Poststro ke cognitive impairment is a major secondary effect of ischemic stroke in many patients;however,few options are available for the early diagnosis and treatment of this condition.The aims of this study were to...Poststro ke cognitive impairment is a major secondary effect of ischemic stroke in many patients;however,few options are available for the early diagnosis and treatment of this condition.The aims of this study were to(1)determine the specific relationship between hypoxic andα-synuclein during the occur of poststroke cognitive impairment and(2)assess whether the serum phosphorylatedα-synuclein level can be used as a biomarker for poststro ke cognitive impairment.We found that the phosphorylatedα-synuclein level was significantly increased and showed pathological aggregation around the cerebral infa rct area in a mouse model of ischemic stroke.In addition,neuronalα-synuclein phosphorylation and aggregation were observed in the brain tissue of mice subjected to chronic hypoxia,suggesting that hypoxia is the underlying cause ofα-synuclein-mediated pathology in the brains of mice with ischemic stroke.Serum phosphorylatedα-synuclein levels in patients with ischemic stroke were significantly lower than those in healt hy subjects,and were positively correlated with cognition levels in patients with ischemic stroke.Furthermore,a decrease in serum high-density lipoprotein levels in stroke patie nts was significantly correlated with a decrease in phosphorylatedα-synuclein levels.Although ischemic stroke mice did not show significant cognitive impairment or disrupted lipid metabolism 14 days after injury,some of them exhibited decreased cognitive function and reduced phosphorylatedα-synuclein levels.Taken together,our results suggest that serum phosphorylatedα-synuclein is a potential biomarker for poststroke cognitive impairment.展开更多
Following an acute stroke,patients often encounter a range of impairments affecting their physical,cognitive,verbal,and social capabilities.Poststroke depression(PSD)has been identified as a significant consequence of...Following an acute stroke,patients often encounter a range of impairments affecting their physical,cognitive,verbal,and social capabilities.Poststroke depression(PSD)has been identified as a significant consequence of stroke and serves as a crucial predictor of patient outcomes.The diagnosis of PSD presents a challenge,as the physical manifestations following a stroke can overlap with certain depressive symptoms,leading to a potential underdiagnosis of this condition.This review employs a narrative approach to synthesize diverse findings within this domain.PSD is categorized as an organic mood disorder,and a more accurate diagnosis may be achieved by considering the location of the stroke,the patient's specific symptoms,and the timeline of depressive symptom onset.Notably,if depressive symptoms emerge at more than one year poststroke,the likelihood of PSD diminishes.The etiology of PSD is currently understood to stem from a combination of physiological and psychosocial factors,as well as their interactions.Several mechanisms associated with PSD have been identified,including inflammation,dysregulation of the hypothalamic-pituitary-adrenal axis,oxidative stress,autophagy,apoptosis,abnormal neurotrophic responses,glutamate-mediated excitotoxicity,dysfunction within brain networks,reduced monoamine levels,locations of brain lesions,and psychosocial influences.This review also outlines potential directions for future research.展开更多
The objective of this study is to analyze the relevant literature on acupoint massage applied to patients with poststroke constipation,to explore the research status,research hotspots,and research frontiers of poststr...The objective of this study is to analyze the relevant literature on acupoint massage applied to patients with poststroke constipation,to explore the research status,research hotspots,and research frontiers of poststroke constipation,and to provide reference for clinical practice and scientific research.With the help of CiteSpace software,the related literatures published in the China National Knowledge Infrastructure database on the application of acupoint massage to constipation after stroke were analyzed,and scientific atlas for visual analysis was drawn.The hot keywords in the field of acupoint massage for post-stroke constipation are constipation,nursing intervention,and traditional Chinese medicine(TCM)nursing,indicating the great importance of TCM nursing for such patients.In mutation word detection,words such as constipation,nursing,stroke,and defecation reflex have earlier mutation times.Massage is the keyword with the longest mutation time,suggesting it is an effective intervention for post-stroke patients and is widely recognized.The commonly used acupoints for poststroke constipation are Tianshu(ST 25),Zhongwan(CV 12),and Qihai(CV 6).These acupoints can regulate qi and blood and enhance gastrointestinal peristalsis,providing guiding significance for formulating relevant clinical practice guidelines.The research of acupoint massage in the nursing of poststroke constipation is still in the stage of practice and exploration,and the specific definition of operation process,technique,acupoint,time,and intensity is still not clear.Multicenter,large-sample,in-depth intervention research,and cohort studies hold immense significance for the future development of this discipline.展开更多
Background: The mechanisms by which acupuncture affects poststroke cognitive impairment (PSCI) remain unclear. Objective: To investigate brain functional network (BFN) changes in patients with PSCI after acupuncture t...Background: The mechanisms by which acupuncture affects poststroke cognitive impairment (PSCI) remain unclear. Objective: To investigate brain functional network (BFN) changes in patients with PSCI after acupuncture therapy. Methods: Twenty-two PSCI patients who underwent acupuncture therapy in our hospital were enrolled as research subjects. Another 14 people matched for age, sex, and education level were included in the normal control (HC) group. All the subjects underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans;the PSCI patients underwent one scan before acupuncture therapy and another after. The network metric difference between PSCI patients and HCs was analyzed via the independent-sample t test, whereas the paired-sample t test was employed to analyze the network metric changes in PSCI patients before vs. after treatment. Results: Small-world network attributes were observed in both groups for sparsities between 0.1 and 0.28. Compared with the HC group, the PSCI group presented significantly lower values for the global topological properties (γ, Cp, and Eloc) of the brain;significantly greater values for the nodal attributes of betweenness centrality in the CUN. L and the HES. R, degree centrality in the SFGdor. L, PCG. L, IPL. L, and HES. R, and nodal local efficiency in the ORBsup. R, ORBsupmed. R, DCG. L, SMG. R, and TPOsup. L;and decreased degree centrality in the MFG. R, IFGoperc. R, and SOG. R. After treatment, PSCI patients presented increased degree centrality in the LING.L, LING.R, and IOG. L and nodal local efficiency in PHG. L, IOG. R, FFG. L, and the HES. L, and decreased betweenness centrality in the PCG. L and CUN. L, degree centrality in the ORBsupmed. R, and nodal local efficiency in ANG. R. Conclusion: Cognitive decline in PSCI patients may be related to BFN disorders;acupuncture therapy may modulate the topological properties of the BFNs of PSCI patients.展开更多
