OBJECTIVE:To evaluate the efficacy of Baishao Luoshi decoction(白芍络石方,BD)on synaptic plasticity in rats with post stroke spasticity(PSS),and to study the mechanism behind the action.METHODS:The PSS model of rat wa...OBJECTIVE:To evaluate the efficacy of Baishao Luoshi decoction(白芍络石方,BD)on synaptic plasticity in rats with post stroke spasticity(PSS),and to study the mechanism behind the action.METHODS:The PSS model of rat was established by middle cerebral artery occlusion(MCAO).The neurological deficit symptoms were evaluated by modified neurological deficit score(mN SS).Muscle tension were evaluated by Modified Ashworth score(MAS).Transmission electron microscopy(TEM)was used to observe the synaptic ultrastructure.The expression of synaptic plasticity-related protein brain derived neurotrophic factor(BDNF),growth associated protein-43(GAP43),synaptophysin(p38)and microtubule-associated protein 2(MAP2)in the brain tissue around the infarct were detected by Western blotting.RESULTS:We found that mNSS were significantly improved and limb spasticity was ameliorated treated by BD.The thickness of postsynaptic density and the synaptic curvature increased significantly.The expression of synaptic plasticity-related protein BDNF,GAP43,p38,MAP2 in the brain tissue around the infarct were raised remarkably after treated by BD.CONCLUSIONS:Alleviating PSS by BD may be related to rescuing the synaptic plasticity,which provides a probable new therapeutic method for PSS.展开更多
[Objectives]To quantify the efficacy of Extracorporeal Shock Wave Therapy(ESWT)for upper limb spasticity in stroke patients using Modified Ashworth Scale(MAS)across three timeframes:immediate,short-term(24 h-4 wks),an...[Objectives]To quantify the efficacy of Extracorporeal Shock Wave Therapy(ESWT)for upper limb spasticity in stroke patients using Modified Ashworth Scale(MAS)across three timeframes:immediate,short-term(24 h-4 wks),and long-term(>4 wks).[Methods]Six databases(PubMed,EMBASE,CENTRAL,CINAHL,Scopus,Web of Science)until May 2025,were systematically searched,identifying 11 RCTs(n=505)meeting inclusion criteria(adults≥18 yrs old with stroke-related spasticity[MAS≥1]).Risk of bias was rigorously assessed using Cochrane criteria,revealing uniformly low risk across all domains.Random-effects meta-analyses(REML model)calculated Hedges'g with 95%CI for MAS outcomes,with subgroup analyses for joint-specific effects.[Results]ESWT demonstrated non-significant immediate MAS reduction(g=-0.69,p=0.07;=93.95%),but statistically significant short-term(g=-0.58,p=0.02;I^(2)=89.64%)and long-term effects(g=-0.52,p=0.02;I^(2)=78.72%).Effects were driven by composite MAS scores(short-term g=-0.63;long-term g=-0.56,both p<0.05)rather than isolated joints(elbow/finger/wrist all non-significant).Substantial heterogeneity persisted across analyses,particularly in joint-specific subgroups(I^(2)>90%).[Conclusions]ESWT provides statistically significant,clinically relevant reductions in global upper limb spasticity with durable efficacy beyond four weeks,supporting its use as a non-invasive adjunct therapy despite substantial heterogeneity warranting protocol standardization.展开更多
Objective To observe the effects of antagonistic needling therapy on lower limb spasticity and the muscle morphology of the tibialis anterior and gastrocnemius in patients with stroke.Methods A total of 100 patients w...Objective To observe the effects of antagonistic needling therapy on lower limb spasticity and the muscle morphology of the tibialis anterior and gastrocnemius in patients with stroke.Methods A total of 100 patients with post-stroke lower limb spasticity were randomly divided into an antagonistic needling group(50 cases,1 case dropped out)and a routine acupuncture group(50 cases,1 case dropped out).Both groups received basic treatment and rehabilitation training.Theroutine acupuncture group was treated with scalp acupuncture at anterior oblique line of vertex-temporal and vertex lateral line 1,combined with body acupuncture at Jianyu(LI15),Hegu(LI4),Zusanli(ST36),Taichong(LR3),etc.on the affected side,with Quchi(LIl1)and Hegu(LI4),Zusanli(ST36)and Fenglong(ST40),Yanglingquan(GB34)and Taichong(LR3)connected to an electroacupuncture device,using disperse wave at 2 Hz of frequency.The antagonistic needling group used the same scalp and upper limb acupoints as the routine acupuncture group,with additional antagonistic needling on the lower limb at Yanglingquan(GB34),Qiuxu(GB40),Jiexi(ST41),and Xuanzhong(GB39)on the affected side,with Quchi(LIl1)and Hegu(LI4),Yanglingquan(GB34)and Qiuxu(GB40),Jiexi(ST41),and Xuanzhong(GB39)connected to an electroacupuncture device,using disperse wave at 2 Hz of frequency.Both groups received treatment once daily for 6 consecutive days per course,with a total of 4 courses.The modified Ashworth scale(MAS),Holden functional ambulation classification(FAC),lower limb Fugl-Meyer assessment(FMA),composite