chinese medicine(TCM)Free San could enhance their therapeutic effects.AIM To evaluate the clinical efficacy and safety of combining SSRIs with Free San in treating PSD,and to assess its impact on HPA axis function.METHODS Ninety-two patients with PSD were enrolled and randomly divided into control groups(n=46)and study groups(n=46).The control group received the SSRI paroxetine alone,whereas the study group received paroxetine combined with Free San for 4 weeks.Hamilton Depression Scale and TCM syndrome scores were assessed before and after treatment.Serum serotonin,norepinephrine,cortisol,cor-ticotropin-releasing hormone,and adrenocorticotropic hormone were measured.The treatment responses and adverse reactions were recorded.RESULTS After treatment,the Hamilton Depression Scale and TCM syndrome scores were significantly lower in the study group than in the control group(P<0.05).Serum serotonin and norepinephrine levels were significantly higher in the study group than in the control group,whereas cortisol,corticotropin-releasing hormone,and adrenocorticotropic hormone levels were significantly lower(P<0.05).The total efficacy rates were 84.78%and 65.22%in the study and control groups,respectively(P<0.05).No significant differences in adverse reactions were observed between the two groups(P>0.05).CONCLUSION Combining SSRIs with Free San can enhance therapeutic efficacy,improve depressive symptoms,and regulate HPA axis function in patients with PSD with good safety and clinical application value.展开更多
Background There has been a long debate among scholars surrounding the relationship between language and cognition. The worldwide study of aphasia is actively exploring the function of language from cognitive point of...Background There has been a long debate among scholars surrounding the relationship between language and cognition. The worldwide study of aphasia is actively exploring the function of language from cognitive point of view. This study aimed to investigate the relationship between linguistic functions and cognitive functions in a clinical study of Chinese patients with post-stroke aphasia. Methods Cognitive functions of 63 Chinese patients with aphasia following a stroke were assessed with the Chinese version of the second edition of Loewenstein Occupational Therapy Cognitive Assessment （LOTCA） battery and their linguistic functions were tested with the Western Aphasia Battery （WAB） Scale, respectively. The correlation between the results observed on the LOTCA battery and those on the WAB was analyzed. Aphasia quotient, performance quotient, cortical quotient, and linguistic function of the patients were compared. Then, each language function was analyzed by way of dependent adopt multiple regression analysis. Results The total score of 63 patients as shown on the LOTCA battery was significantly correlated with the aphasia quotient, performance quotient, and cortical quotient observed on the WAB Scale （P 〈0.05, P 〈0.01）. However, the correlation between visuomotor organization under LOTCA and repeat under WAB was not significant （P 〉0.05）. The attention of LOTCA and WAB＇s spontaneous speech, repeat, naming, and aphasia quotient was not relevant either （P 〉0.05）. In addition, correlations between the results observed on the LOTCA battery and the WAB were significant （P 〈0.05, P 〈0.01）. Among the significant variables finally entered into the standardized canonical discriminant functions, main factors affected the aphasia. Multiple regression analysis showed that orientation, spatial perception, and visual perception had a notable influence on aphasia quotient and naming. Orientation and thinking operation was found to have a notable influence on spontaneous speech. Spatial perception and visual perception was found to have a notable influence on auditory comprehension. Thinking operation and orientation was found to have an obvious influence on reading. Thinking operation, spatial perception, and attention was found to have a notable effect on writing （P 〈0.01）. Conclusion There exists a close relationship between linguistic functions and cognitive orientation, spatial perception, visual perception, and thinking operation in a clinical study of Chinese patients with post-stroke aphasia.展开更多
Objective:To evaluate the existing randomized controlled trials(RCTs)for evidence of the efficacy and safety of head acupuncture(HA)plus Schuell’s language rehabilitation(SLR)in post-stroke aphasia.Methods:Seven data...Objective:To evaluate the existing randomized controlled trials(RCTs)for evidence of the efficacy and safety of head acupuncture(HA)plus Schuell’s language rehabilitation(SLR)in post-stroke aphasia.Methods:Seven databases including Embase,PubMed,Cochrane Library,Technology Periodical Database,the China National Knowledge Infrastructure,SinoMed and Wanfang Data Information Site were searched for RCTs published from database inception until November 14,2021.RCTs that compared HA plus SLR with sham(or blank)control,acupuncture therapy alone,certain language rehabilitation therapy alone or other therapies for post-stroke aphasia were included.Data were extracted and assessed,and the quality of RCTs was evaluated.Fixed-effects model was used,with meta-influence analysis,meta-regression,and regression-based sub-group analyses applied for exploration of heterogeneity.Publication bias was estimated by funnel plots and Egger’s tests.Results:A total of 32 RCTs with1,968 patients were included and 51 comparisons were conducted classified as types of strokes and aphasia.(1)For patients with aphasia after ischemic stroke,HA plus PSA showed significantly higher accumulative markedly effective rate[relative risk(RR)=1.55,95% confidence interval(CI):1.19-2.02,I^(2)=0%]and accumulative effective rate(RR=1.22,95%CI:1.09-1.36,I^(2)=0%).(2)For patients with comprehensive types of stroke,HA plus PSA was more effective in increasing recovery rate(RR=1.89,95%CI:1.39-2.56,I^(2)=0%),accumulative markedly effective rate(RR=1.53,95%CI:1.36-1.72,I^(2)=9%)and accumulative effective rate(RR=1.14,95%CI:1.09-1.19,I^(2)=34%).(3)For patients with aphasia after stroke,HA plus PSA was superior to PSA alone with statistical significance in increasing recovery rate(RR=2.08,95%CI:1.24-3.46,I^(2)=0%),accumulative markedly effective rate(RR=1049,95%CI:1.24-1.78,I^(2)=0%)and accumulative effective rate(RR=1.15,95%CI:1.06-1.24,12=39%).(4)For patients with multiple types of aphasia,HA plus PSA also demonstrated significantly higher recovery rate(RR=1.86,95%CI:1.28-2.72,I^(2)=0%),accumulative markedly effective rate(RR=1.55,95%CI:1.35-1.78,I2=22%),and accumulative effective rate(RR=1.17,95%CI:1.11-1.23,I^(2)=41%).(5)For patients with motor aphasia after ischemic stroke,compared with PSA alone,HA plus PSA showed significantly higher accumulative markedly effective rate(RR=1.38,95%CI:1.06-1079,I^(2)=0%)and accumulative effective rate(RR=1.20,95%CI:1.05-1.37,I^(2)=0%).Meta-regression analyses were performed without significant difference,and publication bias was found in some comparisons.Conclusion:HA plus SLR was significantly associated with better language ability and higher effective rate for patients with post-stroke aphasia,and HA should be operated cautiously especially during acupuncture at eye and neck.(Registration No.CRD42020154475).展开更多