OBJECTIVE： To evaluate the effectiveness and safety of filiform needle acupuncture for poststroke depression, and to compare acupuncture with the therapeutic efficacy of antidepressant drugs. DATA RETRIEVAL： We retr...OBJECTIVE： To evaluate the effectiveness and safety of filiform needle acupuncture for poststroke depression, and to compare acupuncture with the therapeutic efficacy of antidepressant drugs. DATA RETRIEVAL： We retrieved data from the Chinese National Knowledge Infrastructure （1979-2012）, Wanfang （1980-2012）, VIP （1989-2012）, Chinese Biomedical Literature （1975- 2012）, PubMed （1966-2012）, Ovid Lww （-2012）, and Cochrane Library （-2012） Database using the internet. SELECTION CRITERIA： Randomized controlled trials on filiform needle acupuncture versus antidepressant drugs for treatment of poststroke depression were included. Moreover, the in- cluded articles scored at least 4 points on the Jadad scale. Exclusion criteria： other acupuncture therapies as treatment group, not stroke-induced depression patients, score 〈 4 points, non-ran- domized controlled trials, or animal trials. MAIN OUTCOME MEASURES： These were the Hamilton Depression Scale scores, clinical ef- fective rate, Self-Rating Depression Scale scores, Side Effect Rating Scale scores, and incidence of adverse reaction and events. RESULTS： A total of 17 randomized controlled clinical trials were included. Meta-analysis results displayed that after 4 weeks of treatment, clinical effective rate was better in patients treated with fill- form needle acupuncture than those treated with simple antidepressant drugs [relative risk = 1.11, 95% confidence interval （C/）： 1.03-1.21, P = 0.01]. At 6 weeks, clinical effective rate was similar between filiform needle acupuncture and antidepressant drug groups. At 2 weeks after filiform needle acupuncture, Hamilton Depression Scale （17 items） scores were lower than in the antide- pressant drug group （mean difference = -2.34, 95%CI： -3.46 to -1.22, P 〈 0.000,1）. At 4 weeks, Hamilton Depression Scale （24 items） scores were similar between filiform needle acupuncture and antidepressant drug groups. Self-Rating Depression Scale scores were lower in filiform needle acupuncture group than in the antidepressant drug group. Side Effect Rating Scale was used in only two articles, and no meta-analysis was conducted. Safety evaluation of the 17 arti- cles showed that gastrointestinal tract reactions such as nausea and vomiting were very common in the antidepressant drug group. Incidence of adverse reaction and events was very low in the filiform needle acupuncture group. CONCLUSION： Early filiform needle acupuncture for poststroke depression can perfectly con- trol depression. Filiform needle acupuncture is safe and reliable. Therapeutic effects of filiform needle acupuncture were better than those of antidepressant drugs.展开更多
To the editor, I read with interest the recent report on ＂filiform needle acupuncture for poststroke depression＂ （Zhang et al., 2014）. Zhang et al. （2014） performed a meta-analysis and conclud- ed that ＂early ...To the editor, I read with interest the recent report on ＂filiform needle acupuncture for poststroke depression＂ （Zhang et al., 2014）. Zhang et al. （2014） performed a meta-analysis and conclud- ed that ＂early filiform needle acupuncture for poststroke depression can perfectly control depression：＇ In fact, the in- cluded meta-analysis might support the clinical effectiveness of filariform needle acupuncture for poststroke depression. However, there are several concerns. First, the hospital infection due to acupuncture manipulation with filiform is a big topic to be addressed. As Gang et al. （2012） noted, ＂aseptic technic principles aren＇t strictly followed; disinfection and isolation systems are unsound;展开更多
Objective: To explore the effect of zopiclone combined with Deanxit on cytokines and neurotransmitters in patients with poststroke depression. Methods: A total of 78 patients with poststroke depression who were treate...Objective: To explore the effect of zopiclone combined with Deanxit on cytokines and neurotransmitters in patients with poststroke depression. Methods: A total of 78 patients with poststroke depression who were treated in Zaozhuang Mining Group Dongjiao Hospital between January 2015 and February 2017 were divided into control group (n=41, receiving conventional Deanxit therapy) and zopiclone group (n=37, receiving zopiclone combined with Deanxit therapy). The differences in serum nerve injury marker, inflammatory cytokine and monoamine neurotransmitter levels were compared between the two groups before treatment and after 12 weeks of treatment. Results: Before treatment, serum levels of nerve injury markers, inflammatory cytokines and monoamine neurotransmitters were not significantly different between the two groups. After 12 weeks of treatment, serum nerve injury markers NSE and S100B levels of zopiclone group were lower than those of control group whereas BDNF level was higher than that of control group;serum inflammatory cytokines IL-1, IL-2, IL-23 and TNF-α levels of zopiclone group were lower than those of control group;serum monoamine neurotransmitters NE, 5-HT and DA levels of zopiclone group were higher than those of control group. Conclusion: Zopiclone combined with Deanxit therapy can effectively optimize the neurological function, reduce the inflammatory response and increase the secretion of monoamine neurotransmitters in patients with poststroke depression.展开更多
Objective:To observe the clinical efficacy of acupuncture combined with cognitive training in treating mild-tomoderate poststroke cognitive impairment and the impact on cognitive function and cerebral blood flow.Metho...Objective:To observe the clinical efficacy of acupuncture combined with cognitive training in treating mild-tomoderate poststroke cognitive impairment and the impact on cognitive function and cerebral blood flow.Methods:Eighty-eight participants with mild-to-moderate cognitive impairment after a stroke were allocated to an observation group and a control group using the random number table method,each consisting of 44 cases.The two groups received the same conventional symptomatic treatment.In addition,the control group was intervened by cognitive training,and the observation group by cognitive training and Tong Du Xing Shen(unblocking the Governor Vessel and awakening the mind)acupuncture.The intervention lasted 4 weeks in both groups.By the end of the intervention,the two groups were observed for clinical efficacy and the improvements in the symptom score of traditional Chinese medicine(TCM),cognitive function[mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)],cerebral blood flow velocities[cerebral vascular resistance index(RI),arterial blood flow mean velocity(Vm),and arterial systolic velocity(Vs)],and serum biomarkers of neurological deficit[neuron-specific enolase(NSE)and S100βprotein(S100β)].Results:During the observation,each group had 2 eliminated cases.After the intervention,the observation group achieved a total effective rate of 90.5%,higher than that in the control group,which was 73.8%(P<0.05);increases were found in the MMSE and MoCA scores in both groups(P<0.05),and the observation group was higher than the control group(P<0.05);in contrast,decreases were found in the levels of RI and serum NSE and S100β(P<0.05),and the observation group was lower than the control group(P<0.05);the Vs and Vm levels increased in both groups(P<0.05)and were higher in the observation group than in the control group(P<0.05).Conclusion:Tong Du Xing Shen acupuncture plus cognitive training is effective in treating mild-to-moderate poststroke cognitive impairment and can enhance the patient’s cognitive function;improving cerebral blood circulation and reducing cerebral nerve damage may be involved in the mechanism.展开更多
Objective:To evaluate the efficacy and safety of filiform-needle acupuncture(FA)in the treatment of poststroke urinary incontinence(PSUI).Methods:All published papers in PubMed,Excerpta Medica Database(EMBASE),Cochran...Objective:To evaluate the efficacy and safety of filiform-needle acupuncture(FA)in the treatment of poststroke urinary incontinence(PSUI).Methods:All published papers in PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Chongqing VIP Database(VIP),Wanfang Data Knowledge Service Platform(Wanfang),and China Biology Medicine Disc(CBM)were retrieved by computer.The retrieval time was from each database’s inception to December 9,2023.Meta-analysis and sensitivity analysis were performed using the Revman V5.4 software,and GARDE evaluation was performed using GRADEpro GDT.Dichotomous variables were analyzed by the relative risk(RR),and weighted mean difference(WMD)was used for continuous variables.Each effect size was expressed as a 95%confidence interval(CI).Results:A total of 14 studies were included,comprising a total of 1259 patients.The findings of the meta-analysis showed that the improvements of the maximum bladder capacity[WMD=64.63,95%CI(41.73,87.53),P<0.00001],72 h urination frequency[WMD=-5.27,95%CI(-6.40,-4.13),P<0.00001],and 72 h urinary incontinence frequency[WMD=-1.62,95%CI(-2.60,-0.64),P=0.001]in PSUI patients by FA were superior compared to conventional therapy.FA plus rehabilitation therapy(RT)was superior to RT alone in improving the maximum bladder capacity[WMD=35.17,95%CI(28.31,42.03),P<0.00001],the International Consultation on Incontinence questionnaire short form(ICI-Q-SF)score[WMD=-2.66,95%CI(-3.28,-2.05),P<0.00001],and incontinence quality of life questionnaire(I-QOL)score[WMD=8.07,95%CI(3.28,12.32),P=0.0002].The incidence of adverse reactions in FA was higher than that in RT[RR=21.62,95%CI(4.04,115.71),P=0.0003],but the severity was mild and did not affect the integrity of the treatment.Conclusion:FA has better safety,and its improving effect on bladder urinary storage function and urinary incontinence symptoms in patients with PSUI is clear.Combined with RT,it can better improve the quality of life in the patients.However,more high-quality studies are still needed for further updates and verification.展开更多