spasticity scale(CSS),and musculoskeletal ultrasound parameters(thickness and fiber length of the tibialis anterior and gastrocnemius,and pennation angle of the gastrocnemius on both sides) were evaluated before and after treatment.Clinical efficacy was compared between the two groups.Results Compared before treatment,the MAS grades and CSS scores were decreased in both groups after treatment(P<0.01),with greater reductions in the antagonistic needling group(P<0.05,P<0.01).FAC grades and FMA scores were increased in both groups after treatment(P<0.01,P<0.05),with greater improvements in the antagonistic needling group(P<0.05).The muscle thickness,fiber length of the tibialis anterior,the muscle thickness,fiber length and pennation angle of the gastrocnemius on the affected side were improved in both groups after treatment(P<0.01),with greater improvements in the antagonistic needling group(P<0.01,P<0.05).On the unaffected side,these parameters were also increased after treatment in both groups(P<0.01,P<0.05),but the antagonistic needling group showed smaller increases than the routine acupuncture group(P<0.01,P<0.05).The total effective rate in the antagonistic needling group was 91.8%(45/49),higher than 81.6%(40/49)in the routine acupuncture group(P<0.05).Conclusion Antagonistic needling could effectively reduce spasticity,improve motor function,and enhance muscle structure in patients with post-stroke lower limb spasticity.展开更多
Objective To compare the clinical efficacy of jingjin needling combined with rehabilitation training and conventional acupuncture combined with rehabilitation training for post-stroke spastic paralysis.Methods A total...Objective To compare the clinical efficacy of jingjin needling combined with rehabilitation training and conventional acupuncture combined with rehabilitation training for post-stroke spastic paralysis.Methods A total of 60 patients with post-stroke spastic paralysis were randomly divided into an observation group and a control group,30 cases in each one.展开更多
Since 1992,task groups have used free nerve auto grafts to bridge partially transected nerves from the dominant area of the normal cerebral cortex to nerves that innervate spastic muscles from a diseased cerebral cort...Since 1992,task groups have used free nerve auto grafts to bridge partially transected nerves from the dominant area of the normal cerebral cortex to nerves that innervate spastic muscles from a diseased cerebral cortex,using transplanting sutures to alleviate the muscle spasm of cerebral palsy caused by different diseases. This has facilitated rebuilding of some of its neurological function. In this study,80 such patients were followed up,including 20 patients with traumatic brain injury,32 patients with stroke,and 28 pediatric patients with cerebral palsy. After postoperative follow-up of 3 to 21 years,the efficacy rate of this operation was 100% and the excellent and good spasm relief rate was 82.5%.展开更多
基金Supported by the China Postdoctoral Science Foundation:Research on the Mechanism of Baishaoluoshi Decoction in Improving Poststroke Spasticity by KCC2-GABAAR Based on the Theory of“Gan Zhu Jin”(No.2020M682571)Natural Science Foundation of Hunan Province China:Research on the Mechanism of Post-stroke Spasticity by KCC2--GABAAR-Motoneuron Excitability and Chinese Traditional Medicine Intervention Based on the Theory of“Gan Zhu Jin”(No.2019JJ50343)the Scientific Research Project of Education Department of Hunan Province:Research on the Mechanism of Axonal Regeneration and TCM Intervention in Post-Stroke Spasticity Based on the Theory of“Gan Zhu Jin”by Slit-Robo Pathway(No.19C1423)。
文摘OBJECTIVE:To evaluate the efficacy of Baishao Luoshi decoction(白芍络石方,BD)on synaptic plasticity in rats with post stroke spasticity(PSS),and to study the mechanism behind the action.METHODS:The PSS model of rat was established by middle cerebral artery occlusion(MCAO).The neurological deficit symptoms were evaluated by modified neurological deficit score(mN SS).Muscle tension were evaluated by Modified Ashworth score(MAS).Transmission electron microscopy(TEM)was used to observe the synaptic ultrastructure.The expression of synaptic plasticity-related protein brain derived neurotrophic factor(BDNF),growth associated protein-43(GAP43),synaptophysin(p38)and microtubule-associated protein 2(MAP2)in the brain tissue around the infarct were detected by Western blotting.RESULTS:We found that mNSS were significantly improved and limb spasticity was ameliorated treated by BD.The thickness of postsynaptic density and the synaptic curvature increased significantly.The expression of synaptic plasticity-related protein BDNF,GAP43,p38,MAP2 in the brain tissue around the infarct were raised remarkably after treated by BD.CONCLUSIONS:Alleviating PSS by BD may be related to rescuing the synaptic plasticity,which provides a probable new therapeutic method for PSS.