The activation of the sirtuin1(SIRT1)/nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase 1(HO-1)pathway has been shown to mitigate oxidative stress-induced apoptosis and mitochondrial damage by reducing ...The activation of the sirtuin1(SIRT1)/nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase 1(HO-1)pathway has been shown to mitigate oxidative stress-induced apoptosis and mitochondrial damage by reducing reactive oxygen species(ROS)levels.Clinical trials have demonstrated that Zhongfeng Xingnao Liquid(ZFXN)ameliorates post-stroke cognitive impairment(PSCI).However,the underlying mechanism,particularly whether it involves protecting mitochondria and inhibiting apoptosis through the SIRT1/Nrf2/HO-1 pathway,remains unclear.This study employed an oxygen-glucose deprivation(OGD)cell model using SHSY5Y cells and induced PSCI in rats through modified bilateral carotid artery ligation(2VO).The effects of ZFXN on learning and memory,neuroprotective activity,mitochondrial function,oxidative stress,and the SIRT1/Nrf2/HO-1 pathway were evaluated both in vivo and in vitro.Results indicated that ZFXN significantly increased the B-cell lymphoma 2(Bcl2)/Bcl2-associated X(Bax)ratio,reduced terminal deoxynucleotidyl transferase-mediated d UTP nickend-labeling(TUNEL)+cells,and markedly improved cognition,synaptic plasticity,and neuronal function in the hippocampus and cortex.Furthermore,ZFXN exhibited potent antioxidant activity,evidenced by decreased ROS and malondialdehyde(MDA)content and increased superoxide dismutase(SOD),catalase(CAT),and glutathione(GSH)levels.ZFXN also demonstrated considerable enhancement of mitochondrial membrane potential(MMP),Tom 20 fluorescence intensity,adenosine triphosphate(ATP)and energy charge(EC)levels,and mitochondrial complexⅠandⅢactivity,thereby inhibiting mitochondrial damage.Additionally,ZFXN significantly increased SIRT1 activity and elevated SIRT1,nuclear Nrf2,and HO-1 levels.Notably,these effects were substantially counteracted when SIRT1 was suppressed by the inhibitor EX-527 in vitro.In conclusion,ZFXN alleviates PSCI by activating the SIRT1/Nrf2/HO-1 pathway and preventing mitochondrial damage.展开更多
BACKGROUND Post-stroke depression(PSD),a condition commonly developed in patients with chronic stroke,impairs both functional rehabilitation and daily living.AIM To comprehensively analyze PSD contributors in chronic ...BACKGROUND Post-stroke depression(PSD),a condition commonly developed in patients with chronic stroke,impairs both functional rehabilitation and daily living.AIM To comprehensively analyze PSD contributors in chronic phase stroke and construct a precise nomogram.METHODS Two hundred patients with chronic stroke admitted in over 7 years(January 2017 to January 2024),were enrolled and categorized into the PSD group(n=96)and the non-PSD(NPSD)group(n=104).Demographic characteristics,clinicopathological data,and biochemical indicators were collected and analyzed by univariate analysis.Significant predictors identified in the univariate analysis were subsequently incorporated into a binary logistic regression model to assess their independent effects on PSD risk.The discriminative ability/calibration of the developed PSD prediction nomogram was assessed.RESULTS Compared with the NPSD group,the PSD group included a higher proportion of patients aged≥60 years,divorced/widowed,with an education level below senior high school,presenting with≥2 comorbidities,exhibiting severe neurological impairment,and having multiple lesions.Additionally,the PSD group showed significantly higher neutrophil-to-lymphocyte ratio(NLR)and platelet-tolymphocyte ratio(PLR)than the NPSD group.After assigning values to significant predictors,multivariate analysis indicated that educational level(P=0.046),NLR(P<0.001),and PLR(P<0.001)were independently associated with PSD in patients with chronic stroke.The developed nomogram exhibited favorable discrimination performance.The nomogram's calibration remained accurate for high-risk stratification but displayed modest inconsistencies in lowand middle-risk categories.CONCLUSION Education level,NLR,and PLR independently contribute to PSD in patients with chronic stroke.The constructed nomogram effectively predicts PSD risk within the range of 0.10-0.90,presenting a valuable tool for clinical monitoring and risk assessment of PSD in patients with chronic stroke.展开更多
Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this ...Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this approach from the perspective of gut microbiota.Methods:This multicenter,randomized,double-blind(patients and assessors),placebo-controlled trial will enroll 80 patients with PSD,and include a 1-week run-in period,a 4-week treatment phase,and a 12-week follow-up.Eligible participants will randomly be assigned in a 1:1 ratio to either the acupoint application or placebo(non-acupoint)groups.Treatments will be administered thrice weekly for 4 weeks.The primary outcome is change in the Hamilton Rating Scale for Depression(HAMD)score.Secondary outcomes include the Beck Depression Inventory(BDI),36-Item Short-Form Health Survey(SF-36),Barthel Index of Activities of Daily Living,Social Adaptation Self-Evaluation Scale(SASS),and gut microbiota profiling.All outcomes will be assessed at baseline(prior to treatment),during treatment(weeks 2 and 4),and during follow-up(weeks 8,12,and 16).The Treatment Emergent Symptom Scale(TESS)will be used for evaluation throughout the 4-week treatment phase.Discussion:The results of this study will provide important evidence supporting a novel treatment strategy for PSD that targets gastrointestinal regulation,potentially informing future clinical practice.展开更多
Post-stroke depression(PSD) is a common psychiatric complication affecting nearly one-third of stroke survivors, leading to increased disability, mortality, and cognitive decline. Traditional Chinese Medicine(TCM) has...Post-stroke depression(PSD) is a common psychiatric complication affecting nearly one-third of stroke survivors, leading to increased disability, mortality, and cognitive decline. Traditional Chinese Medicine(TCM) has proven effective in treating PSD through syndrome differentiation, yet existing animal models primarily reflect Western medical concepts and fail to incorporate the TCM principle of “同病异治”( treating the same disease with different methods). This paper provides a review of the current methods for constructing animal models of post-stroke depression(PSD) from the perspective of Traditional Chinese Medicine(TCM) syndrome differentiation and proposes multi-dimensional assessment indicators. By integrating TCM theories with modern biomedical techniques, this study offers a comprehensive framework for deepening the understanding of the pathogenesis and therapeutic evaluation of PSD. This approach not only contributes to advancing PSD research but also paves the way for innovative treatment strategies that combine traditional and modern medicine.展开更多
