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Zhu GC, Chen KM, Belcastro F. Comparing the effects of different acupoint-stimulating therapies in mitigating post-stroke spasticity and motor dysfunction in older stroke survivors: A network meta-analysis of randomized trials. Maturitas 2024; 187:108040. [PMID: 38852490 DOI: 10.1016/j.maturitas.2024.108040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/06/2024] [Accepted: 05/30/2024] [Indexed: 06/11/2024]
Abstract
Acupoint-stimulating therapies have often been used to manage stroke-related spasticity and motor dysfunction. However, the effects of different acupoint-stimulating therapies in older stroke survivors have been unclear. This systematic review and network meta-analysis compared the effects of different acupoint-stimulating therapies in managing spasticity and motor dysfunction in older stroke survivors. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched 7 databases for studies published up to July 2023. Inclusion criteria were: (1) older adults with strokes; (2) treatments were acupoint-stimulating therapies; (3) a control group did not receive acupoint-stimulating therapy, or the study compared different acupoint-stimulating therapies; and (4) outcomes included spasticity and motor function. Methodological quality was assessed with Risk-of-bias tool for randomized trials version 2, while R and Metainsight were used to conduct the network meta-analysis. We analyzed 27 studies and the results showed that non-invasive electroacupuncture and warm acupuncture were more effective in reducing spasticity than conventional acupuncture (standardized mean difference and 95 % confidence intervals = 1.35/1.19 [0.57; 2.13/0.54; 1.83]) and invasive electroacupuncture (standardized mean difference and 95 % confidence intervals = 0.96/0.80 [0.12; 1.80/0.08; 1.51]). Conventional acupuncture and invasive electroacupuncture were effective in improving motor function (standardized mean difference and 95 % confidence intervals = 0.99/1.41 [0.42; 1.56/0.54; 2.28]). However, there was significant inconsistency for the effects of invasive electroacupuncture between studies. Our findings suggest that for older stroke survivors with spasticity, non-invasive electroacupuncture and warm acupuncture are appropriate, whereas conventional acupuncture is more appropriate for patients aiming for motor recovery. SYSTEMATIC REVIEW REGISTRATION: This study was registered in the PROSPERO database (CRD42023442202).
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Affiliation(s)
- Guan-Cheng Zhu
- Center for Long-Term Care Research, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan.
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung 80708, Taiwan; Center for Long-Term Care Research, Kaohsiung Medical University, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan.
| | - Frank Belcastro
- Department of Education and Psychology, University of Dubuque, 2000 University Ave., Dubuque, IA 52001, USA
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2
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Valentijn PP, Tymchenko L, Gruisen W, Bruls B, Abdalla Pereira F, Arends RY. Effectiveness of Integrated Care for Diabetes Mellitus Type 2, Cardiovascular and Chronic Respiratory Diseases: A Systematic Review and Meta-Analysis. Int J Integr Care 2024; 24:16. [PMID: 39184531 PMCID: PMC11342834 DOI: 10.5334/ijic.7744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 08/01/2024] [Indexed: 08/27/2024] Open
Abstract
Introduction In this paper, we use the Rainbow Model of Integrated Care (RMIC) framework to evaluate the effectiveness of integrated care in terms of enhancing the outcomes of chronic conditions such as diabetes mellitus type 2 (DMT2), cardiovascular diseases (CVD), chronic respiratory diseases (CRD), or their combinations. Methods The data extracted from randomized controlled trials (RCT) of integrated care interventions for DMT2, CVD, and CRD (follow-up ≥ 3 months) in 11 databases were analysed using random-effects meta-analysis. Results A total of 54 eligible studies covering 12,976 participants, with a mean follow-up of 54 weeks, were included. In moderate-quality evidence, integrated care interventions reduced mortality for CVD, adverse events for CVD and DMT2, and improved quality of life for CVD and DMT2, physical and mental functioning, self-management, and blood pressure control. Conclusion Integrated care can reduce all-cause mortality, adverse events, and improve quality of life, physical and mental functioning, self-management and blood pressure control in chronic disease patients. However, available evidence for some outcomes (e.g., all-cause hospital admissions) remains uncertain.