Nervonic acid(NA)is an important long-chain monounsaturated fatty acid found in mammalian nervous tissue.It has recently garnered research attention due to its therapeutic potential in treating psychiatric and neurode...Nervonic acid(NA)is an important long-chain monounsaturated fatty acid found in mammalian nervous tissue.It has recently garnered research attention due to its therapeutic potential in treating psychiatric and neurodegenerative disorders.In this study,we investigated the efficacy of NA in treating ischemia/reperfusion and poststroke events in a rat model.Specifically,there was significant reduction in the infarct area,cell death,and neuronal swelling after NA treatment,and the improvement in cerebral blood flow was also observed on day five after middle cerebral artery occlusion.Moreover,NA treatment led to the upregulation of brain-derived neurotrophic factors and myelin basic protein genes.NA displayed improved effects on depressive-like behavior of rats by three validated assays—the sucrose preference test,open-field test,and forced swim test.Regarding the mechanism of action,direct supplementation of NA in the brain was observed.We also observed the indirect effects of NA on the gut microbiota.Notably,the NA group gradually restored the bacterial diversity and the EGb group exhibited no impact based on observed-out analysis.We found an increase in the abundance of Blautia and Sutterella,which participated in phenylalanine metabolism.The metabolomics of plasma and brain samples revealed a decrease in the levels of phenylalanine-based amino acids,which alleviated the inhibitory effects on glutamine metabolism and promoted the recovery and signaling transmission of neurons after stroke.Altogether,our findings suggest that NA can be a viable treatment option for alleviating stroke and its associated poststroke depressive-like behaviors.展开更多
Background： The pathophysiology of poststroke depression （PSD） remains elusive because of its proposed multifactorial nature. Accumulating evidence suggests that brain-derived neurotrophic factor （BDNF） plays a k...Background： The pathophysiology of poststroke depression （PSD） remains elusive because of its proposed multifactorial nature. Accumulating evidence suggests that brain-derived neurotrophic factor （BDNF） plays a key role in the pathophysiology of depression and PSD. And the cerebellar dysfunction may be important in the etiology of depression; it is not clear whether it also has a major effect on the risk of PSD. This study aimed to explore the expression of BDNF and high-affinity receptors tyrosine kinase B （TrkB） in the cerebellum of rats with PSD. Methods： The rat models with focal cerebral ischemic were made using a thread embolization method. PSD rat models were established with comprehensive separate breeding and unpredicted chronic mild stress （UCMS） on this basis. A normal control group, depression group, and a stroke group were used to compare with the PSD group. Thirteen rats were used in each group. Immunohistochemistry and reverse transcription-polymerase chain reaction （RT-PCR） for detecting the expression of BDNF and TrkB protein and mRNA in the cerebellum were used at the 29th day following the UCMS. Results： Compared with the normal control group and the stroke group, the number of BDNF immunoreactive （IR） positive neurons was less in the PSD group （P 〈 0.05）. Furthermore, the number ofTrkB 1R positive cells was significantly less in the PSD group than that in the normal control group （P 〈 0.05）. The gene expression of BDNF and TrkB in the cerebellum of PSD rats also decreased compared to the normal control group （P 〈 0.05）. Conclusions： These findings suggested a possible association between expression of BDNF and TrkB in the cerebellum and the pathogeuesis of PSD.展开更多
Acupuncture and rehabilitation therapies were used to treat 40 cases of shoulder-hand syndrome, the results show that integration of acupuncture and rehabilitation can increase therapeutic effects and shorten treatmen...Acupuncture and rehabilitation therapies were used to treat 40 cases of shoulder-hand syndrome, the results show that integration of acupuncture and rehabilitation can increase therapeutic effects and shorten treatment courses to accelerate recovery.展开更多
Objective:This study aimed to systematically evaluate the clinical efficiency and safety of moxibustion for the treatment of poststroke insomnia(PSI).Methods:We searched PubMed,the Cochrane Library,Embase,China Nation...Objective:This study aimed to systematically evaluate the clinical efficiency and safety of moxibustion for the treatment of poststroke insomnia(PSI).Methods:We searched PubMed,the Cochrane Library,Embase,China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service platform(Wanfang Data),Chinese Scientific Journal Database(VIP),and clinical rial for trandomized controlled trials on moxibustion as a treatment for PSI,including results from the creation of all databases until December 12,2020.The functional languages used were Chinese and English.Two reviewers independently performed the literature search,data extraction,and quality evaluation.The primary and secondary outcome measures were the effective rate and adverse events,respectively.The meta-analysis was carried out using RevMan5.4 software and Stata15.Results:Of the 11 trials,996 patients in China's Mainland were included.Compared to the control group,the combination of single moxibustion therapy or moxibustion combined with acupuncture in the treatment of DN could reduce the sleep quality score(SQS)(mean difference[MD]=-0.50,95%confidence interval[CI][-0.89,-0.11],Z=2.51,P=0.01),time to falling asleep score(MD=-0.39,95%CI[-0.49,-0.29],Z=7.79,P<0.00001),sleep time score(MD=-0.34,95%CI[-0.59,-0.09],Z=2.64,P=0.008),sleep efficiency score(MD=-0.30,95%CI[-0.52,-0.08],Z=2.69,P=0.007),sleep disorder score(MD=-0.29,95%CI[-0.49,-0.09],Z=2.85,P=0.004),daily function disturbance score(MD=-0.54,95%CI[-0.82,-0.26],Z=3.78,P=0.0002),Pittsburgh Sleep Quality Index aggregate score(MD=-2.30,95%CI[-2.97,-1.63],Z=6.71,P<0.00001),SPIEGEL aggregate score(MD=-7.62,95%CI[-8.12,-7.12],Z=29.75,P<0.00001),and stroke-specific quality of life aggregate score(MD=12.68,95%CI[0.92,24.44],Z=2.11,P=0.03).Conclusion:This study indicates that moxibustion contributes to the treatment of PSI.Nevertheless,more extensive trials are required to validate the results due to the small sample sizes,few reports on adverse effects,and high risk of bias in the included studies.展开更多
Objective： To observe the clinical efficacy of puncturing Renying （ST 9） in the treatment of poststroke dysphagia. Methods： Sixty cases of poststroke dysphagia were randomized into two groups, a control group in w...Objective： To observe the clinical efficacy of puncturing Renying （ST 9） in the treatment of poststroke dysphagia. Methods： Sixty cases of poststroke dysphagia were randomized into two groups, a control group in which 30 cases were given rehabilitation training, and a treatment group in which 30 cases were treated by puncturing Renying （ST 9） and rehabilitation training, with a course of four weeks. Results： The total effective rate for dysphagia was higher in the treatment group than in the control group （P〈0.05）. Conclusion： Puncturing Renying （ST 9） is quite effective for poststroke dysphagia.展开更多
