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
Objective:To evaluate the clinical efficacy of the Governor Vessel-unblocking and mind-regulating acupuncture method plus repetitive transcranial magnetic stimulation(rTMS)in the treatment of post-stroke insomnia.Meth...Objective:To evaluate the clinical efficacy of the Governor Vessel-unblocking and mind-regulating acupuncture method plus repetitive transcranial magnetic stimulation(rTMS)in the treatment of post-stroke insomnia.Methods:A total of 72 patients with post-stroke insomnia were randomly divided into 2 groups,with 36 cases in each group.The control group received rTMS treatment with a frequency of 1 Hz and a motion threshold value of 90%.The observation group received acupuncture with Governor Vessel-unblocking and mind-regulating method based on the rTMS treatment of the control group.The points were Baihui(GV 20),Shenting(GV 24),Yintang(GV 29),Fengfu(GV 16),Sishencong(EX-HN I),Shenmen(HT I),Sanyinjiao(SP 6);Shenmai(BL 62)and Zhaohai(Kl 6).The treatment was performed once a day for 5 d a week followed by 2 d of rest for 4 weeks.The improvements of Pittsburgh sleep quality index(PSQI),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores were observed after treatment,and the clinical efficacy was compared between the two groups.Results:After 4 weeks of treatment,the PSQI,SAS,and SDS scores of the two groups were all reduced,and the intra-group differences were statistically significant(all P<0.001).After treatment,the three scores in the observation group were all lower than those in the control group,and the differences between the two groups were statistically significant(P<0.05,P<0.05,P<0.001).There was a statistically significant difference between the observation group and the control group comparing the clinical efficacy(P<0.05).Conclusion:The therapeutic effect of the Governor Vessel-unblocking and mind-regulating acupuncture method plus rTMS in treating post-stroke insomnia is better than rTMS alone,and it can better improve the anxiety and depression of patients.展开更多
Objective： To observe the clinical effect of auricular acupoint sticking plus music therapy for post-stroke insomnia. Methods： A total of 154 cases with post-stroke insomnia were randomly divided into a control grou...Objective： To observe the clinical effect of auricular acupoint sticking plus music therapy for post-stroke insomnia. Methods： A total of 154 cases with post-stroke insomnia were randomly divided into a control group and an observation group by the random digital table, 77 cases in each group. The control group was treated by auricular acupoint sticking, while the observation group was treated by auricular acupoint sticking plus music therapy, to compare the clinical effects at the end of the treatment and three months after the treatment between the two groups. Results： At the end of treatment, the total effective rate was 98.7% in the observation group, remarkably higher than 89.6% in the control group, with a statistically significant difference between the two groups （P〈0.05）. Three months after the end of the treatment, the total effective rate was 90.9% in the observation group, remarkably higher than 80.5% in the control group, with a statistically significant difference between the two groups （P〈0.05）. Conclusion： Auricular acupoint sticking plus music therapy was affirmative in the clinical effects for post-stroke insomnia, providing a new idea to design a best nursing and rehabilitative plan for the patients with post-stroke insomnia.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 analyze the effectiveness of applying ShuGan JieYu Capsules(SGJYC)combined with trazodone in patients with post-stroke depression(PSD)with insomnia.Methods:60 cases of PSD with insomnia patients admitted ...Objective:To analyze the effectiveness of applying ShuGan JieYu Capsules(SGJYC)combined with trazodone in patients with post-stroke depression(PSD)with insomnia.Methods:60 cases of PSD with insomnia patients admitted to the hospital from May 2022 to May 2023 were selected and randomly divided into a reference group(trazodone)and a research group(SGJYC combined with trazodone)of 30 cases each.Statistics were analyzed using the Hamilton Depression Rating Scale(HAM-D),Pittsburgh Sleep Quality Index(PSQI),and Activities of Daily Living(ADL)scale before treatment and 4,8,and 12 weeks after