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Affiliation(s)
- Pim P. Valentijn
- Essenburgh Research & Consultancy, Essenburgh Group, Harderwijk, the Netherlands
- Research Group Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Liza Tymchenko
- Essenburgh Research & Consultancy, Essenburgh Group, Harderwijk, the Netherlands
| | - Wiro Gruisen
- Healthcare Division, CZ Health Insurance, Tilburg, the Netherlands
| | - Bem Bruls
- Health Centre Hoensbroek North, Hoensbroek, the Netherlands
- General Practitioners Eastern South Limburg, Heerlen, the Netherlands
| | | | - Rosa Y. Arends
- Essenburgh Research & Consultancy, Essenburgh Group, Harderwijk, the Netherlands
- University of Applied Sciences Utrecht, Utrecht, the Netherlands
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3
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Liu Y, Cui W, Liu H, Yao M, Shen W, Miao L, Wei J, Liang X, Zhang Y. Exploring the "gene-metabolite" network of ischemic stroke with blood stasis and toxin syndrome by integrated transcriptomics and metabolomics strategy. Sci Rep 2024; 14:11947. [PMID: 38789486 PMCID: PMC11126742 DOI: 10.1038/s41598-024-61633-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
A research model combining a disease and syndrome can provide new ideas for the treatment of ischemic stroke. In the field of traditional Chinese medicine, blood stasis and toxin (BST) syndrome is considered an important syndrome seen in patients with ischemic stroke (IS). However, the biological basis of IS-BST syndrome is currently not well understood. Therefore, this study aimed to explore the biological mechanism of IS-BST syndrome. This study is divided into two parts: (1) establishment of an animal model of ischemic stroke disease and an animal model of BST syndrome in ischemic stroke; (2) use of omics methods to identify differentially expressed genes and metabolites in the models. We used middle cerebral artery occlusion (MCAO) surgery to establish the disease model, and utilized carrageenan combined with active dry yeast and MCAO surgery to construct the IS-BST syndrome model. Next, we used transcriptomics and metabolomics methods to explore the differential genes and metabolites in the disease model and IS-BST syndrome model. It is found that the IS-BST syndrome model exhibited more prominent characteristics of IS disease and syndrome features. Both the disease model and the IS-BST syndrome model share some common biological processes, such as thrombus formation, inflammatory response, purine metabolism, sphingolipid metabolism, and so on. Results of the "gene-metabolite" network revealed that the IS-BST syndrome model exhibited more pronounced features of complement-coagulation cascade reactions and amino acid metabolism disorders. Additionally, the "F2 (thrombin)-NMDAR/glutamate" pathway was coupled with the formation process of the blood stasis and toxin syndrome. This study reveals the intricate mechanism of IS-BST syndrome, offering a successful model for investigating the combination of disease and syndrome.
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Affiliation(s)
- Yue Liu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Wenqiang Cui
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Hongxi Liu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Mingjiang Yao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
- Beijing Key Laboratory of Pharmacology of Chinese Materia Region, Institute of Basic Medical Sciences, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Wei Shen
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Lina Miao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Jingjing Wei
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
| | - Xiao Liang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
| | - Yunling Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
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4
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Feng L, Kong L, Dong X, Lai X, Zhang D, Ren B, Liu S, Xie X, Li C, Song Y, Du Y, Cao K, Zhang C, Gao Y. China Stroke Registry for Patients With Traditional Chinese Medicine (CASES-TCM): Rationale and Design of a Prospective, Multicenter, Observational Study. Front Pharmacol 2021; 12:743883. [PMID: 34531755 PMCID: PMC8438566 DOI: 10.3389/fphar.2021.743883] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/23/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Given the complexity of stroke treatment and the current widespread use of traditional Chinese medicine (TCM) in the absence of robust, large, long-term effectiveness and safety studies, and the lack of nationwide epidemiology and clinical characteristics of patients with stroke receiving TCM treatment, the acquisition of data from longitudinal cohorts is essential. We intend to generate the major clinical characteristics of patients with stroke who receive TCM treatment and to investigate the effectiveness and safety of TCM in the Chinese population. Methods: The China Stroke Registry for Patients with Traditional Chinese Medicine (CASES-TCM) study is a prospective, multicenter, observational disease registry aiming to register 20,000 hospitalized patients. Eligible adult patients with clearly diagnosed acute ischemic stroke or intracerebral hemorrhage within 7 days of symptom onset will be consecutively registered from 126 participating sites across China. Baseline data will be recorded, and all patients will be regularly followed up at 3, 6, 12, and 24 months after stroke onset. Collected data will be entered into a web-based system with high-level data security. The primary outcomes include the distribution of scores on the modified Rankin Scale at the 3-months follow-up, and recurrent stroke events within the 12-months follow-up. Conclusion: To our knowledge, the CASES-TCM study is the first and largest nationwide registry to document comprehensive data on TCM treatment in patients with acute stroke. The findings of this study will be valuable to improve our knowledge about TCM treatment for patients with stroke and its subsequent outcomes in the actual clinical setting, consequently facilitating and standardizing the optimization of individualized interventions with TCM for stroke prevention and treatment in China. Study registration: This study was registered with Clinicaltrials.gov (URL: https://clinicaltrials.gov/, Unique identifier: NCT04921397).