Objective:To observe the clinical efficacy of subcutaneous row needling at the Foot Motor Sensory Area combined with point application therapy and its influence on defecation-related symptoms.Methods:Seventy eligible ...Objective:To observe the clinical efficacy of subcutaneous row needling at the Foot Motor Sensory Area combined with point application therapy and its influence on defecation-related symptoms.Methods:Seventy eligible patients with poststroke constipation were assigned to an observation group or a control group using the random number table method,with 35 patients in each group.The observation group received subcutaneous row needling at the Foot Motor Sensory Area combined with point application therapy,whereas the control group received lactulose oral solution.After treatment,the total effective rate and safety were compared between the two groups,and changes in the patient assessment of constipation symptom(PAC-SYM),stool form,and constipation symptom scores were observed.Results:The total effective rate was 87.9%in the observation group and 69.7%in the control group,and the difference was statistically significant(P<0.05).No obvious adverse reactions occurred in either group.After treatment,PAC-SYM and constipation symptom scores in both groups were lower than before treatment(P<0.05),with the observation group scoring lower than the control group(P<0.05).After treatment,the Bristol stool form scale(BSFS)score in both groups increased(P<0.05)and approached the score of normal stool form;the difference in the BSFS score between the two groups was not statistically significant(P>0.05).Conclusion:Compared to oral lactulose,subcutaneous insertion with row needling at the scalp Foot Motor Sensory Area combined with point application therapy can better improve poststroke constipation symptoms,shorten both the interval between bowel movements and the duration of each bowel movement,and reduce rectal and abdominal discomfort,with fewer adverse reactions and good safety.展开更多
Objective:To observe the efficacy of synchronous scalp acupuncture and rehabilitation training in the treatment of poststroke dysphagia.Methods:A total of 106 participants were divided into an observation group and a ...Objective:To observe the efficacy of synchronous scalp acupuncture and rehabilitation training in the treatment of poststroke dysphagia.Methods:A total of 106 participants were divided into an observation group and a control group using the random number table method,with 53 cases in each group.The control group was treated with scalp acupuncture in addition to conventional rehabilitation training.The observation group was treated with synchronous scalp acupuncture and conventional rehabilitation training.Water swallowing test(WST),blood oxygen-saturation change amplitude,mini-mental state examination(MMSE),and standardized swallowing assessment(SSA)were assessed before treatment,after 2 weeks of treatment,and at follow-ups at week 4 and week 6.The effective rate was calculated based on the change in the WST grading after 2 weeks of treatment.Results:After 2 weeks of treatment,there was an insignificant difference in the total effective rate between the two groups(P>0.05),but the inter-group difference in the cured plus markedly effective rate was significant(P<0.01).The intra-group differences in the WST grading,blood oxygen-saturation change amplitude,and the scores of MMSE and SSA were significant among the 4 time points in the two groups(P<0.01).At follow-up at week 6,the WST grading and SSA score in the observation group were superior to those in the control group(P<0.01).Conclusion:Both intervention protocols can improve the swallowing function,physical function,and psychological status;the observation group’s intervention is better than that of the control group in improving swallowing function.展开更多
Objective:To observe the effects of shallow needling at Baihui(GV20)on neurological function and cerebral hemodynamics in patients with poststroke depression(PSD).Methods:A total of 90 PSD patients were divided into a...Objective:To observe the effects of shallow needling at Baihui(GV20)on neurological function and cerebral hemodynamics in patients with poststroke depression(PSD).Methods:A total of 90 PSD patients were divided into a Western medication group and a shallow needling group using the random number table,with 45 cases in each group.The Western medication group was treated with oral paroxetine tablets.The shallow needling group was treated with shallow needling at Baihui(GV20).The treatment course for both groups was 4 weeks.After treatment,the clinical efficacy was compared between the two groups.The scores of Hamilton depression scale-24(HAMD-24)and National Institutes of Health stroke scale(NIHSS),the cerebral hemodynamic changes,and the adverse reactions were observed.Results:After treatment,the total effective rate was 88.9%in the Western medication group and 84.4%in the shallow needling group;the difference between the two groups was not statistically significant(P>0.05).After treatment,the scores of HAMD-24 and NIHSS in both groups decreased(P<0.05).The difference in the HAMD-24 score between the two groups was not statistically significant(P>0.05).The NIHSS score in the shallow needling group was lower than that in the Western medication group,and the difference between the two groups was statistically significant(P<0.05).After treatment,there were no significant differences in the blood flow resistance index of the left middle cerebral artery(LMCA),right middle cerebral artery(RMCA),and basilar artery(BA)in the Western medication group compared to those before treatment.The blood flow resistance index of LMCA,RMCA,and BA in the shallow needling group was lower than that before treatment(P<0.05),and was significantly lower compared to the Western medication group(P<0.05).The incidence of adverse reactions in the shallow needling group was significantly lower than that in the Western medication group(P<0.05).Conclusion:The curative effect of shallow needling at Baihui(GV20)in the treatment of PSD is equivalent to that of oral paroxetine tablets.However,shallow needling at Baihui(GV20)is more effective in improving neurological function and cerebral perfusion,and the incidence of adverse reactions is lower.展开更多
OBJECTIVE:Acupuncture has often been used for aphasia rehabilitation in China.The purpose of this paper was to:1) provide a historic overview of acupuncture for aphasia due to stroke;2) summarize the commonly used acu...OBJECTIVE:Acupuncture has often been used for aphasia rehabilitation in China.The purpose of this paper was to:1) provide a historic overview of acupuncture for aphasia due to stroke;2) summarize the commonly used acupuncture approaches;and 3) objectively comment on the effectiveness of acupuncture for the rehabilitation of this type of disorder.METHODS:The Elsevier database and a Chinese database(CNKI) were searched through December,2010 with the key words "aphasia,acupuncture" in English and Chinese,respectively.Case reports,uncontrolled clinical observations and controlled clinical trials were all included if acupuncture was the sole treatment or the main component of complex intervention for the rehabilitation of aphasia caused by cerebrovascular disease.RESULTS:More than 100 relevant articles were found.After analyzing these articles,we found that acupuncture for apoplectic aphasia most often included tongue,scalp,body and combination acupuncture.Tongue bleeding,deep insertion and strong stimulation were adopted by many practitioners.The ten most frequently used acupoints(or areas) were Lianquan(RN 23),Jinjin(EX-HN 12),Yuye(EX-HN 13),Tongli(HT 5),Fengchi(GB 20),Neiguan(PC 6),Baihui(DU 20),No.1,2 and 3 language sections,Sanyinjiao(SP 6) and Yamen(DU 15).CONCLUSIONS:Controlled clinical studies and a systematic literature review demonstrate that acupuncture has therapeutic effects on aphasia after stroke.展开更多
The present study established a rat model of post-stroke depression using incomplete ischemia induced by unilateral carotid artery ligation in combination with solitary raising and subcutaneous injection of a small do...The present study established a rat model of post-stroke depression using incomplete ischemia induced by unilateral carotid artery ligation in combination with solitary raising and subcutaneous injection of a small dose of reserpine. After intragastric perfusion with 45 mg/100 g, 15 mg/100 g, and 7.5 mg/100 g of Xingnao Jieyu for 7, 14 and 21 days, neuronal morphology in the frontal lobe and hippocampus was improved, depression state and voluntary behaviors were also effectively improved in rats with post-stroke depression. Moreover, the effects of Xingnao Jieyu at a dose of 45 and 15 mg/100 g were similar to the traditional antidepressant Prozac.展开更多