Post-stroke depression(PSD)is a prevalent but often underdiagnosed complication affecting stroke survivors,with significant implications for recovery and quality of life.Emerging evidence suggests that central obesity...Post-stroke depression(PSD)is a prevalent but often underdiagnosed complication affecting stroke survivors,with significant implications for recovery and quality of life.Emerging evidence suggests that central obesity,as measured by the weight-to-waist index(WWI),may play a crucial role in PSD risk and severity.Traditional obesity metrics,such as body mass index,may not accurately capture the impact of visceral fat distribution on neuropsychiatric outcomes.This letter highlights the growing recognition of WWI as a precise indicator of metabolic and inflammatory disturbances linked to post-stroke mental health.Integrating WWI into routine stroke rehabilitation assessments could facilitate early identification of high-risk patients and improve intervention strategies.Further research is needed to establish standardized WWI cutoff values and explore potential therapeutic targets for PSD prevention.展开更多
Objective:To investigate the clinical efficacy of Xiaochaihu Decoction combined with Xiaoxianxiong Decoction in the treatment of post-stroke pneumonia.Methods:To complete the sample grouping comparison,all patients wi...Objective:To investigate the clinical efficacy of Xiaochaihu Decoction combined with Xiaoxianxiong Decoction in the treatment of post-stroke pneumonia.Methods:To complete the sample grouping comparison,all patients with post-stroke pneumonia were investigated,and the number of cases was 60.These patients’diseases were consistent with the dialectical standards of traditional Chinese medicine(phlegm-heat obstructing lungs).The patients were randomly divided into a control group(30 cases,treated with antibiotics and symptomatic methods)and a treatment group(30 cases,treated with Xiaochaihu Decoction and Xiaoxianxiong Decoction on the basis of the control group).Various indicators were compared.Results:The total clinical effective rates were 93%and 80%in the treatment group and the control group,respectively,with statistical significance(P<0.05).The improvement of various clinical symptoms was compared,and the values in the treatment group were reduced,showing significance(P<0.05).Analysis of serum factor indicators showed that the overall trend of the treatment group was reduced,and the comparison between groups was below 0.05.Conclusion:Xiaochaihu Decoction combined with Xiaoxianxiong Decoction has a significant clinical effect in the treatment of post-stroke pneumonia(phlegm-heat obstructing lungs syndrome),which can reduce inflammatory reactions and has few adverse reactions,worthy of clinical application.展开更多
BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains ina...BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains inadequately explored in the literature.AIM To elucidate the relationship between WWI and PSD.METHODS Data from the National Health and Nutrition Examination Survey 2005 to 2018 were analyzed.Multivariable logistic regression models and propensity score matching were utilized to investigate the association between WWI and PSD,with adjustments for potential confounders.The restricted cubic spline statistical method was applied to explore non-linear associations.RESULTS Participants with elevated WWI values had a significantly greater risk of developing PSD.Specifically,individuals in the higher WWI range exhibited more than twice the likelihood of developing PSD compared to those with lower WWI values(odds ratio=2.21,95%confidence interval:1.84-2.66,P<0.0001).After propensity score matching,the risk of PSD remained significantly elevated(odds ratio=1.43,95%confidence interval:1.09-1.88,P=0.01).Tertile analysis revealed that participants in the highest WWI tertile faced a significantly higher risk of PSD compared to those in the lowest tertile.Restricted cubic spline analysis further revealed a non-linear association,with the risk of PSD plateauing at higher WWI values.CONCLUSION There is a significant association between elevated WWI and increased risk of PSD.Thus,regular depression screening should be implemented in stroke patients with elevated WWI to enhance patient outcomes.展开更多
Objective:To evaluate the efficacy of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia.Methods:CNKI,VIP,Wan Fang Database,MEDLINE,Embase,Web of Science and Cochrane Li...Objective:To evaluate the efficacy of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia.Methods:CNKI,VIP,Wan Fang Database,MEDLINE,Embase,Web of Science and Cochrane Library were searched for published researches up to March,2021.Randomized controlled trials RCTs that focused on scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia were included.We managed the data analysis with RevMan 5.3 software.Results:A total of 16 RCTs with 1323 patients were involved.The results of meta-analysis showed that:①The effective rate of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia after stroke was significantly better than that of simple language rehabilitation training[OR=3.94,95%CI(2.73,5.68),P<0.00001];②In the evaluation of language function,compared with the language rehabilitation training,the scalp acupuncture combined with language rehabilitation training can significantly improve the reading ability of the patients with motor aphasia after stroke[MD=7.22,95%CI(3.55,10.89),P=0.0001],writing ability[MD=6.51,95%CI(3.61,9.41),P<0.0001],expressive ability[MD=4.13,95%CI(2.37,5.89),P<0.0001],retelling ability[MD=5.00,95%CI(2.38,7.63),P=0.0002],listening comprehension ability[MD=5.36,95%CI(3.12,7.61),P<0.00001]and naming ability[MD=5.60,95%CI(4.20,7.00),P<0.00001];③Compared with simple language rehabilitation training,scalp acupuncture combined with language rehabilitation can significantly improve the daily life language communication ability of patients with motor aphasia,and the difference was statistically significant[MD=30.01,95%CI(11.30,48.72),P=0.002].Conclusion:Scalp acupuncture combined with language rehabilitation training has a significant effect on motor aphasia.However,due to the small sample size,more RCTs are needed to confirm that.展开更多
Objective To assess the efficacy and safety of treating post-stroke depression with acupuncture compared to western medicine systematically. Methods Databases were retrieved such as Cochrane Library, PubMed, Web of Si...Objective To assess the efficacy and safety of treating post-stroke depression with acupuncture compared to western medicine systematically. Methods Databases were retrieved such as Cochrane Library, PubMed, Web of Sicence, EMbase, CBM, CNKI and WanFang Data so as to look up randomized controlled trials （RCT） of treating post-stroke depression with acupuncture and western medicine, and the time limit for the retrieval spanned from the date of database established to September 2013. By extracting data and evaluating methodological quality of included studies according to inclusion and exclusion criteria, RevMan 5.2 software was applied for Meta-analysis and evidence quality was assessed by adopting the GRADE system. Results Atotal of 23 RCTs （845 patients with post-stroke depression） were included in this study. It was revealed by Meta-analysis that the differences of the two groups were statistically significant in terms of HAMD scale scores measured at the end of the treatment by comparing the treatment of acupuncture and western medicine [SMD=0.26, 95% CI （0.11, 0.40）], but via susceptibility analysis （excluding low quality studies）, the differences were not statistically significant [SMD=-0.06, 95% CI （-0.37, 0.25）], and the reliability of the results was low; in terms of adverse events, the differences were statistically significant [RR= 0.32, 95% Cl （0.19, 0.53）], and the risk of adverse events reduced by 68% in the acupuncture group. From the assessment on evidence quality grade based on GRADE system, it was revealed that HAMD scores and adverse events were evidences with fairly low quality. Conclusion Although this system assessment showed that treating post-stroke depression with acupuncture was more effective compared with western medicine, the result was less reliable and quality of evidences was poor. The above-mentioned results need more high- quality randomized controlled trials for further verification.展开更多