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Affiliation(s)
- Luda Feng
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Lingbo Kong
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Xinglu Dong
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Xinxing Lai
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China.,Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Dandan Zhang
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Beida Ren
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Shen Liu
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaolong Xie
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Chuanpeng Li
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Yuebo Song
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Yawei Du
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Kegang Cao
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China.,Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chi Zhang
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China.,Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Gao
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.,Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China.,Chinese Medicine Key Research Room of Brain Disorders Syndrome and Treatment of the National Administration of Traditional Chinese Medicine, Beijing, China
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5
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Cabanas-Valdés R, Calvo-Sanz J, Serra-Llobet P, Alcoba-Kait J, González-Rueda V, Rodríguez-Rubio PR. The Effectiveness of Massage Therapy for Improving Sequelae in Post-Stroke Survivors. A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094424. [PMID: 33919371 PMCID: PMC8122530 DOI: 10.3390/ijerph18094424] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 12/26/2022]
Abstract
Objective: To assess the effect of therapeutic massage for improving sequelae in stroke survivors. Methods: A systematic review of the nine medical databases from January 1961 to December 2020 was carried out. The bibliography was screened to identify randomized controlled clinical trials (RCTs). Two reviewers independently screened references, selected relevant studies, extracted data and assessed the risk of bias using the PEDro scale. The primary outcome was upper and lower limb motor function and spasticity. Results: A total of 3196 studies were identified and 18 RCT were finally included (1989 individuals). A meta-analysis of RCTs in the comparison of Chinese massage (Tuina) plus conventional physiotherapy versus conventional physiotherapy was performed. The mean difference (MD) in the subacute stage on upper limb motor-function using the Fugl Meyer Assessment was 2.75; (95% confidence interval (CI) from 0.97 to 4.53, p = 0.002, I2 = 36%). The MD on upper limb spasticity using modified Ashworth scale was −0.15; (95% CI from −0.24 to −0.06, p < 0.02, I2 = 0%).The MD on lower limb spasticity was −0.59; (95% CI from −0.78 to −0.40, p < 0.001, I2 = 0%) in the endpoint. Conclusions: Therapeutic massage, especially Tuina, in addition to conventional therapy is effective for improving motor function and for reducing spasticity in stroke survivors.
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Affiliation(s)
- Rosa Cabanas-Valdés
- Physiotherapy Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain; (P.S.-L.); (J.A.-K.); (V.G.-R.); (P.R.R.-R.)
- Correspondence:
| | - Jordi Calvo-Sanz
- Physiotherapy Department, School of Health Sciences, Tecno Campus, Mataró-Pompeu Fabra University (TCM-UPF), 08302 Barcelona, Spain;
- Hospital Asepeyo Sant Cugat del Vallès, 08174 Barcelona, Spain
| | - Pol Serra-Llobet
- Physiotherapy Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain; (P.S.-L.); (J.A.-K.); (V.G.-R.); (P.R.R.-R.)
| | - Joana Alcoba-Kait
- Physiotherapy Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain; (P.S.-L.); (J.A.-K.); (V.G.-R.); (P.R.R.-R.)
- CENAC, 08028 Barcelona, Spain
| | - Vanessa González-Rueda
- Physiotherapy Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain; (P.S.-L.); (J.A.-K.); (V.G.-R.); (P.R.R.-R.)
- Fundació Institut Universitari per a la Recerca a l’Atenció Primaria de Salut Jordi Gol i Gurina, 08007 Barcelona, Spain
| | - Pere Ramón Rodríguez-Rubio
- Physiotherapy Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain; (P.S.-L.); (J.A.-K.); (V.G.-R.); (P.R.R.-R.)
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6
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Zhou ZR, Zhao YH, Sun R, Zhang YR. Effects of Xingnaojing on serum high-sensitivity C-reactive protein and neuron-specific enolase in patients with acute cerebral hemorrhage: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21379. [PMID: 33157907 PMCID: PMC7647605 DOI: 10.1097/md.0000000000021379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND This study will systematically explore the effects of Xingnaojing (XNJ) on serum high-sensitivity C-reactive protein (hs-CRP) and neuron-specific enolase (NSE) in patients with acute cerebral hemorrhage (ACH). METHODS We will comprehensively search the following electronic databases (MEDLINE, EMBASE, Cochrane Library, Allied and Complementary Medicine Database, and China National Knowledge Infrastructure) from inception to the March 1, 2020. There are no limitations related to the language and publication status. Two authors will independently perform all citation identification, information extraction, and study quality. All potential conflicts will be solved through discussion with the help of a third author. RevMan 5.3 software will be used for data synthesis and statistical analysis. RESULTS This study will summarize the present evidence to investigate the effects of XNJ on serum hs-CRP and NSE in patients with ACH. CONCLUSION This study may provide an impressive understanding of perspective from scientific basis for effects of XNJ on serum hs-CRP and NSE in patients with ACH. STUDY REGISTRATION PROSPERO CRD42020171648.