A number of studies have assessed the influence of depression on the risk of cardiovascular disease. A growing literature indicates a link between depression and cerebrovascular events, although the direction of this ...A number of studies have assessed the influence of depression on the risk of cardiovascular disease. A growing literature indicates a link between depression and cerebrovascular events, although the direction of this association remains unclear. Numerous data have emerged suggesting an association between depressive symptoms and subsequent risk of stroke, thus leading to the hypothesis that a direct causality between depression and stroke exists. Notwithstanding, how depression may act as a risk factor for stroke is still unclear. Depression might be linked to stroke via neuroendocrine and inflammation effects, through correlation with major comorbidities such as hypertensionand diabetes or by intervention of lifestyle behavioral mediators. Finally, antidepressant medications have recently drawn attention for a possible association with increased risk of stroke, although such findings remain uncertain. Depression has been also established as an important consequence after stroke, exerting a significant adverse impact on the course of motor recovery, social functioning and, overall, on quality of life. Post stroke depression occurs in nearly one third of stroke cases, but the exact mechanism leading to depression after stroke is still incompletely understood. In this article, we will review contemporary epidemiologic studies, discuss potential mechanisms and specific aspects of the complex relation between depression and stroke.展开更多
基金supported by the Scientific Research Project of China Rehabilitation Research Center,No.2021zx-23the National Natural Science Foundation of China,No.32100925the Beijing Nova Program,No.Z211100002121038。
文摘Poststro ke cognitive impairment is a major secondary effect of ischemic stroke in many patients;however,few options are available for the early diagnosis and treatment of this condition.The aims of this study were to(1)determine the specific relationship between hypoxic andα-synuclein during the occur of poststroke cognitive impairment and(2)assess whether the serum phosphorylatedα-synuclein level can be used as a biomarker for poststro ke cognitive impairment.We found that the phosphorylatedα-synuclein level was significantly increased and showed pathological aggregation around the cerebral infa rct area in a mouse model of ischemic stroke.In addition,neuronalα-synuclein phosphorylation and aggregation were observed in the brain tissue of mice subjected to chronic hypoxia,suggesting that hypoxia is the underlying cause ofα-synuclein-mediated pathology in the brains of mice with ischemic stroke.Serum phosphorylatedα-synuclein levels in patients with ischemic stroke were significantly lower than those in healt hy subjects,and were positively correlated with cognition levels in patients with ischemic stroke.Furthermore,a decrease in serum high-density lipoprotein levels in stroke patie nts was significantly correlated with a decrease in phosphorylatedα-synuclein levels.Although ischemic stroke mice did not show significant cognitive impairment or disrupted lipid metabolism 14 days after injury,some of them exhibited decreased cognitive function and reduced phosphorylatedα-synuclein levels.Taken together,our results suggest that serum phosphorylatedα-synuclein is a potential biomarker for poststroke cognitive impairment.
文摘Following an acute stroke,patients often encounter a range of impairments affecting their physical,cognitive,verbal,and social capabilities.Poststroke depression(PSD)has been identified as a significant consequence of stroke and serves as a crucial predictor of patient outcomes.The diagnosis of PSD presents a challenge,as the physical manifestations following a stroke can overlap with certain depressive symptoms,leading to a potential underdiagnosis of this condition.This review employs a narrative approach to synthesize diverse findings within this domain.PSD is categorized as an organic mood disorder,and a more accurate diagnosis may be achieved by considering the location of the stroke,the patient's specific symptoms,and the timeline of depressive symptom onset.Notably,if depressive symptoms emerge at more than one year poststroke,the likelihood of PSD diminishes.The etiology of PSD is currently understood to stem from a combination of physiological and psychosocial factors,as well as their interactions.Several mechanisms associated with PSD have been identified,including inflammation,dysregulation of the hypothalamic-pituitary-adrenal axis,oxidative stress,autophagy,apoptosis,abnormal neurotrophic responses,glutamate-mediated excitotoxicity,dysfunction within brain networks,reduced monoamine levels,locations of brain lesions,and psychosocial influences.This review also outlines potential directions for future research.
文摘The objective of this study is to analyze the relevant literature on acupoint massage applied to patients with poststroke constipation,to explore the research status,research hotspots,and research frontiers of poststroke constipation,and to provide reference for clinical practice and scientific research.With the help of CiteSpace software,the related literatures published in the China National Knowledge Infrastructure database on the application of acupoint massage to constipation after stroke were analyzed,and scientific atlas for visual analysis was drawn.The hot keywords in the field of acupoint massage for post-stroke constipation are constipation,nursing intervention,and traditional Chinese medicine(TCM)nursing,indicating the great importance of TCM nursing for such patients.In mutation word detection,words such as constipation,nursing,stroke,and defecation reflex have earlier mutation times.Massage is the keyword with the longest mutation time,suggesting it is an effective intervention for post-stroke patients and is widely recognized.The commonly used acupoints for poststroke constipation are Tianshu(ST 25),Zhongwan(CV 12),and Qihai(CV 6).These acupoints can regulate qi and blood and enhance gastrointestinal peristalsis,providing guiding significance for formulating relevant clinical practice guidelines.The research of acupoint massage in the nursing of poststroke constipation is still in the stage of practice and exploration,and the specific definition of operation process,technique,acupoint,time,and intensity is still not clear.Multicenter,large-sample,in-depth intervention research,and cohort studies hold immense significance for the future development of this discipline.
文摘Background: The mechanisms by which acupuncture affects poststroke cognitive impairment (PSCI) remain unclear. Objective: To investigate brain functional network (BFN) changes in patients with PSCI after acupuncture therapy. Methods: Twenty-two PSCI patients who underwent acupuncture therapy in our hospital were enrolled as research subjects. Another 14 people matched for age, sex, and education level were included in the normal control (HC) group. All the subjects underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans;the PSCI patients underwent one scan before acupuncture therapy and another after. The network metric difference between PSCI patients and HCs was analyzed via the independent-sample t test, whereas the paired-sample t test was employed to analyze the network metric changes in PSCI patients before vs. after treatment. Results: Small-world network attributes were observed in both groups for sparsities between 0.1 and 0.28. Compared with the HC group, the PSCI group presented significantly lower values for the global topological properties (γ, Cp, and Eloc) of the brain;significantly greater values for the nodal attributes of betweenness centrality in the CUN. L and the HES. R, degree centrality in the SFGdor. L, PCG. L, IPL. L, and HES. R, and nodal local efficiency in the ORBsup. R, ORBsupmed. R, DCG. L, SMG. R, and TPOsup. L;and decreased degree centrality in the MFG. R, IFGoperc. R, and SOG. R. After treatment, PSCI patients presented increased degree centrality in the LING.L, LING.R, and IOG. L and nodal local efficiency in PHG. L, IOG. R, FFG. L, and the HES. L, and decreased betweenness centrality in the PCG. L and CUN. L, degree centrality in the ORBsupmed. R, and nodal local efficiency in ANG. R. Conclusion: Cognitive decline in PSCI patients may be related to BFN disorders;acupuncture therapy may modulate the topological properties of the BFNs of PSCI patients.