Objective To explore the better treatment of post-stroke depression. Methods Sixty cases of post-stroke depression ranged from mild to middle degree were randomly divided into comprehensive therapy group and medicatio...Objective To explore the better treatment of post-stroke depression. Methods Sixty cases of post-stroke depression ranged from mild to middle degree were randomly divided into comprehensive therapy group and medication group, 30 cases in each group. In comprehensive therapy group, electroacupuncture at temple-three-needle was mainly applied and Fluoxetine Hydrochloride capsule was taken by oral administration; in medication group, Fluoxetine Hydrochloride capsule was applied by oral administration. Functional Independent Measure （FIM） Scale and WHOQOL-BREF evaluation results before and after treatment were compared after 4 weeks treatment. Results Comparing with the FIM scores before treatment, the differences in the two groups were significant （both P0.01）, and the improvement in comprehensive therapy group （74.97±9.52） was superior to that in medication group （66.70±9.23） （P0.01）. Signif icant differences were presented statistically in comparison of index scores of WHOQOL-BREF before and after treatment in two groups （P0.05, P0.01）, and it in comprehensive therapy group was superior to that in medication group （P0.05, P0.01）. Conclusion Activities of daily life and quality of life of post-stroke depression can be significantly improved by electroacupuncture at temple-three-needle and oral administration of Fluoxetine Hydrochloride capsule.展开更多
This systematic review is aim to comprehensively evaluate the efficacy of acupoint stimulation in managing of post-stroke spasticity. The eligible randomized controlled clinical trials （RCTs） and quasi-randomized co...This systematic review is aim to comprehensively evaluate the efficacy of acupoint stimulation in managing of post-stroke spasticity. The eligible randomized controlled clinical trials （RCTs） and quasi-randomized controlled clinical trials （quasi-RCTs） will be searched from the following databases： the Cochrane Central Register of Controlled Trials （CENTRAL）, MEDLINE, EMBASE, China National Knowledge Infrastructure （CNKI）, Chinese Scientific Journal Database （VIP）, Wanfang Database, Chinese BioMedical Literature Database （CBM）. The Cochrane risk of bias tool will be used to assess the trials. No patients or their family will be bothered in this systematic review, so there is no need for the permission of institutional review board （IRB）. The completed systematic review will be published in a peer-reviewed journal.展开更多
Objective To observe the therapeutic effect of electroacupuncture （EA） of ＂Niwan Bazhen＂ points in the treatment of post-stroke depression. Methods A total of 66 post-stroke depression patients were randomized int...Objective To observe the therapeutic effect of electroacupuncture （EA） of ＂Niwan Bazhen＂ points in the treatment of post-stroke depression. Methods A total of 66 post-stroke depression patients were randomized into treatment group （EA＋oral administration of Prozac-20, n =31 ） and control group （o- ral administration of Prozac-20, 20 mg/d, 28 days altogether, n =30）. For patients of treatment group, EA （2/100 Hz, a tolerable stimulation strength） was applied to ＂Niwan Bazhen＂ points [Baihui （百会 GV20）, etc. ] for 30 min, once daily, （except weekends） continuously for one month. Halmiton Rating Scale （HAMD） for Depression and Chinese Scale for Stroke （CSS） were used to evaluate the therapeutic effect. Results After the treatment, of the 30 and 31 cases in control and treatment groups, 4 and 6 were cured, 10 and 14 experienced marked improvement.in their symptoms, 6 and 7 had an improvement, 6 and 4 failed, with the cure＋ markedly effective rates being 46.7% and 64.5% respectively. The therapeutic effect of treatment group was significantly superior to that of control group （ P〈0.05）. The decreased values of both HAMD and C,,SS of treatment group were remarkably lower than those of control group （P〈0.01,0.05） . Conclusion EA of ＂Niwan Bazhen＂ points is an effective remedy for post-stroke depression.展开更多
Although depression may affect patients＇ recovery and even their survival rate after stroke,it is often overlooked or inadequately managed.And data regarding the treatment efficacy and safety of fluoxetine in this se...Although depression may affect patients＇ recovery and even their survival rate after stroke,it is often overlooked or inadequately managed.And data regarding the treatment efficacy and safety of fluoxetine in this setting are inconsistent.We aimed to systematically assess those two indices in patients with post-stroke depression （PSD）.Through a systematic literature search in 10 biomedical databases,244 articles were first identified,through which we collected and evaluated a total of 600 patients identified from 11 RCTs.The meta-analysis with Revman software indicated that fluoxetine was more effective than placebo,the combined results of 9 RCTs showed that fluoxetine decreased the depression rating scale scores significantly compared with placebo,and the pooled weighted mean difference （WMD） was 0.44 （95% CI-0.03 to 0.92）.Moreover,time-dependent effects were also observed.No consistent evidence was found for its positive effects on the recovery of neurological impairments and improvements in activities of daily living （ADL）.Six studies reported rate of adverse effects in both fluoxetine groups and control groups and showed no significant difference between them （OR=0.03,95% CI-0.00 to 0.07）.This meta-analysis suggested that fluoxetine may be effective and safe for patients with PSD and it may have time-dependent effects.展开更多
文摘Aphasia is an impairment of language use following brain damage. There is no consensual definition of aphasia beyond this general description （Code and Petheram, 2011）. In a more restricted defini- tion, however, aphasia is an impairment of linguistic processing at the phonological, morphological, lexical semantic or syntactic level which is usually caused by lesions of the left cerebral hemisphere. This impairment can affect language reception and expression depending on the various aphasic syndromes （McNeil and Pratt, 2001）. Aphasia results in restrictions in those activities of daily living which rely on communication.
文摘Objective To investigate the clinical application value of Loewenstein Occupational Therapy Cognitive Assessment （LOTCA） battery in Chinese patients with post-stroke aphasia. Methods Cognitive fimctions of 59 Chinese patients with aphasia following a stroke were assessed with the Chinese version of the second edition of LOTCA battery and their linguistic functions were tested with the Western Aphasia Battery （WAB） Scale, respectively. The results of LOTCA were analyzed and compared across different groups, in the light of gender, age, educational background, the length of illness, and the degree of aphasia.