文摘[Objectives]To quantify the efficacy of Extracorporeal Shock Wave Therapy(ESWT)for upper limb spasticity in stroke patients using Modified Ashworth Scale(MAS)across three timeframes:immediate,short-term(24 h-4 wks),and long-term(>4 wks).[Methods]Six databases(PubMed,EMBASE,CENTRAL,CINAHL,Scopus,Web of Science)until May 2025,were systematically searched,identifying 11 RCTs(n=505)meeting inclusion criteria(adults≥18 yrs old with stroke-related spasticity[MAS≥1]).Risk of bias was rigorously assessed using Cochrane criteria,revealing uniformly low risk across all domains.Random-effects meta-analyses(REML model)calculated Hedges'g with 95%CI for MAS outcomes,with subgroup analyses for joint-specific effects.[Results]ESWT demonstrated non-significant immediate MAS reduction(g=-0.69,p=0.07;=93.95%),but statistically significant short-term(g=-0.58,p=0.02;I^(2)=89.64%)and long-term effects(g=-0.52,p=0.02;I^(2)=78.72%).Effects were driven by composite MAS scores(short-term g=-0.63;long-term g=-0.56,both p<0.05)rather than isolated joints(elbow/finger/wrist all non-significant).Substantial heterogeneity persisted across analyses,particularly in joint-specific subgroups(I^(2)>90%).[Conclusions]ESWT provides statistically significant,clinically relevant reductions in global upper limb spasticity with durable efficacy beyond four weeks,supporting its use as a non-invasive adjunct therapy despite substantial heterogeneity warranting protocol standardization.
文摘Objective To observe the effects of antagonistic needling therapy on lower limb spasticity and the muscle morphology of the tibialis anterior and gastrocnemius in patients with stroke.Methods A total of 100 patients with post-stroke lower limb spasticity were randomly divided into an antagonistic needling group(50 cases,1 case dropped out)and a routine acupuncture group(50 cases,1 case dropped out).Both groups received basic treatment and rehabilitation training.Theroutine acupuncture group was treated with scalp acupuncture at anterior oblique line of vertex-temporal and vertex lateral line 1,combined with body acupuncture at Jianyu(LI15),Hegu(LI4),Zusanli(ST36),Taichong(LR3),etc.on the affected side,with Quchi(LIl1)and Hegu(LI4),Zusanli(ST36)and Fenglong(ST40),Yanglingquan(GB34)and Taichong(LR3)connected to an electroacupuncture device,using disperse wave at 2 Hz of frequency.The antagonistic needling group used the same scalp and upper limb acupoints as the routine acupuncture group,with additional antagonistic needling on the lower limb at Yanglingquan(GB34),Qiuxu(GB40),Jiexi(ST41),and Xuanzhong(GB39)on the affected side,with Quchi(LIl1)and Hegu(LI4),Yanglingquan(GB34)and Qiuxu(GB40),Jiexi(ST41),and Xuanzhong(GB39)connected to an electroacupuncture device,using disperse wave at 2 Hz of frequency.Both groups received treatment once daily for 6 consecutive days per course,with a total of 4 courses.The modified Ashworth scale(MAS),Holden functional ambulation classification(FAC),lower limb Fugl-Meyer assessment(FMA),composite spasticity scale(CSS),and musculoskeletal ultrasound parameters(thickness and fiber length of the tibialis anterior and gastrocnemius,and pennation angle of the gastrocnemius on both sides) were evaluated before and after treatment.Clinical efficacy was compared between the two groups.Results Compared before treatment,the MAS grades and CSS scores were decreased in both groups after treatment(P<0.01),with greater reductions in the antagonistic needling group(P<0.05,P<0.01).FAC grades and FMA scores were increased in both groups after treatment(P<0.01,P<0.05),with greater improvements in the antagonistic needling group(P<0.05).The muscle thickness,fiber length of the tibialis anterior,the muscle thickness,fiber length and pennation angle of the gastrocnemius on the affected side were improved in both groups after treatment(P<0.01),with greater improvements in the antagonistic needling group(P<0.01,P<0.05).On the unaffected side,these parameters were also increased after treatment in both groups(P<0.01,P<0.05),but the antagonistic needling group showed smaller increases than the routine acupuncture group(P<0.01,P<0.05).The total effective rate in the antagonistic needling group was 91.8%(45/49),higher than 81.6%(40/49)in the routine acupuncture group(P<0.05).Conclusion Antagonistic needling could effectively reduce spasticity,improve motor function,and enhance muscle structure in patients with post-stroke lower limb spasticity.
文摘Objective To compare the clinical efficacy of jingjin needling combined with rehabilitation training and conventional acupuncture combined with rehabilitation training for post-stroke spastic paralysis.Methods A total of 60 patients with post-stroke spastic paralysis were randomly divided into an observation group and a control group,30 cases in each one.
基金supported by the Shanghai Science and Technology Project(No.10411953800)
文摘Since 1992,task groups have used free nerve auto grafts to bridge partially transected nerves from the dominant area of the normal cerebral cortex to nerves that innervate spastic muscles from a diseased cerebral cortex,using transplanting sutures to alleviate the muscle spasm of cerebral palsy caused by different diseases. This has facilitated rebuilding of some of its neurological function. In this study,80 such patients were followed up,including 20 patients with traumatic brain injury,32 patients with stroke,and 28 pediatric patients with cerebral palsy. After postoperative follow-up of 3 to 21 years,the efficacy rate of this operation was 100% and the excellent and good spasm relief rate was 82.5%.