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Affiliation(s)
- Zhe-ren Zhou
- Department of Emergency, Hospital of Xi’an Jiaotong University
| | | | - Rong Sun
- Department of Emergency, Xi’an Gaoxin Hospital
| | - Yu-rong Zhang
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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7
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Zeng S, Liu Y, Wang X, Zhang L, Guo Y, Feng Q. Traditional Chinese Medicine Could Play an Important Role in Integrative Palliative Care in China. J Altern Complement Med 2020; 26:770-773. [PMID: 32924559 DOI: 10.1089/acm.2020.0160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
| | - Yefang Liu
- Third School of Clinical Medicine, Chengdu University of TCM, Chengdu, China
| | - Xiaoli Wang
- Third School of Clinical Medicine, Chengdu University of TCM, Chengdu, China
| | - Lu Zhang
- Chengdu University of TCM, Chengdu, China
| | - Yinling Guo
- Chengdu University of TCM, Chengdu, China.,School of Basic Medical Sciences, Chengdu University of TCM, Chengdu, China
| | - Quansheng Feng
- Chengdu University of TCM, Chengdu, China.,School of Basic Medical Sciences, Chengdu University of TCM, Chengdu, China
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8
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Wang Y, Zhang L, Pan YJ, Fu W, Huang SW, Xu B, Dou LP, Hou Q, Li C, Yu L, Zhou HF, Yang JH, Wan HT. Investigation of Invigorating Qi and Activating Blood Circulation Prescriptions in Treating Qi Deficiency and Blood Stasis Syndrome of Ischemic Stroke Patients: Study Protocol for a Randomized Controlled Trial. Front Pharmacol 2020; 11:892. [PMID: 32625091 PMCID: PMC7311665 DOI: 10.3389/fphar.2020.00892] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/29/2020] [Indexed: 01/19/2023] Open
Abstract
Ischemic stroke (IS) is characterized by high morbidity and high mortality. The integration of Traditional Chinese medicine (TCM) and western medicine has shown promising benefits in relieving symptoms, promoting neurological recovery, and improving the quality of life of patients with IS. In TCM, Qi-deficiency along with blood-stasis (QDBS) syndrome is one of the common types of IS that is treated by invigorating Qi and activating blood circulation. In TCM theory, improving the corresponding degree of prescription-syndrome correlation (PSC) is helpful to improve clinical efficacy. In this study, we intend to use similar prescriptions that invigorate Qi and activate blood circulation: Buyang Huanwu granules (BHG), Naoxintong capsules (NXTC), and Yangyin Tongnao granules (YTG). The goal is to evaluate their level of PSC inpatients with IS with QDBS syndrome and find relevant biomarkers to provide an objective basis for precise treatment of TCM and improve the clinical therapeutic effects. A multicenter, randomized, double-blinded, and placebo-controlled intervention trial will be conducted in IS patients with QDBS syndrome, followed by an add-on of Chinese patent medicine. A total of 160 subjects will be randomly assigned to the BHG, NXTC, YTG, and placebo groups in a 1:2:1:1 allocation ratio. All subjects will undergo 28 days of treatment and then followed for another 180 days. The primary outcome is the changes in the National Institutes of Health Stroke Scale score after 28 days of medication. The secondary outcomes include the modified Rankin scale score, activity of daily living scale score, and TCM symptom score. Data will be analyzed in accordance with a predefined statistical analysis plan. Ethical approval of this trial has been granted by the Research Ethics Committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (ID: 2017-Y-004-02). Written informed consent of patients will be required. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR1800015189), and the results will be disseminated to the public through peer-reviewed journals and academic conferences.