基金Supported by Ministerio de Economía,Industria y Competitividad,Instituto de Salud Carlos III,Madrid,Spain,No. PI16/01514
文摘BACKGROUND Neuropsychiatric symptoms(NPS)have been insufficiently examined in persons with aphasia(PWA)because most previous studies exclude participants with language and communication disorders.AIM To report a two-part study consisting of a literature review and an observational study on NPS in post-stroke aphasia.METHODS Study 1 reviewed articles obtained from PubMed,PsycINFO,Google Scholar and Cochrane databases after cross-referencing key words of post-stroke aphasia to NPS and disorders.Study 2 examined language deficits and activities of daily living in 20 PWA(median age:58,range:28-65 years;13 men)with the Western Aphasia Battery-Revised and the Barthel Index,respectively.Informants of these 20 PWA were proxy-evaluated with the Neuropsychiatric Inventory and domain-specific scales,including the Stroke Aphasia Depression Questionnaire-10 item version and the Starkstein Apathy Scale.In addition,an adapted version of the Hospital Anxiety and Depression Scale was directly administered to the PWA themselves.This observational study is based on the baseline assessment of an intervention clinical trial(EudraCT:2017-002858-36;ClinicalTrials.gov identifier:NCT04134416).RESULTS The literature review revealed a broad spectrum of NPS in PWA,including depression,anxiety,apathy,agitation/aggression,eating and sleep disorders,psychosis,and hypomania/mania.These findings alert to the need for improving assessment and treatment approaches of NPS taking into consideration their frequent occurrence in PWA.Study 2 showed that the 20 participants had mild-to-moderate aphasia severity and were functionally independent.A wide range of comorbid NPS was found in the post-stroke aphasic population(median number of NPS:5,range:1-8).The majority of PWA(75%)had depressive symptoms,followed by agitation/aggression(70%),irritability(70%),anxiety(65%)and appetite/eating symptoms(65%).Half of them also presented symptoms of apathy,whereas euphoria and psychotic symptoms were rare(5%).Domain-specific scales revealed that 45%of participants had apathy and 30%were diagnosed with depression and anxiety.CONCLUSION Concurrent NPS are frequent in the chronic period of post-stroke aphasia.Therefore,further research on reliable and valid assessment tools and treatment for this aphasic population is strongly warranted.
基金Supported by Science and Technology Program of Nantong City,No.Key003 and No.JCZ2022040Nantong Young Medical Expert,No.46+2 种基金Science and Technology Program of Nantong Health Committee,No.MA2019003,No.MA2021017,and No.MSZ2024038Kangda College of Nanjing Medical University,No.KD2021JYYJYB025,No.KD2022KYJJZD022,and No.KD2024KYJJZD289Nantong Municipal Health Commission Project,No.MSZ2023020.
文摘Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but the neuropsychiatric sequelae in the chronic stage have become increasingly prominent.Post-stroke depression is one of the very important manifestations.This article conducts a further discussion on this issue.
基金Supported by Open Project of Jiangsu Province Key Laboratory of Integrated Traditional Chinese and Western Medicine for the Prevention and Treatment of Geriatric Diseases,No.202232.
文摘BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their efficacy is limited.This study investigated whether combining SSRIs with traditional Chinese medicine(TCM)Free San could enhance their therapeutic effects.AIM To evaluate the clinical efficacy and safety of combining SSRIs with Free San in treating PSD,and to assess its impact on HPA axis function.METHODS Ninety-two patients with PSD were enrolled and randomly divided into control groups(n=46)and study groups(n=46).The control group received the SSRI paroxetine alone,whereas the study group received paroxetine combined with Free San for 4 weeks.Hamilton Depression Scale and TCM syndrome scores were assessed before and after treatment.Serum serotonin,norepinephrine,cortisol,cor-ticotropin-releasing hormone,and adrenocorticotropic hormone were measured.The treatment responses and adverse reactions were recorded.RESULTS After treatment,the Hamilton Depression Scale and TCM syndrome scores were significantly lower in the study group than in the control group(P<0.05).Serum serotonin and norepinephrine levels were significantly higher in the study group than in the control group,whereas cortisol,corticotropin-releasing hormone,and adrenocorticotropic hormone levels were significantly lower(P<0.05).The total efficacy rates were 84.78%and 65.22%in the study and control groups,respectively(P<0.05).No significant differences in adverse reactions were observed between the two groups(P>0.05).CONCLUSION Combining SSRIs with Free San can enhance therapeutic efficacy,improve depressive symptoms,and regulate HPA axis function in patients with PSD with good safety and clinical application value.
文摘Background There has been a long debate among scholars surrounding the relationship between language and cognition. The worldwide study of aphasia is actively exploring the function of language from cognitive point of view. This study aimed to investigate the relationship between linguistic functions and cognitive functions in a clinical study of Chinese patients with post-stroke aphasia. Methods Cognitive functions of 63 Chinese patients with aphasia following a stroke were assessed with the Chinese version of the second edition of Loewenstein Occupational Therapy Cognitive Assessment （LOTCA） battery and their linguistic functions were tested with the Western Aphasia Battery （WAB） Scale, respectively. The correlation between the results observed on the LOTCA battery and those on the WAB was analyzed. Aphasia quotient, performance quotient, cortical quotient, and linguistic function of the patients were compared. Then, each language function was analyzed by way of dependent adopt multiple regression analysis. Results The total score of 63 patients as shown on the LOTCA battery was significantly correlated with the aphasia quotient, performance quotient, and cortical quotient observed on the WAB Scale （P 〈0.05, P 〈0.01）. However, the correlation between visuomotor organization under LOTCA and repeat under WAB was not significant （P 〉0.05）. The attention of LOTCA and WAB＇s spontaneous speech, repeat, naming, and aphasia quotient was not relevant either （P 〉0.05）. In addition, correlations between the results observed on the LOTCA battery and the WAB were significant （P 〈0.05, P 〈0.01）. Among the significant variables finally entered into the standardized canonical discriminant functions, main factors affected the aphasia. Multiple regression analysis showed that orientation, spatial perception, and visual perception had a notable influence on aphasia quotient and naming. Orientation and thinking operation was found to have a notable influence on spontaneous speech. Spatial perception and visual perception was found to have a notable influence on auditory comprehension. Thinking operation and orientation was found to have an obvious influence on reading. Thinking operation, spatial perception, and attention was found to have a notable effect on writing （P 〈0.01）. Conclusion There exists a close relationship between linguistic functions and cognitive orientation, spatial perception, visual perception, and thinking operation in a clinical study of Chinese patients with post-stroke aphasia.