treatment.Results:Before treatment,The results of HAM-D,PSQI,and ADL scale studies in the two groups before treatment were not statistically significant(P>0.05);4,8,and 12 weeks after treatment,the results of HAM-D and PSQI studies in the research group were lower than that of the reference group,and the results of ADL scale studies were higher than that of the reference group.There was a significant difference between the groups(P<0.05).The total adverse reaction rate of the research group was lower than that of the reference group,and there was a significant difference between the groups(P<0.05).Conclusion:The combination of SGJYC and trazodone reduced depression in post-stroke patients,corrected insomnia,improved sleep quality,was safe,and had a low rate of adverse reactions.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
OBJECTIVE:To evaluate the effectiveness of cycling in combination with electroacupuncture in treatment of poststroke hemiplegia patients at National Hospital of Acupuncture,Vietnam.METHODS:The study was designed as a ...OBJECTIVE:To evaluate the effectiveness of cycling in combination with electroacupuncture in treatment of poststroke hemiplegia patients at National Hospital of Acupuncture,Vietnam.METHODS:The study was designed as a single-centre,outcome-assessor-blinded parallel randomised controlled trial with 120 post-stroke hemiplegia patients randomly assigned into two groups:electroacupuncture plus cycling(CT group) and electroacupuncture(AT group).Patients were assessed before and after the treatment(using muscle grading,modified Rankin,Barthel,Orgorozo scores and electromyography).Statistical Man–Whitney U test,and Fisher’s exact tests were used to compare between CT and AT groups.RESULTS:The results reported statistically significant improvement in motor function in patients suffering from hemiplegia following ischemic stroke in both CT and AT groups.Patients in CT group experienced a greater improvement compared to those in AT group including better muscle contraction(increased frequency and amplitude of electromyography and increased muscle grading scale);increased recovery(Orgogozo scale),increased independency(Barthel scale) and decreased disability(Modified Rankin scale)(P < 0.01).CONCLUSIONS:Combination with cycling training significantly improves the recovery of post-stroke patients treated with electroacupuncture.展开更多
OBJECTIVE:To investigate the optimal timing and underlying mechanism of electroacupuncture(EA)at Baihui(GV 20)and Dazhui(GV 14)for improved long-term functional recovery after focal cerebral ischemia in a photothrombo...OBJECTIVE:To investigate the optimal timing and underlying mechanism of electroacupuncture(EA)at Baihui(GV 20)and Dazhui(GV 14)for improved long-term functional recovery after focal cerebral ischemia in a photothrombotic stroke mouse model.METHODS:Totally 50 adult male C57 BL/6 J mice were assigned into 5 groups:(a)the control group,sham-operated mice(n=10);(b)the vehicle group,focal cerebral ischemia induction without EA(n=10);(c)the acute EA group,mice received EA immediately post-ischemia,followed by once-daily treatments for 7 consecutive days(n=10);(d)the subacute EA group,mice received EA 4 days post-ischemia,followed by once-daily treatments for 7 consecutive days(n=10);(e)the delayed EA group.EA stimulation(2 Hz,2 V for 20 min)was applied to acupuncture points(acupoints),Baihui(GV 20)and Dazhui(GV 14),once a day for 7 consecutive days beginning immediately(acute treatment),4 d(subacute treatment)and 10 d(delayed treatment)after focal cerebral ischemia in C57 BL/6 J mice.Behavioral assessments were conducted 21 and 28 d post-ischemia and histopathological analyses were performed 28 days post-ischemia.RESULTS:The subacute EA treatment at Baihui(GV20)and Dazhui(GV 14)significantly improved functional recovery compared to the vehicle group 28 d after ischemic brain injury,although brain atrophy was not reduced.The number of Neu N+and Neu N+/Brd U+cells as well as GFAP intensity in the ipsilateral cortex were significantly increased in the subacute group compared to the vehicle group 28 d post-ischemia.We concluded that EA stimulation 4 d post-ischemia(subacute treatment)enhanced neurogenesis and astrogliosis,likely contributing to long-term functional recovery following focal cerebral ischemia.CONCLUSION:Our findings suggest that the timing of the EA therapy at Baihui(GV 20)and Dazhui(GV 14)determines the therapeutic effects in mice with focal cerebral ischemia induced by photothrombotic occlusion.展开更多