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Affiliation(s)
- Yu Wang
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ling Zhang
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuan-jiang Pan
- Department of Chemistry, Zhejiang University, Hangzhou, China
| | - Wei Fu
- Department of Cardiac-Cerebral Diseases, Yinchuan Cardiac-Cerebral Treatment Internet Hospital, Yinchuan, China
| | - Shu-wei Huang
- Department of Cardiovascular Diseases, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Bin Xu
- Department of Neurology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Li-ping Dou
- Department of Cardiovascular Diseases, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Qun Hou
- Department of Neurology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Chang Li
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Li Yu
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Hui-fen Zhou
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jie-hong Yang
- Basic Medical and Public Health College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Hai-tong Wan
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
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9
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Huang CC, Chiang PY, Cheng YC, Huang BR. Efficacy and Safety of Wendan Decoction for Acute Brain Injury: A Randomized Controlled Study. J Altern Complement Med 2020; 26:392-397. [PMID: 32207984 DOI: 10.1089/acm.2019.0349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Objectives: Despite the remarkable advances in critical care management of acute brain injury for the past 20 years, the prognoses remain poor. However, numerous reports indicate the efficacy of Traditional Chinese Medicine (TCM) therapy in stroke rehabilitation. This study aimed to determine the efficacy and safety of integrated TCM (Wendan decoction [WDD]) in patients with acute brain injury as a combination therapy in the early stages. Design: Prospective randomized controlled trial. Setting: Single-center study. Subjects: Sixty patients diagnosed with acute brain injury were randomly assigned to intervention and control groups, equally, and 41 patients completed the study. Interventions: All patients were treated by conventional neurologic intensive care. The 23 patients in the intervention group were administered with an integrated WDD in the early stages three times daily; combination treatment was initiated within 14 days and lasted >1 month. Outcome measures: Duration of ventilator use, intensive care unit stays, Glasgow Coma Scale (GCS) scores, motor response, the best muscle power, disability rating scale (DRS) scores, modified Rankin scale (mRS) scores, and the mortality rate for the first month. The other outcome measures were GCS scores, motor response, the best muscle power, DRS, mRS, and Barthel index (BI) scores 6 months later. Results: There was no mortality in the intervention group, but the rate was 39% in the control group for first month. Comparisons between groups showed significant differences (p < 0.05) in GCS, DRS, mRS, and BI scores, indicating improvements in the intervention group after 6 months. Conclusions: In the early stages of acute brain injury, combination treatment with WDD was found to be safe. Furthermore, this treatment may improve neurologic functional outcomes after 6 months.
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Affiliation(s)
- Chung-Chun Huang
- Department of Chinese Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Pei-Yeh Chiang
- Department of Neurosurgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Yu-Chen Cheng
- Department of Chinese Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Bor-Ren Huang
- Department of Neurosurgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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10
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Luo Y, Wang CZ, Hesse-Fong J, Lin JG, Yuan CS. Application of Chinese Medicine in Acute and Critical Medical Conditions. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2019; 47:1223-1235. [PMID: 31505937 DOI: 10.1142/s0192415x19500629] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Western medicine is routinely used in developed nations as well as in Eastern countries, where traditional medicine is frequently used by a selection of patients or family member as a complement to mainstream Western medicine. Chinese medicine plays an important role in the treatment of chronic diseases, especially when Western medicine is not very effective. Many published reports have shown that Chinese medicine could also be successfully used in the management of acute and critical illnesses. Chinese medicine has a holistic view of the human body, and emphasizes individualization based on body balance and mind-body interaction and employs herbal medicines and acupuncture. This review paper gives a brief overview of Chinese medicine theory and therapeutic modality and then addresses the application of Chinese medicine in the treatment of acute and critical medical conditions, including epidemics. Using this ancient therapy as a complementary medicine, the management of serious medical conditions, such as SARS, acute heart diseases, and ischemic cerebral stroke, are presented. In order to promote more widespread application of Chinese medicine, well-designed controlled clinical trials are urgently needed to prove its safety and effectiveness.