基金Supported by Xinglin Scholars Scientific Research Promotion Plan of Chengdu University of Traditional Chinese Medicine-Innovation Team of Traditional Chinese Medicine Otorhinolaryngology Discipline,Natural Science(No.XKTD2021003)。
文摘Objective:To evaluate the existing randomized controlled trials(RCTs)for evidence of the efficacy and safety of head acupuncture(HA)plus Schuell’s language rehabilitation(SLR)in post-stroke aphasia.Methods:Seven databases including Embase,PubMed,Cochrane Library,Technology Periodical Database,the China National Knowledge Infrastructure,SinoMed and Wanfang Data Information Site were searched for RCTs published from database inception until November 14,2021.RCTs that compared HA plus SLR with sham(or blank)control,acupuncture therapy alone,certain language rehabilitation therapy alone or other therapies for post-stroke aphasia were included.Data were extracted and assessed,and the quality of RCTs was evaluated.Fixed-effects model was used,with meta-influence analysis,meta-regression,and regression-based sub-group analyses applied for exploration of heterogeneity.Publication bias was estimated by funnel plots and Egger’s tests.Results:A total of 32 RCTs with1,968 patients were included and 51 comparisons were conducted classified as types of strokes and aphasia.(1)For patients with aphasia after ischemic stroke,HA plus PSA showed significantly higher accumulative markedly effective rate[relative risk(RR)=1.55,95% confidence interval(CI):1.19-2.02,I^(2)=0%]and accumulative effective rate(RR=1.22,95%CI:1.09-1.36,I^(2)=0%).(2)For patients with comprehensive types of stroke,HA plus PSA was more effective in increasing recovery rate(RR=1.89,95%CI:1.39-2.56,I^(2)=0%),accumulative markedly effective rate(RR=1.53,95%CI:1.36-1.72,I^(2)=9%)and accumulative effective rate(RR=1.14,95%CI:1.09-1.19,I^(2)=34%).(3)For patients with aphasia after stroke,HA plus PSA was superior to PSA alone with statistical significance in increasing recovery rate(RR=2.08,95%CI:1.24-3.46,I^(2)=0%),accumulative markedly effective rate(RR=1049,95%CI:1.24-1.78,I^(2)=0%)and accumulative effective rate(RR=1.15,95%CI:1.06-1.24,12=39%).(4)For patients with multiple types of aphasia,HA plus PSA also demonstrated significantly higher recovery rate(RR=1.86,95%CI:1.28-2.72,I^(2)=0%),accumulative markedly effective rate(RR=1.55,95%CI:1.35-1.78,I2=22%),and accumulative effective rate(RR=1.17,95%CI:1.11-1.23,I^(2)=41%).(5)For patients with motor aphasia after ischemic stroke,compared with PSA alone,HA plus PSA showed significantly higher accumulative markedly effective rate(RR=1.38,95%CI:1.06-1079,I^(2)=0%)and accumulative effective rate(RR=1.20,95%CI:1.05-1.37,I^(2)=0%).Meta-regression analyses were performed without significant difference,and publication bias was found in some comparisons.Conclusion:HA plus SLR was significantly associated with better language ability and higher effective rate for patients with post-stroke aphasia,and HA should be operated cautiously especially during acupuncture at eye and neck.(Registration No.CRD42020154475).
基金supported by the Science&Technology Department of Sichuan Province(No.2019YFS0040)the Improvement Plan of“Xinglin Scholar”Scientific Research Talent,Chengdu University of Traditional Chinese Medicine(No.XKTD2022002)。
文摘The activation of the sirtuin1(SIRT1)/nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase 1(HO-1)pathway has been shown to mitigate oxidative stress-induced apoptosis and mitochondrial damage by reducing reactive oxygen species(ROS)levels.Clinical trials have demonstrated that Zhongfeng Xingnao Liquid(ZFXN)ameliorates post-stroke cognitive impairment(PSCI).However,the underlying mechanism,particularly whether it involves protecting mitochondria and inhibiting apoptosis through the SIRT1/Nrf2/HO-1 pathway,remains unclear.This study employed an oxygen-glucose deprivation(OGD)cell model using SHSY5Y cells and induced PSCI in rats through modified bilateral carotid artery ligation(2VO).The effects of ZFXN on learning and memory,neuroprotective activity,mitochondrial function,oxidative stress,and the SIRT1/Nrf2/HO-1 pathway were evaluated both in vivo and in vitro.Results indicated that ZFXN significantly increased the B-cell lymphoma 2(Bcl2)/Bcl2-associated X(Bax)ratio,reduced terminal deoxynucleotidyl transferase-mediated d UTP nickend-labeling(TUNEL)+cells,and markedly improved cognition,synaptic plasticity,and neuronal function in the hippocampus and cortex.Furthermore,ZFXN exhibited potent antioxidant activity,evidenced by decreased ROS and malondialdehyde(MDA)content and increased superoxide dismutase(SOD),catalase(CAT),and glutathione(GSH)levels.ZFXN also demonstrated considerable enhancement of mitochondrial membrane potential(MMP),Tom 20 fluorescence intensity,adenosine triphosphate(ATP)and energy charge(EC)levels,and mitochondrial complexⅠandⅢactivity,thereby inhibiting mitochondrial damage.Additionally,ZFXN significantly increased SIRT1 activity and elevated SIRT1,nuclear Nrf2,and HO-1 levels.Notably,these effects were substantially counteracted when SIRT1 was suppressed by the inhibitor EX-527 in vitro.In conclusion,ZFXN alleviates PSCI by activating the SIRT1/Nrf2/HO-1 pathway and preventing mitochondrial damage.
文摘BACKGROUND Post-stroke depression(PSD),a condition commonly developed in patients with chronic stroke,impairs both functional rehabilitation and daily living.AIM To comprehensively analyze PSD contributors in chronic phase stroke and construct a precise nomogram.METHODS Two hundred patients with chronic stroke admitted in over 7 years(January 2017 to January 2024),were enrolled and categorized into the PSD group(n=96)and the non-PSD(NPSD)group(n=104).Demographic characteristics,clinicopathological data,and biochemical indicators were collected and analyzed by univariate analysis.Significant predictors identified in the univariate analysis were subsequently incorporated into a binary logistic regression model to assess their independent effects on PSD risk.The discriminative ability/calibration of the developed PSD prediction nomogram was assessed.RESULTS Compared with the NPSD group,the PSD group included a higher proportion of patients aged≥60 years,divorced/widowed,with an education level below senior high school,presenting with≥2 comorbidities,exhibiting severe neurological impairment,and having multiple lesions.Additionally,the PSD group showed significantly higher neutrophil-to-lymphocyte ratio(NLR)and platelet-tolymphocyte ratio(PLR)than the NPSD group.After assigning values to significant predictors,multivariate analysis indicated that educational level(P=0.046),NLR(P<0.001),and PLR(P<0.001)were independently associated with PSD in patients with chronic stroke.The developed nomogram exhibited favorable discrimination performance.The nomogram's calibration remained accurate for high-risk stratification but displayed modest inconsistencies in lowand middle-risk categories.CONCLUSION Education level,NLR,and PLR independently contribute to PSD in patients with chronic stroke.The constructed nomogram effectively predicts PSD risk within the range of 0.10-0.90,presenting a valuable tool for clinical monitoring and risk assessment of PSD in patients with chronic stroke.
基金supported by the Chinese Medicine Development Fund,Hong Kong SAR,China(23B2/027A_R1)the National Natural Science Foundation of China(81704198).