Objective:To perform a network meta-analysis on four commonly used acupuncture therapies(electroacupuncture,fire acupuncture,warm acupuncture,and filiform needling) and rehabilitation therapy in the treatment of post-...Objective:To perform a network meta-analysis on four commonly used acupuncture therapies(electroacupuncture,fire acupuncture,warm acupuncture,and filiform needling) and rehabilitation therapy in the treatment of post-stroke spastic hemiplegia so as to compare the differences in clinical therapeutic effect between acupuncture therapy and rehabilitation therapy as well as among different therapeutic methods of acupuncture.Methods:A computer-based retrieval was conducted in Chinese and English databases,i.e.CNKI,WanFang,VIP,SinoMed,PubMed,Embase,Web of Science and Cochrane library.The search period limit was from the database establishment to April 17,2020.Data analysis was performed through Revman 5.3,Gemtc 0.14.3 and Stata 14.2.Results:A total of 27 trials were finally eligible,including 1880 patients,943 patients of which were in observation group and 937 patients in control group.In terms of the improvement of effective rate,electroacupuncture,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,warm acupuncture was the highest in probability to be the optimal measure.Regarding the improvement in Fugl-Meyer Assessment(FMA) motor function score,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,fire needling method was the highest in probability to be the optimal measure.In view of the improvement of BI score,fire needling method was better than electroacupuncture and filiform needling method,while,warm acupuncture was better than electroacupuncture,thus,fire needling method may be the optimal measure.For the modified Ashworth muscular tension assessment,there was no significant differences in pairwise comparison among different interventions and warm acupuncture was probably the optimal measure.Conclusion:The overall therapeutic effect of 4 acupuncture therapies is better than rehabilitation therapy on post-stroke spastic hemiplegia,respectively,among which,the therapeutic effect of warm acupuncture and fire needling method is the best.However,because of a limitation of the varieties of acupuncturemoxibustion therapy and the number of included trials,it needs to conduct more rigorous and scientific randomized controlled trials so that this conclusion can be further confirmed.展开更多
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Objective:To evaluate the clinical efficacy of the Governor Vessel-unblocking and mind-regulating acupuncture method plus repetitive transcranial magnetic stimulation(rTMS)in the treatment of post-stroke insomnia.Methods:A total of 72 patients with post-stroke insomnia were randomly divided into 2 groups,with 36 cases in each group.The control group received rTMS treatment with a frequency of 1 Hz and a motion threshold value of 90%.The observation group received acupuncture with Governor Vessel-unblocking and mind-regulating method based on the rTMS treatment of the control group.The points were Baihui(GV 20),Shenting(GV 24),Yintang(GV 29),Fengfu(GV 16),Sishencong(EX-HN I),Shenmen(HT I),Sanyinjiao(SP 6);Shenmai(BL 62)and Zhaohai(Kl 6).The treatment was performed once a day for 5 d a week followed by 2 d of rest for 4 weeks.The improvements of Pittsburgh sleep quality index(PSQI),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores were observed after treatment,and the clinical efficacy was compared between the two groups.Results:After 4 weeks of treatment,the PSQI,SAS,and SDS scores of the two groups were all reduced,and the intra-group differences were statistically significant(all P<0.001).After treatment,the three scores in the observation group were all lower than those in the control group,and the differences between the two groups were statistically significant(P<0.05,P<0.05,P<0.001).There was a statistically significant difference between the observation group and the control group comparing the clinical efficacy(P<0.05).Conclusion:The therapeutic effect of the Governor Vessel-unblocking and mind-regulating acupuncture method plus rTMS in treating post-stroke insomnia is better than rTMS alone,and it can better improve the anxiety and depression of patients.