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Affiliation(s)
- Yun Luo
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, P. R. China.,Tang Center for Herbal Medicine Research, University of Chicago, Chicago, Illinois 60637, USA.,Department of Anesthesia and Critical Care, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA
| | - Chong-Zhi Wang
- Tang Center for Herbal Medicine Research, University of Chicago, Chicago, Illinois 60637, USA.,Department of Anesthesia and Critical Care, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA
| | - Julia Hesse-Fong
- Tang Center for Herbal Medicine Research, University of Chicago, Chicago, Illinois 60637, USA.,Department of Anesthesia and Critical Care, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA
| | - Jaung-Geng Lin
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | - Chun-Su Yuan
- Tang Center for Herbal Medicine Research, University of Chicago, Chicago, Illinois 60637, USA.,Department of Anesthesia and Critical Care, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA.,Committee on Clinical Pharmacology and Pharmacogenomics, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA
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Chen CH, Hung KS, Chung YC, Yeh ML. Mind-body interactive qigong improves physical and mental aspects of quality of life in inpatients with stroke: A randomized control study. Eur J Cardiovasc Nurs 2019; 18:658-666. [PMID: 31232097 DOI: 10.1177/1474515119860232] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Stroke, a medical condition that causes physical disability and mental health problems, impacts negatively on quality of life. Post-stroke rehabilitation is critical to restoring quality of life in these patients. OBJECTIVES This study was designed to evaluate the effect of a mind-body interactive qigong intervention on the physical and mental aspects of quality of life, considering bio-physiological and mental covariates in subacute stroke inpatients. METHODS A randomized controlled trial with repeated measures design was used. A total of 68 participants were recruited from the medical and rehabilitation wards at a teaching hospital in northern Taiwan and then randomly assigned either to the Chan-Chuang qigong group, which received standard care plus a 10-day mind-body interactive exercise program, or to the control group, which received standard care only. Data were collected using the National Institutes of Health Stroke Scale, Hospital Anxiety and Depression Scale, Short Form-12, stroke-related neurologic deficit, muscular strength, heart rate variability and fatigue at three time points: pre-intervention, halfway through the intervention (day 5) and on the final day of the intervention (day 10). RESULTS The results of the mixed-effect model analysis showed that the qigong group had a significantly higher quality of life score at day 10 (p<0.05) than the control group. Among the covariates, neurologic deficit (p=0.04), muscle strength (p=0.04), low frequency to high frequency ratio (p=0.02) and anxiety (p=0.04) were significantly associated with changes in quality of life. Conversely, heart rate, heart rate variability (standard deviation of normal-to-normal intervals, low frequency and high frequency), fatigue and depression were not significantly associated with change in quality of life (p >0.05). CONCLUSIONS This study supports the potential benefits of a 10-day mind-body interactive exercise (Chan-Chuang qigong) program for subacute stroke inpatients and provides information that may be useful in planning adjunctive rehabilitative care for stroke inpatients.
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Affiliation(s)
- Ching-Hsiang Chen
- Department of Nursing, Hsinchu Cathay General Hospital, Hsinchu, Taiwan
| | - Kuo-Sheng Hung
- Graduate Institute of Injury Prevention and Control, and Department of Neurosurgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chu Chung
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Mei-Ling Yeh
- Department of Nursing, National Taipei University of Nursing & Health Sciences, Taipei, Taiwan
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Zheng C, Lee Y, Bin H, Jiong W. A randomized controlled trial comparing electroacupuncture with manual acupuncture for motor function recovery after ischemic stroke. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Liu S, Li M, Tang W, Wang G, Lv Y. An fMRI study of the effects on normal language areas when acupuncturing the Tongli (HT 5) and Xuanzhong (GB 39) acupoints. J Int Med Res 2017; 45:1961-1975. [PMID: 28868952 PMCID: PMC5805221 DOI: 10.1177/0300060517720344] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective Functional magnetic resonance imaging (fMRI) analysis of the effects of
acupuncturing the Tongli (HT5) and Tongli
(HT5)–Xuanzhong (GB39) acupoints on the normal
language areas with a view to providing a theoretical basis for using
acupuncture to treat patients with aphasia. Methods This study enrolled healthy volunteers. The following acupoints were
stimulated: right Tongli (HT5), right Tongli
(HT5)–Xuanzhong (GB39), right Tongli (HT5)
sham acupuncture, left Tongli (HT5), and left Tongli
(HT5)–Xuanzhong (GB39) acupoints. Acupuncture
stimulation was delivered whilst fMRI scanning of the brain was
undertaken. Results Ten healthy volunteers (five males) were included in this study (mean age
44.5 ± 2.5 years; range 40–55 years). Based on the statistical analyses,
only acupuncturing the right Tongli (HT5) acupoint resulted in
activation of multiple regions of the bilateral cerebral hemisphere that
were closely related to the language regions. The right Tongli
(HT5) stimulation had a laterality index of 0.0952; with the
activated voxels on the left side language-related areas being greater than
those on the right side. Conclusions Acupuncturing the right Tongli (HT5) acupoint results in
activation of the bilateral language-related areas, so this acupoint might
be useful for the acupuncture treatment of aphasia caused by cerebral
infarction.