文摘Objective:To evaluate the efficacy and safety of acupoint application for post-stroke depression(PSD)by regulating gastrointestinal function.A secondary objective is to explore the potential mechanism underlying this approach from the perspective of gut microbiota.Methods:This multicenter,randomized,double-blind(patients and assessors),placebo-controlled trial will enroll 80 patients with PSD,and include a 1-week run-in period,a 4-week treatment phase,and a 12-week follow-up.Eligible participants will randomly be assigned in a 1:1 ratio to either the acupoint application or placebo(non-acupoint)groups.Treatments will be administered thrice weekly for 4 weeks.The primary outcome is change in the Hamilton Rating Scale for Depression(HAMD)score.Secondary outcomes include the Beck Depression Inventory(BDI),36-Item Short-Form Health Survey(SF-36),Barthel Index of Activities of Daily Living,Social Adaptation Self-Evaluation Scale(SASS),and gut microbiota profiling.All outcomes will be assessed at baseline(prior to treatment),during treatment(weeks 2 and 4),and during follow-up(weeks 8,12,and 16).The Treatment Emergent Symptom Scale(TESS)will be used for evaluation throughout the 4-week treatment phase.Discussion:The results of this study will provide important evidence supporting a novel treatment strategy for PSD that targets gastrointestinal regulation,potentially informing future clinical practice.
基金Jilin Provincial Department of Education,Grant/Award Number:JJKH20230958KJJilin Scientific and Technological Development Program,Grant/Award Number:YDZJ202401092ZYTS。
文摘Post-stroke depression(PSD) is a common psychiatric complication affecting nearly one-third of stroke survivors, leading to increased disability, mortality, and cognitive decline. Traditional Chinese Medicine(TCM) has proven effective in treating PSD through syndrome differentiation, yet existing animal models primarily reflect Western medical concepts and fail to incorporate the TCM principle of “同病异治”( treating the same disease with different methods). This paper provides a review of the current methods for constructing animal models of post-stroke depression(PSD) from the perspective of Traditional Chinese Medicine(TCM) syndrome differentiation and proposes multi-dimensional assessment indicators. By integrating TCM theories with modern biomedical techniques, this study offers a comprehensive framework for deepening the understanding of the pathogenesis and therapeutic evaluation of PSD. This approach not only contributes to advancing PSD research but also paves the way for innovative treatment strategies that combine traditional and modern medicine.
基金The New Professor Research Program of Korean Technology in 2025.
文摘Post-stroke depression(PSD)is a prevalent but often underdiagnosed complication affecting stroke survivors,with significant implications for recovery and quality of life.Emerging evidence suggests that central obesity,as measured by the weight-to-waist index(WWI),may play a crucial role in PSD risk and severity.Traditional obesity metrics,such as body mass index,may not accurately capture the impact of visceral fat distribution on neuropsychiatric outcomes.This letter highlights the growing recognition of WWI as a precise indicator of metabolic and inflammatory disturbances linked to post-stroke mental health.Integrating WWI into routine stroke rehabilitation assessments could facilitate early identification of high-risk patients and improve intervention strategies.Further research is needed to establish standardized WWI cutoff values and explore potential therapeutic targets for PSD prevention.
文摘Objective:To investigate the clinical efficacy of Xiaochaihu Decoction combined with Xiaoxianxiong Decoction in the treatment of post-stroke pneumonia.Methods:To complete the sample grouping comparison,all patients with post-stroke pneumonia were investigated,and the number of cases was 60.These patients’diseases were consistent with the dialectical standards of traditional Chinese medicine(phlegm-heat obstructing lungs).The patients were randomly divided into a control group(30 cases,treated with antibiotics and symptomatic methods)and a treatment group(30 cases,treated with Xiaochaihu Decoction and Xiaoxianxiong Decoction on the basis of the control group).Various indicators were compared.Results:The total clinical effective rates were 93%and 80%in the treatment group and the control group,respectively,with statistical significance(P<0.05).The improvement of various clinical symptoms was compared,and the values in the treatment group were reduced,showing significance(P<0.05).Analysis of serum factor indicators showed that the overall trend of the treatment group was reduced,and the comparison between groups was below 0.05.Conclusion:Xiaochaihu Decoction combined with Xiaoxianxiong Decoction has a significant clinical effect in the treatment of post-stroke pneumonia(phlegm-heat obstructing lungs syndrome),which can reduce inflammatory reactions and has few adverse reactions,worthy of clinical application.
文摘BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains inadequately explored in the literature.AIM To elucidate the relationship between WWI and PSD.METHODS Data from the National Health and Nutrition Examination Survey 2005 to 2018 were analyzed.Multivariable logistic regression models and propensity score matching were utilized to investigate the association between WWI and PSD,with adjustments for potential confounders.The restricted cubic spline statistical method was applied to explore non-linear associations.RESULTS Participants with elevated WWI values had a significantly greater risk of developing PSD.Specifically,individuals in the higher WWI range exhibited more than twice the likelihood of developing PSD compared to those with lower WWI values(odds ratio=2.21,95%confidence interval:1.84-2.66,P<0.0001).After propensity score matching,the risk of PSD remained significantly elevated(odds ratio=1.43,95%confidence interval:1.09-1.88,P=0.01).Tertile analysis revealed that participants in the highest WWI tertile faced a significantly higher risk of PSD compared to those in the lowest tertile.Restricted cubic spline analysis further revealed a non-linear association,with the risk of PSD plateauing at higher WWI values.CONCLUSION There is a significant association between elevated WWI and increased risk of PSD.Thus,regular depression screening should be implemented in stroke patients with elevated WWI to enhance patient outcomes.
基金supported by Gansu Natural Science Foundation(No.1610RJZA078)Research Project of Gansu Administration of Traditional Chinese Medicine(No.GZK-2017-19)Key Talent Projects of Gansu Province in 2019(No.Ganzu Tongzi No.39)。
文摘Objective:To evaluate the efficacy of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia.Methods:CNKI,VIP,Wan Fang Database,MEDLINE,Embase,Web of Science and Cochrane Library were searched for published researches up to March,2021.Randomized controlled trials RCTs that focused on scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia were included.We managed the data analysis with RevMan 5.3 software.Results:A total of 16 RCTs with 1323 patients were involved.The results of meta-analysis showed that:①The effective rate of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia after stroke was significantly better than that of simple language rehabilitation training[OR=3.94,95%CI(2.73,5.68),P<0.00001];②In the evaluation of language function,compared with the language rehabilitation training,the scalp acupuncture combined with language rehabilitation training can significantly improve the reading ability of the patients with motor aphasia after stroke[MD=7.22,95%CI(3.55,10.89),P=0.0001],writing ability[MD=6.51,95%CI(3.61,9.41),P<0.0001],expressive ability[MD=4.13,95%CI(2.37,5.89),P<0.0001],retelling ability[MD=5.00,95%CI(2.38,7.63),P=0.0002],listening comprehension ability[MD=5.36,95%CI(3.12,7.61),P<0.00001]and naming ability[MD=5.60,95%CI(4.20,7.00),P<0.00001];③Compared with simple language rehabilitation training,scalp acupuncture combined with language rehabilitation can significantly improve the daily life language communication ability of patients with motor aphasia,and the difference was statistically significant[MD=30.01,95%CI(11.30,48.72),P=0.002].Conclusion:Scalp acupuncture combined with language rehabilitation training has a significant effect on motor aphasia.However,due to the small sample size,more RCTs are needed to confirm that.