基金supported by Project of Zhejiang Provincial Administration of Traditional Chinese MedicineNo.2013ZA070~~
文摘Objective： To observe the clinical effect of auricular acupoint sticking plus music therapy for post-stroke insomnia. Methods： A total of 154 cases with post-stroke insomnia were randomly divided into a control group and an observation group by the random digital table, 77 cases in each group. The control group was treated by auricular acupoint sticking, while the observation group was treated by auricular acupoint sticking plus music therapy, to compare the clinical effects at the end of the treatment and three months after the treatment between the two groups. Results： At the end of treatment, the total effective rate was 98.7% in the observation group, remarkably higher than 89.6% in the control group, with a statistically significant difference between the two groups （P〈0.05）. Three months after the end of the treatment, the total effective rate was 90.9% in the observation group, remarkably higher than 80.5% in the control group, with a statistically significant difference between the two groups （P〈0.05）. Conclusion： Auricular acupoint sticking plus music therapy was affirmative in the clinical effects for post-stroke insomnia, providing a new idea to design a best nursing and rehabilitative plan for the patients with post-stroke insomnia.
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Research Project on Heilongjiang Province Traditional Chinese Medicine No.ZHY2022-057。
文摘Objective:To analyze the effectiveness of applying ShuGan JieYu Capsules(SGJYC)combined with trazodone in patients with post-stroke depression(PSD)with insomnia.Methods:60 cases of PSD with insomnia patients admitted to the hospital from May 2022 to May 2023 were selected and randomly divided into a reference group(trazodone)and a research group(SGJYC combined with trazodone)of 30 cases each.Statistics were analyzed using the Hamilton Depression Rating Scale(HAM-D),Pittsburgh Sleep Quality Index(PSQI),and Activities of Daily Living(ADL)scale before treatment and 4,8,and 12 weeks after treatment.Results:Before treatment,The results of HAM-D,PSQI,and ADL scale studies in the two groups before treatment were not statistically significant(P>0.05);4,8,and 12 weeks after treatment,the results of HAM-D and PSQI studies in the research group were lower than that of the reference group,and the results of ADL scale studies were higher than that of the reference group.There was a significant difference between the groups(P<0.05).The total adverse reaction rate of the research group was lower than that of the reference group,and there was a significant difference between the groups(P<0.05).Conclusion:The combination of SGJYC and trazodone reduced depression in post-stroke patients,corrected insomnia,improved sleep quality,was safe,and had a low rate of adverse reactions.
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.
文摘OBJECTIVE:To evaluate the effectiveness of cycling in combination with electroacupuncture in treatment of poststroke hemiplegia patients at National Hospital of Acupuncture,Vietnam.METHODS:The study was designed as a single-centre,outcome-assessor-blinded parallel randomised controlled trial with 120 post-stroke hemiplegia patients randomly assigned into two groups:electroacupuncture plus cycling(CT group) and electroacupuncture(AT group).Patients were assessed before and after the treatment(using muscle grading,modified Rankin,Barthel,Orgorozo scores and electromyography).Statistical Man–Whitney U test,and Fisher’s exact tests were used to compare between CT and AT groups.RESULTS:The results reported statistically significant improvement in motor function in patients suffering from hemiplegia following ischemic stroke in both CT and AT groups.Patients in CT group experienced a greater improvement compared to those in AT group including better muscle contraction(increased frequency and amplitude of electromyography and increased muscle grading scale);increased recovery(Orgogozo scale),increased independency(Barthel scale) and decreased disability(Modified Rankin scale)(P < 0.01).CONCLUSIONS:Combination with cycling training significantly improves the recovery of post-stroke patients treated with electroacupuncture.