基金supported by the Guangdong Provincial"211 Engineering"Stage-III Key Disciplines Construction Project in China,No.Yue 2009431
文摘OBJECTIVE： To evaluate the effectiveness and safety of filiform needle acupuncture for poststroke depression, and to compare acupuncture with the therapeutic efficacy of antidepressant drugs. DATA RETRIEVAL： We retrieved data from the Chinese National Knowledge Infrastructure （1979-2012）, Wanfang （1980-2012）, VIP （1989-2012）, Chinese Biomedical Literature （1975- 2012）, PubMed （1966-2012）, Ovid Lww （-2012）, and Cochrane Library （-2012） Database using the internet. SELECTION CRITERIA： Randomized controlled trials on filiform needle acupuncture versus antidepressant drugs for treatment of poststroke depression were included. Moreover, the in- cluded articles scored at least 4 points on the Jadad scale. Exclusion criteria： other acupuncture therapies as treatment group, not stroke-induced depression patients, score 〈 4 points, non-ran- domized controlled trials, or animal trials. MAIN OUTCOME MEASURES： These were the Hamilton Depression Scale scores, clinical ef- fective rate, Self-Rating Depression Scale scores, Side Effect Rating Scale scores, and incidence of adverse reaction and events. RESULTS： A total of 17 randomized controlled clinical trials were included. Meta-analysis results displayed that after 4 weeks of treatment, clinical effective rate was better in patients treated with fill- form needle acupuncture than those treated with simple antidepressant drugs [relative risk = 1.11, 95% confidence interval （C/）： 1.03-1.21, P = 0.01]. At 6 weeks, clinical effective rate was similar between filiform needle acupuncture and antidepressant drug groups. At 2 weeks after filiform needle acupuncture, Hamilton Depression Scale （17 items） scores were lower than in the antide- pressant drug group （mean difference = -2.34, 95%CI： -3.46 to -1.22, P 〈 0.000,1）. At 4 weeks, Hamilton Depression Scale （24 items） scores were similar between filiform needle acupuncture and antidepressant drug groups. Self-Rating Depression Scale scores were lower in filiform needle acupuncture group than in the antidepressant drug group. Side Effect Rating Scale was used in only two articles, and no meta-analysis was conducted. Safety evaluation of the 17 arti- cles showed that gastrointestinal tract reactions such as nausea and vomiting were very common in the antidepressant drug group. Incidence of adverse reaction and events was very low in the filiform needle acupuncture group. CONCLUSION： Early filiform needle acupuncture for poststroke depression can perfectly con- trol depression. Filiform needle acupuncture is safe and reliable. Therapeutic effects of filiform needle acupuncture were better than those of antidepressant drugs.
文摘To the editor, I read with interest the recent report on ＂filiform needle acupuncture for poststroke depression＂ （Zhang et al., 2014）. Zhang et al. （2014） performed a meta-analysis and conclud- ed that ＂early filiform needle acupuncture for poststroke depression can perfectly control depression：＇ In fact, the in- cluded meta-analysis might support the clinical effectiveness of filariform needle acupuncture for poststroke depression. However, there are several concerns. First, the hospital infection due to acupuncture manipulation with filiform is a big topic to be addressed. As Gang et al. （2012） noted, ＂aseptic technic principles aren＇t strictly followed; disinfection and isolation systems are unsound;
基金Shandong Provincial Natural Science Foundation Project(Grant No.81471371).
文摘Objective: To explore the effect of zopiclone combined with Deanxit on cytokines and neurotransmitters in patients with poststroke depression. Methods: A total of 78 patients with poststroke depression who were treated in Zaozhuang Mining Group Dongjiao Hospital between January 2015 and February 2017 were divided into control group (n=41, receiving conventional Deanxit therapy) and zopiclone group (n=37, receiving zopiclone combined with Deanxit therapy). The differences in serum nerve injury marker, inflammatory cytokine and monoamine neurotransmitter levels were compared between the two groups before treatment and after 12 weeks of treatment. Results: Before treatment, serum levels of nerve injury markers, inflammatory cytokines and monoamine neurotransmitters were not significantly different between the two groups. After 12 weeks of treatment, serum nerve injury markers NSE and S100B levels of zopiclone group were lower than those of control group whereas BDNF level was higher than that of control group;serum inflammatory cytokines IL-1, IL-2, IL-23 and TNF-α levels of zopiclone group were lower than those of control group;serum monoamine neurotransmitters NE, 5-HT and DA levels of zopiclone group were higher than those of control group. Conclusion: Zopiclone combined with Deanxit therapy can effectively optimize the neurological function, reduce the inflammatory response and increase the secretion of monoamine neurotransmitters in patients with poststroke depression.
文摘Objective:To observe the clinical efficacy of acupuncture combined with cognitive training in treating mild-tomoderate poststroke cognitive impairment and the impact on cognitive function and cerebral blood flow.Methods:Eighty-eight participants with mild-to-moderate cognitive impairment after a stroke were allocated to an observation group and a control group using the random number table method,each consisting of 44 cases.The two groups received the same conventional symptomatic treatment.In addition,the control group was intervened by cognitive training,and the observation group by cognitive training and Tong Du Xing Shen(unblocking the Governor Vessel and awakening the mind)acupuncture.The intervention lasted 4 weeks in both groups.By the end of the intervention,the two groups were observed for clinical efficacy and the improvements in the symptom score of traditional Chinese medicine(TCM),cognitive function[mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)],cerebral blood flow velocities[cerebral vascular resistance index(RI),arterial blood flow mean velocity(Vm),and arterial systolic velocity(Vs)],and serum biomarkers of neurological deficit[neuron-specific enolase(NSE)and S100βprotein(S100β)].Results:During the observation,each group had 2 eliminated cases.After the intervention,the observation group achieved a total effective rate of 90.5%,higher than that in the control group,which was 73.8%(P<0.05);increases were found in the MMSE and MoCA scores in both groups(P<0.05),and the observation group was higher than the control group(P<0.05);in contrast,decreases were found in the levels of RI and serum NSE and S100β(P<0.05),and the observation group was lower than the control group(P<0.05);the Vs and Vm levels increased in both groups(P<0.05)and were higher in the observation group than in the control group(P<0.05).Conclusion:Tong Du Xing Shen acupuncture plus cognitive training is effective in treating mild-to-moderate poststroke cognitive impairment and can enhance the patient’s cognitive function;improving cerebral blood circulation and reducing cerebral nerve damage may be involved in the mechanism.
文摘Objective:To evaluate the efficacy and safety of filiform-needle acupuncture(FA)in the treatment of poststroke urinary incontinence(PSUI).Methods:All published papers in PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Chongqing VIP Database(VIP),Wanfang Data Knowledge Service Platform(Wanfang),and China Biology Medicine Disc(CBM)were retrieved by computer.The retrieval time was from each database’s inception to December 9,2023.Meta-analysis and sensitivity analysis were performed using the Revman V5.4 software,and GARDE evaluation was performed using GRADEpro GDT.Dichotomous variables were analyzed by the relative risk(RR),and weighted mean difference(WMD)was used for continuous variables.Each effect size was expressed as a 95%confidence interval(CI).Results:A total of 14 studies were included,comprising a total of 1259 patients.The findings of the meta-analysis showed that the improvements of the maximum bladder capacity[WMD=64.63,95%CI(41.73,87.53),P<0.00001],72 h urination frequency[WMD=-5.27,95%CI(-6.40,-4.13),P<0.00001],and 72 h urinary incontinence frequency[WMD=-1.62,95%CI(-2.60,-0.64),P=0.001]in PSUI patients by FA were superior compared to conventional therapy.FA plus rehabilitation therapy(RT)was superior to RT alone in improving the maximum bladder capacity[WMD=35.17,95%CI(28.31,42.03),P<0.00001],the International Consultation on Incontinence questionnaire short form(ICI-Q-SF)score[WMD=-2.66,95%CI(-3.28,-2.05),P<0.00001],and incontinence quality of life questionnaire(I-QOL)score[WMD=8.07,95%CI(3.28,12.32),P=0.0002].The incidence of adverse reactions in FA was higher than that in RT[RR=21.62,95%CI(4.04,115.71),P=0.0003],but the severity was mild and did not affect the integrity of the treatment.Conclusion:FA has better safety,and its improving effect on bladder urinary storage function and urinary incontinence symptoms in patients with PSUI is clear.Combined with RT,it can better improve the quality of life in the patients.However,more high-quality studies are still needed for further updates and verification.