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Affiliation(s)
- Shuyong Liu
- 1 School of Medicine, Shandong University, Jinan, Shandong Province, China.,2 Department of Radiology, Taian City Central Hospital, Taian, Shandong Province, China
| | - Min Li
- 1 School of Medicine, Shandong University, Jinan, Shandong Province, China.,2 Department of Radiology, Taian City Central Hospital, Taian, Shandong Province, China
| | - Weijun Tang
- 3 Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Guangbin Wang
- 1 School of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Yinghui Lv
- 2 Department of Radiology, Taian City Central Hospital, Taian, Shandong Province, China
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Layne K, Ferro A. Traditional Chinese medicines in the management of cardiovascular diseases: a comprehensive systematic review. Br J Clin Pharmacol 2016; 83:20-32. [PMID: 27195823 DOI: 10.1111/bcp.13013] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/19/2016] [Accepted: 05/11/2016] [Indexed: 02/06/2023] Open
Abstract
AIMS The aim was to perform a systematic review of the efficacy of traditional Chinese medicines (TCM) in cardiovascular disease. METHODS Electronic databases were searched up to 11 November 2015 for all randomized-controlled trials evaluating the effect of TCM in hypertension, ischaemic stroke, heart failure, coronary heart disease and type 2 diabetes mellitus. Pooled odds ratios (ORs) were calculated using a fixed-effects model. RESULTS Four hypertension studies were eligible for statistical analysis and included 133 patients receiving TCM and 130 control patients. There were significant reductions in systolic blood pressure in patients receiving TCM, comparable to results achieved with pharmaceutical medicines. An OR of 3.781 (95% confidence interval 2.392, 5.977; P = 0.000) was observed for the anti-hypertensive effect of TCM. Significant heterogeneity was present (P = 0.011), with a tendency towards publication bias that did not reach significance (P = 0.05275). Outcome measures for other cardiovascular diseases were inconsistent. CONCLUSIONS Certain TCM compounds appear to have significant anti-hypertensive effects, and although some are associated in some studies with improved outcomes in coronary heart disease, heart failure and type 2 diabetes mellitus, the data are inconsistent and will require large-scale randomized-controlled trials to allow full evaluation of any potential therapeutic benefit in these areas.
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Affiliation(s)
- Kerry Layne
- Department of Clinical Pharmacology, Cardiovascular Division, King's College London, London, UK
| | - Albert Ferro
- Department of Clinical Pharmacology, Cardiovascular Division, King's College London, London, UK
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Abstract
INTRODUCTION Stroke is a major cause of death and disability, and imposes a huge burden and significant workload for patients, their families and society. As a special form of physical activity, Tai Chi is may be useful for stroke rehabilitation. The objective of this review is to systematically evaluate the efficacy and safety of Tai Chi for rehabilitation in stroke patients. METHODS AND ANALYSIS We will conduct a systematic search of the following electronic databases from their inception to 31 October 2015: MEDLINE, EMBASE, the Cochrane Library, the Chinese BioMedical Literature Database (CBM), the Chinese National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP), Wanfang and the Chinese Dissertation Database. All relevant randomised controlled trials (RCTs) in English and Chinese will be included. The main outcomes will be changes in the neurological function of patients and in independence in activities of daily living. Adverse events, adherence, costs and the cost effectiveness of Tai Chi will also be assessed. Two independent reviewers will select studies, extract data and assess quality. Review Manager 5.3 will be used for assessment of risk of bias, data synthesis and subgroup analysis. ETHICS AND DISSEMINATION This systematic review does not require formal ethical approval because all data will be analysed anonymously. Results will provide a general overview and evidence concerning the efficacy and safety of Tai Chi for stroke rehabilitation. Findings will be disseminated through peer-reviewed publications. TRIAL REGISTRATION NUMBER CRD42015026999.
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Affiliation(s)
- Yong Zhang
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
- National Institute of Complementary Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
- Department of International Communications, Beijing University of Chinese Medicine, Beijing, China
| | - Shanshan Wang
- National Institute of Complementary Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Department of International Communications, Beijing University of Chinese Medicine, Beijing, China
| | - Pei Chen
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoshu Zhu
- National Institute of Complementary Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Zongheng Li
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
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Zhang Y, Liu H, Fu C, Ning Y, Zhang J, Zhou L, Li Z, Bai P. The biomechanical effect of acupuncture for poststroke cavovarus foot: study protocol for a randomized controlled pilot trial. Trials 2016; 17:146. [PMID: 26987963 PMCID: PMC4797349 DOI: 10.1186/s13063-016-1264-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 02/26/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Poststroke cavovarus foot greatly affects patients' activities of daily life and raises the risks of falls and consequent fractures. Acupuncture appears to be safe and effective in promoting motor functions and enhancing the activities of daily life among patients with poststroke cavovarus foot. The current study aims to study the biomechanical effect of acupuncture for poststroke cavovarus foot with objective outcome measurements. METHODS/DESIGN This is an assessor and analyst-blinded, randomized, controlled pilot study. A total of 60 eligible patients with poststroke cavovarus foot will be allocated by a 1:1 ratio into an acupuncture treatment group and a control group. Patients in the control group will receive conventional rehabilitation therapies, whereas a combination of acupuncture and conventional rehabilitation therapies will be applied in the acupuncture group. The primary outcome measures are three objective biomechanical parameters from the RSSCAN gait system: varus angle, dynamic plantar pressure distribution, and static plantar contact area. Scores of the Berg Balance Scale, the Fugl-Meyer Assessment, and the Stroke-Specific Quality of Life Scale, as well as other biomechanical parameters such as the step length and width, step time phase, and weight shifting phase will be selected as secondary outcome measurements. All assessments will be conducted at baseline, 4 weeks after the treatment course, and after a follow-up period of 3 months. DISCUSSION Results of the current study will provide detailed interpretations of the biomechanical effect of acupuncture for stroke rehabilitation and foundations for future larger clinical studies. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR-IPC-15006889 (8 August 2015).