基金Supported by a 2-Year Research Grant of Pusan National University
文摘OBJECTIVE:To investigate the optimal timing and underlying mechanism of electroacupuncture(EA)at Baihui(GV 20)and Dazhui(GV 14)for improved long-term functional recovery after focal cerebral ischemia in a photothrombotic stroke mouse model.METHODS:Totally 50 adult male C57 BL/6 J mice were assigned into 5 groups:(a)the control group,sham-operated mice(n=10);(b)the vehicle group,focal cerebral ischemia induction without EA(n=10);(c)the acute EA group,mice received EA immediately post-ischemia,followed by once-daily treatments for 7 consecutive days(n=10);(d)the subacute EA group,mice received EA 4 days post-ischemia,followed by once-daily treatments for 7 consecutive days(n=10);(e)the delayed EA group.EA stimulation(2 Hz,2 V for 20 min)was applied to acupuncture points(acupoints),Baihui(GV 20)and Dazhui(GV 14),once a day for 7 consecutive days beginning immediately(acute treatment),4 d(subacute treatment)and 10 d(delayed treatment)after focal cerebral ischemia in C57 BL/6 J mice.Behavioral assessments were conducted 21 and 28 d post-ischemia and histopathological analyses were performed 28 days post-ischemia.RESULTS:The subacute EA treatment at Baihui(GV20)and Dazhui(GV 14)significantly improved functional recovery compared to the vehicle group 28 d after ischemic brain injury,although brain atrophy was not reduced.The number of Neu N+and Neu N+/Brd U+cells as well as GFAP intensity in the ipsilateral cortex were significantly increased in the subacute group compared to the vehicle group 28 d post-ischemia.We concluded that EA stimulation 4 d post-ischemia(subacute treatment)enhanced neurogenesis and astrogliosis,likely contributing to long-term functional recovery following focal cerebral ischemia.CONCLUSION:Our findings suggest that the timing of the EA therapy at Baihui(GV 20)and Dazhui(GV 14)determines the therapeutic effects in mice with focal cerebral ischemia induced by photothrombotic occlusion.
基金Supported by National Administration of Traditional Chinese Medicine,Construction Project of Inheritance Studio of National Famous Traditional Chinese Medicine Experts:[2016]No.42.
文摘Objective:To perform a network meta-analysis on four commonly used acupuncture therapies(electroacupuncture,fire acupuncture,warm acupuncture,and filiform needling) and rehabilitation therapy in the treatment of post-stroke spastic hemiplegia so as to compare the differences in clinical therapeutic effect between acupuncture therapy and rehabilitation therapy as well as among different therapeutic methods of acupuncture.Methods:A computer-based retrieval was conducted in Chinese and English databases,i.e.CNKI,WanFang,VIP,SinoMed,PubMed,Embase,Web of Science and Cochrane library.The search period limit was from the database establishment to April 17,2020.Data analysis was performed through Revman 5.3,Gemtc 0.14.3 and Stata 14.2.Results:A total of 27 trials were finally eligible,including 1880 patients,943 patients of which were in observation group and 937 patients in control group.In terms of the improvement of effective rate,electroacupuncture,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,warm acupuncture was the highest in probability to be the optimal measure.Regarding the improvement in Fugl-Meyer Assessment(FMA) motor function score,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,fire needling method was the highest in probability to be the optimal measure.In view of the improvement of BI score,fire needling method was better than electroacupuncture and filiform needling method,while,warm acupuncture was better than electroacupuncture,thus,fire needling method may be the optimal measure.For the modified Ashworth muscular tension assessment,there was no significant differences in pairwise comparison among different interventions and warm acupuncture was probably the optimal measure.Conclusion:The overall therapeutic effect of 4 acupuncture therapies is better than rehabilitation therapy on post-stroke spastic hemiplegia,respectively,among which,the therapeutic effect of warm acupuncture and fire needling method is the best.However,because of a limitation of the varieties of acupuncturemoxibustion therapy and the number of included trials,it needs to conduct more rigorous and scientific randomized controlled trials so that this conclusion can be further confirmed.