基金financially supported by the Scientific and technological innovation project of the China Academy of Chinese Medical Sciences(CI2021A05032,CI2021B017)the Fundamental Research Funds for the Central Public Welfare Research Institutes(RXRC2022003,XTCX2023001).
文摘Nervonic acid(NA)is an important long-chain monounsaturated fatty acid found in mammalian nervous tissue.It has recently garnered research attention due to its therapeutic potential in treating psychiatric and neurodegenerative disorders.In this study,we investigated the efficacy of NA in treating ischemia/reperfusion and poststroke events in a rat model.Specifically,there was significant reduction in the infarct area,cell death,and neuronal swelling after NA treatment,and the improvement in cerebral blood flow was also observed on day five after middle cerebral artery occlusion.Moreover,NA treatment led to the upregulation of brain-derived neurotrophic factors and myelin basic protein genes.NA displayed improved effects on depressive-like behavior of rats by three validated assays—the sucrose preference test,open-field test,and forced swim test.Regarding the mechanism of action,direct supplementation of NA in the brain was observed.We also observed the indirect effects of NA on the gut microbiota.Notably,the NA group gradually restored the bacterial diversity and the EGb group exhibited no impact based on observed-out analysis.We found an increase in the abundance of Blautia and Sutterella,which participated in phenylalanine metabolism.The metabolomics of plasma and brain samples revealed a decrease in the levels of phenylalanine-based amino acids,which alleviated the inhibitory effects on glutamine metabolism and promoted the recovery and signaling transmission of neurons after stroke.Altogether,our findings suggest that NA can be a viable treatment option for alleviating stroke and its associated poststroke depressive-like behaviors.
基金Acknowledgments We would like to thank Dr. Tricia for her invaluable comments in the writing of this manuscript. I This research- was supported by a grant from the Yunnan Natural Science Foundation （No. 2009ZC126M）.
文摘Background： The pathophysiology of poststroke depression （PSD） remains elusive because of its proposed multifactorial nature. Accumulating evidence suggests that brain-derived neurotrophic factor （BDNF） plays a key role in the pathophysiology of depression and PSD. And the cerebellar dysfunction may be important in the etiology of depression; it is not clear whether it also has a major effect on the risk of PSD. This study aimed to explore the expression of BDNF and high-affinity receptors tyrosine kinase B （TrkB） in the cerebellum of rats with PSD. Methods： The rat models with focal cerebral ischemic were made using a thread embolization method. PSD rat models were established with comprehensive separate breeding and unpredicted chronic mild stress （UCMS） on this basis. A normal control group, depression group, and a stroke group were used to compare with the PSD group. Thirteen rats were used in each group. Immunohistochemistry and reverse transcription-polymerase chain reaction （RT-PCR） for detecting the expression of BDNF and TrkB protein and mRNA in the cerebellum were used at the 29th day following the UCMS. Results： Compared with the normal control group and the stroke group, the number of BDNF immunoreactive （IR） positive neurons was less in the PSD group （P 〈 0.05）. Furthermore, the number ofTrkB 1R positive cells was significantly less in the PSD group than that in the normal control group （P 〈 0.05）. The gene expression of BDNF and TrkB in the cerebellum of PSD rats also decreased compared to the normal control group （P 〈 0.05）. Conclusions： These findings suggested a possible association between expression of BDNF and TrkB in the cerebellum and the pathogeuesis of PSD.
文摘Acupuncture and rehabilitation therapies were used to treat 40 cases of shoulder-hand syndrome, the results show that integration of acupuncture and rehabilitation can increase therapeutic effects and shorten treatment courses to accelerate recovery.
基金supported by the Special Research Project of the Traditional Chinese Medicine Industry(201107006)the School-level Scientific Research Project of Tianjin University of Traditional Chinese Medicine(XJ201801)。
文摘Objective:This study aimed to systematically evaluate the clinical efficiency and safety of moxibustion for the treatment of poststroke insomnia(PSI).Methods:We searched PubMed,the Cochrane Library,Embase,China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service platform(Wanfang Data),Chinese Scientific Journal Database(VIP),and clinical rial for trandomized controlled trials on moxibustion as a treatment for PSI,including results from the creation of all databases until December 12,2020.The functional languages used were Chinese and English.Two reviewers independently performed the literature search,data extraction,and quality evaluation.The primary and secondary outcome measures were the effective rate and adverse events,respectively.The meta-analysis was carried out using RevMan5.4 software and Stata15.Results:Of the 11 trials,996 patients in China's Mainland were included.Compared to the control group,the combination of single moxibustion therapy or moxibustion combined with acupuncture in the treatment of DN could reduce the sleep quality score(SQS)(mean difference[MD]=-0.50,95%confidence interval[CI][-0.89,-0.11],Z=2.51,P=0.01),time to falling asleep score(MD=-0.39,95%CI[-0.49,-0.29],Z=7.79,P<0.00001),sleep time score(MD=-0.34,95%CI[-0.59,-0.09],Z=2.64,P=0.008),sleep efficiency score(MD=-0.30,95%CI[-0.52,-0.08],Z=2.69,P=0.007),sleep disorder score(MD=-0.29,95%CI[-0.49,-0.09],Z=2.85,P=0.004),daily function disturbance score(MD=-0.54,95%CI[-0.82,-0.26],Z=3.78,P=0.0002),Pittsburgh Sleep Quality Index aggregate score(MD=-2.30,95%CI[-2.97,-1.63],Z=6.71,P<0.00001),SPIEGEL aggregate score(MD=-7.62,95%CI[-8.12,-7.12],Z=29.75,P<0.00001),and stroke-specific quality of life aggregate score(MD=12.68,95%CI[0.92,24.44],Z=2.11,P=0.03).Conclusion:This study indicates that moxibustion contributes to the treatment of PSI.Nevertheless,more extensive trials are required to validate the results due to the small sample sizes,few reports on adverse effects,and high risk of bias in the included studies.
文摘Objective： To observe the clinical efficacy of puncturing Renying （ST 9） in the treatment of poststroke dysphagia. Methods： Sixty cases of poststroke dysphagia were randomized into two groups, a control group in which 30 cases were given rehabilitation training, and a treatment group in which 30 cases were treated by puncturing Renying （ST 9） and rehabilitation training, with a course of four weeks. Results： The total effective rate for dysphagia was higher in the treatment group than in the control group （P〈0.05）. Conclusion： Puncturing Renying （ST 9） is quite effective for poststroke dysphagia.