基金Supported by Special Project for Practice Development of National TCM Clinical Research Bases:JDZX 2012154
文摘Objective To assess the efficacy and safety of treating post-stroke depression with acupuncture compared to western medicine systematically. Methods Databases were retrieved such as Cochrane Library, PubMed, Web of Sicence, EMbase, CBM, CNKI and WanFang Data so as to look up randomized controlled trials （RCT） of treating post-stroke depression with acupuncture and western medicine, and the time limit for the retrieval spanned from the date of database established to September 2013. By extracting data and evaluating methodological quality of included studies according to inclusion and exclusion criteria, RevMan 5.2 software was applied for Meta-analysis and evidence quality was assessed by adopting the GRADE system. Results Atotal of 23 RCTs （845 patients with post-stroke depression） were included in this study. It was revealed by Meta-analysis that the differences of the two groups were statistically significant in terms of HAMD scale scores measured at the end of the treatment by comparing the treatment of acupuncture and western medicine [SMD=0.26, 95% CI （0.11, 0.40）], but via susceptibility analysis （excluding low quality studies）, the differences were not statistically significant [SMD=-0.06, 95% CI （-0.37, 0.25）], and the reliability of the results was low; in terms of adverse events, the differences were statistically significant [RR= 0.32, 95% Cl （0.19, 0.53）], and the risk of adverse events reduced by 68% in the acupuncture group. From the assessment on evidence quality grade based on GRADE system, it was revealed that HAMD scores and adverse events were evidences with fairly low quality. Conclusion Although this system assessment showed that treating post-stroke depression with acupuncture was more effective compared with western medicine, the result was less reliable and quality of evidences was poor. The above-mentioned results need more high- quality randomized controlled trials for further verification.
文摘Objective To explore the better treatment of post-stroke depression. Methods Sixty cases of post-stroke depression ranged from mild to middle degree were randomly divided into comprehensive therapy group and medication group, 30 cases in each group. In comprehensive therapy group, electroacupuncture at temple-three-needle was mainly applied and Fluoxetine Hydrochloride capsule was taken by oral administration; in medication group, Fluoxetine Hydrochloride capsule was applied by oral administration. Functional Independent Measure （FIM） Scale and WHOQOL-BREF evaluation results before and after treatment were compared after 4 weeks treatment. Results Comparing with the FIM scores before treatment, the differences in the two groups were significant （both P0.01）, and the improvement in comprehensive therapy group （74.97±9.52） was superior to that in medication group （66.70±9.23） （P0.01）. Signif icant differences were presented statistically in comparison of index scores of WHOQOL-BREF before and after treatment in two groups （P0.05, P0.01）, and it in comprehensive therapy group was superior to that in medication group （P0.05, P0.01）. Conclusion Activities of daily life and quality of life of post-stroke depression can be significantly improved by electroacupuncture at temple-three-needle and oral administration of Fluoxetine Hydrochloride capsule.
基金Supported by Beijing Chinese medicine inheritance of double hundred project
文摘This systematic review is aim to comprehensively evaluate the efficacy of acupoint stimulation in managing of post-stroke spasticity. The eligible randomized controlled clinical trials （RCTs） and quasi-randomized controlled clinical trials （quasi-RCTs） will be searched from the following databases： the Cochrane Central Register of Controlled Trials （CENTRAL）, MEDLINE, EMBASE, China National Knowledge Infrastructure （CNKI）, Chinese Scientific Journal Database （VIP）, Wanfang Database, Chinese BioMedical Literature Database （CBM）. The Cochrane risk of bias tool will be used to assess the trials. No patients or their family will be bothered in this systematic review, so there is no need for the permission of institutional review board （IRB）. The completed systematic review will be published in a peer-reviewed journal.
文摘Objective To observe the therapeutic effect of electroacupuncture （EA） of ＂Niwan Bazhen＂ points in the treatment of post-stroke depression. Methods A total of 66 post-stroke depression patients were randomized into treatment group （EA＋oral administration of Prozac-20, n =31 ） and control group （o- ral administration of Prozac-20, 20 mg/d, 28 days altogether, n =30）. For patients of treatment group, EA （2/100 Hz, a tolerable stimulation strength） was applied to ＂Niwan Bazhen＂ points [Baihui （百会 GV20）, etc. ] for 30 min, once daily, （except weekends） continuously for one month. Halmiton Rating Scale （HAMD） for Depression and Chinese Scale for Stroke （CSS） were used to evaluate the therapeutic effect. Results After the treatment, of the 30 and 31 cases in control and treatment groups, 4 and 6 were cured, 10 and 14 experienced marked improvement.in their symptoms, 6 and 7 had an improvement, 6 and 4 failed, with the cure＋ markedly effective rates being 46.7% and 64.5% respectively. The therapeutic effect of treatment group was significantly superior to that of control group （ P〈0.05）. The decreased values of both HAMD and C,,SS of treatment group were remarkably lower than those of control group （P〈0.01,0.05） . Conclusion EA of ＂Niwan Bazhen＂ points is an effective remedy for post-stroke depression.
文摘Although depression may affect patients＇ recovery and even their survival rate after stroke,it is often overlooked or inadequately managed.And data regarding the treatment efficacy and safety of fluoxetine in this setting are inconsistent.We aimed to systematically assess those two indices in patients with post-stroke depression （PSD）.Through a systematic literature search in 10 biomedical databases,244 articles were first identified,through which we collected and evaluated a total of 600 patients identified from 11 RCTs.The meta-analysis with Revman software indicated that fluoxetine was more effective than placebo,the combined results of 9 RCTs showed that fluoxetine decreased the depression rating scale scores significantly compared with placebo,and the pooled weighted mean difference （WMD） was 0.44 （95% CI-0.03 to 0.92）.Moreover,time-dependent effects were also observed.No consistent evidence was found for its positive effects on the recovery of neurological impairments and improvements in activities of daily living （ADL）.Six studies reported rate of adverse effects in both fluoxetine groups and control groups and showed no significant difference between them （OR=0.03,95% CI-0.00 to 0.07）.This meta-analysis suggested that fluoxetine may be effective and safe for patients with PSD and it may have time-dependent effects.