文摘Objective:To observe the clinical efficacy of subcutaneous row needling at the Foot Motor Sensory Area combined with point application therapy and its influence on defecation-related symptoms.Methods:Seventy eligible patients with poststroke constipation were assigned to an observation group or a control group using the random number table method,with 35 patients in each group.The observation group received subcutaneous row needling at the Foot Motor Sensory Area combined with point application therapy,whereas the control group received lactulose oral solution.After treatment,the total effective rate and safety were compared between the two groups,and changes in the patient assessment of constipation symptom(PAC-SYM),stool form,and constipation symptom scores were observed.Results:The total effective rate was 87.9%in the observation group and 69.7%in the control group,and the difference was statistically significant(P<0.05).No obvious adverse reactions occurred in either group.After treatment,PAC-SYM and constipation symptom scores in both groups were lower than before treatment(P<0.05),with the observation group scoring lower than the control group(P<0.05).After treatment,the Bristol stool form scale(BSFS)score in both groups increased(P<0.05)and approached the score of normal stool form;the difference in the BSFS score between the two groups was not statistically significant(P>0.05).Conclusion:Compared to oral lactulose,subcutaneous insertion with row needling at the scalp Foot Motor Sensory Area combined with point application therapy can better improve poststroke constipation symptoms,shorten both the interval between bowel movements and the duration of each bowel movement,and reduce rectal and abdominal discomfort,with fewer adverse reactions and good safety.
文摘Objective:To observe the efficacy of synchronous scalp acupuncture and rehabilitation training in the treatment of poststroke dysphagia.Methods:A total of 106 participants were divided into an observation group and a control group using the random number table method,with 53 cases in each group.The control group was treated with scalp acupuncture in addition to conventional rehabilitation training.The observation group was treated with synchronous scalp acupuncture and conventional rehabilitation training.Water swallowing test(WST),blood oxygen-saturation change amplitude,mini-mental state examination(MMSE),and standardized swallowing assessment(SSA)were assessed before treatment,after 2 weeks of treatment,and at follow-ups at week 4 and week 6.The effective rate was calculated based on the change in the WST grading after 2 weeks of treatment.Results:After 2 weeks of treatment,there was an insignificant difference in the total effective rate between the two groups(P>0.05),but the inter-group difference in the cured plus markedly effective rate was significant(P<0.01).The intra-group differences in the WST grading,blood oxygen-saturation change amplitude,and the scores of MMSE and SSA were significant among the 4 time points in the two groups(P<0.01).At follow-up at week 6,the WST grading and SSA score in the observation group were superior to those in the control group(P<0.01).Conclusion:Both intervention protocols can improve the swallowing function,physical function,and psychological status;the observation group’s intervention is better than that of the control group in improving swallowing function.
文摘Objective:To observe the effects of shallow needling at Baihui(GV20)on neurological function and cerebral hemodynamics in patients with poststroke depression(PSD).Methods:A total of 90 PSD patients were divided into a Western medication group and a shallow needling group using the random number table,with 45 cases in each group.The Western medication group was treated with oral paroxetine tablets.The shallow needling group was treated with shallow needling at Baihui(GV20).The treatment course for both groups was 4 weeks.After treatment,the clinical efficacy was compared between the two groups.The scores of Hamilton depression scale-24(HAMD-24)and National Institutes of Health stroke scale(NIHSS),the cerebral hemodynamic changes,and the adverse reactions were observed.Results:After treatment,the total effective rate was 88.9%in the Western medication group and 84.4%in the shallow needling group;the difference between the two groups was not statistically significant(P>0.05).After treatment,the scores of HAMD-24 and NIHSS in both groups decreased(P<0.05).The difference in the HAMD-24 score between the two groups was not statistically significant(P>0.05).The NIHSS score in the shallow needling group was lower than that in the Western medication group,and the difference between the two groups was statistically significant(P<0.05).After treatment,there were no significant differences in the blood flow resistance index of the left middle cerebral artery(LMCA),right middle cerebral artery(RMCA),and basilar artery(BA)in the Western medication group compared to those before treatment.The blood flow resistance index of LMCA,RMCA,and BA in the shallow needling group was lower than that before treatment(P<0.05),and was significantly lower compared to the Western medication group(P<0.05).The incidence of adverse reactions in the shallow needling group was significantly lower than that in the Western medication group(P<0.05).Conclusion:The curative effect of shallow needling at Baihui(GV20)in the treatment of PSD is equivalent to that of oral paroxetine tablets.However,shallow needling at Baihui(GV20)is more effective in improving neurological function and cerebral perfusion,and the incidence of adverse reactions is lower.
文摘OBJECTIVE:Acupuncture has often been used for aphasia rehabilitation in China.The purpose of this paper was to:1) provide a historic overview of acupuncture for aphasia due to stroke;2) summarize the commonly used acupuncture approaches;and 3) objectively comment on the effectiveness of acupuncture for the rehabilitation of this type of disorder.METHODS:The Elsevier database and a Chinese database(CNKI) were searched through December,2010 with the key words "aphasia,acupuncture" in English and Chinese,respectively.Case reports,uncontrolled clinical observations and controlled clinical trials were all included if acupuncture was the sole treatment or the main component of complex intervention for the rehabilitation of aphasia caused by cerebrovascular disease.RESULTS:More than 100 relevant articles were found.After analyzing these articles,we found that acupuncture for apoplectic aphasia most often included tongue,scalp,body and combination acupuncture.Tongue bleeding,deep insertion and strong stimulation were adopted by many practitioners.The ten most frequently used acupoints(or areas) were Lianquan(RN 23),Jinjin(EX-HN 12),Yuye(EX-HN 13),Tongli(HT 5),Fengchi(GB 20),Neiguan(PC 6),Baihui(DU 20),No.1,2 and 3 language sections,Sanyinjiao(SP 6) and Yamen(DU 15).CONCLUSIONS:Controlled clinical studies and a systematic literature review demonstrate that acupuncture has therapeutic effects on aphasia after stroke.
基金supported by the Major Program of "13115" Science and Technology Innovation Project (Preclinical study of Xingnao Jieyu capsule), No. 2010ZDKG-65
文摘The present study established a rat model of post-stroke depression using incomplete ischemia induced by unilateral carotid artery ligation in combination with solitary raising and subcutaneous injection of a small dose of reserpine. After intragastric perfusion with 45 mg/100 g, 15 mg/100 g, and 7.5 mg/100 g of Xingnao Jieyu for 7, 14 and 21 days, neuronal morphology in the frontal lobe and hippocampus was improved, depression state and voluntary behaviors were also effectively improved in rats with post-stroke depression. Moreover, the effects of Xingnao Jieyu at a dose of 45 and 15 mg/100 g were similar to the traditional antidepressant Prozac.
文摘A number of studies have assessed the influence of depression on the risk of cardiovascular disease. A growing literature indicates a link between depression and cerebrovascular events, although the direction of this association remains unclear. Numerous data have emerged suggesting an association between depressive symptoms and subsequent risk of stroke, thus leading to the hypothesis that a direct causality between depression and stroke exists. Notwithstanding, how depression may act as a risk factor for stroke is still unclear. Depression might be linked to stroke via neuroendocrine and inflammation effects, through correlation with major comorbidities such as hypertensionand diabetes or by intervention of lifestyle behavioral mediators. Finally, antidepressant medications have recently drawn attention for a possible association with increased risk of stroke, although such findings remain uncertain. Depression has been also established as an important consequence after stroke, exerting a significant adverse impact on the course of motor recovery, social functioning and, overall, on quality of life. Post stroke depression occurs in nearly one third of stroke cases, but the exact mechanism leading to depression after stroke is still incompletely understood. In this article, we will review contemporary epidemiologic studies, discuss potential mechanisms and specific aspects of the complex relation between depression and stroke.