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Affiliation(s)
- Yong Zhang
- Department of Rehabilitation, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700, China
| | - Hongwei Liu
- Department of Neurology, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700, China
| | - Caihong Fu
- Department of Neurology, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700, China
| | - Yanzhe Ning
- Department of Neurology, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700, China
| | - Jiajia Zhang
- Department of Acupuncture, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700, China
| | - Li Zhou
- Department of Rehabilitation, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700, China
| | - Zongheng Li
- Department of Rehabilitation, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700, China
| | - Peng Bai
- Department of Acupuncture, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700, China.
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Liu AJ, Li JH, Li HQ, Fu DL, Lu L, Bian ZX, Zheng GQ. Electroacupuncture for Acute Ischemic Stroke: A Meta-Analysis of Randomized Controlled Trials. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2016; 43:1541-66. [PMID: 26621442 DOI: 10.1142/s0192415x15500883] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Electroacupuncture (EA) is an extension technique of acupuncture based on traditional acupuncture combined with modern electrotherapy. Here, we conducted a systematic review specifically to assess the effectiveness and safety of EA for acute ischemic stroke. Eight databases were searched for randomized-controlled clinical trials (RCTs) of EA for acute ischemic stroke published from inception to June 2013. Ultimately, 67 studies claimed to be RCTs. Eighteen studies with 1411 individuals were selected for the analyses, which got [Formula: see text] “yes” in the domains of Cochrane risk of bias tool. The meta-analysis showed a significant effect of EA for improving Barthel Index ([Formula: see text]), Fugl–Meyer Assessment ([Formula: see text]), National Institutes of Health Stroke Scale ([Formula: see text]) and Revised Scandinavian Stroke Scale ([Formula: see text]) compared with western conventional treatments (WCTs). In an analysis of the total clinical efficacy rate, there was a significant difference between EA and WCTs ([Formula: see text]). Adverse effects were monitored in 6 studies, and were well tolerated in all stroke patients. According to the GRADE approach, the quality of evidence was mostly high or moderate. In conclusion, this systematic review revealed the evidence in support of the use of EA for acute ischemic stroke, although further larger sample-size and rigorously designed RCTs are required.
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Affiliation(s)
- Ai-Ju Liu
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Ji-Huang Li
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Hui-Qin Li
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Deng-Lei Fu
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
| | - Lin Lu
- School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Zhao-Xiang Bian
- School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Guo-Qing Zheng
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
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Chuang SF, Shih CC, Yeh CC, Lane HL, Tsai CC, Chen TL, Lin JG, Chen T, Liao CC. Decreased risk of acute myocardial infarction in stroke patients receiving acupuncture treatment: a nationwide matched retrospective cohort study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:318. [PMID: 26353964 PMCID: PMC4563856 DOI: 10.1186/s12906-015-0828-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 08/25/2015] [Indexed: 11/11/2022]
Abstract
Background Whether acupuncture protects stroke patients from acute myocardial infarction (AMI) has not been studied previously. The purpose of this study was to investigate the risk of AMI among stroke patients receiving acupuncture treatment. Methods Taiwan’s National Health Insurance Research Database was used to conduct a retrospective cohort study of 23475 stroke patients aged 40–79 years receiving acupuncture treatment and 46950 propensity score-matched stroke patients not receiving acupuncture treatment who served as controls from 2000 to 2004. Both stroke cohorts were followed until the end of 2009 and were adjusted for immortal time to measure the incidence and adjusted hazard ratios (HRs) with 95 % confidence intervals (CIs) for new-onset AMI in multivariate Cox proportional hazard models. Results Stroke patients who received acupuncture treatment (9.2 per 1000 person-years) exhibited a lower incidence of AMI compared with those who did not receive acupuncture treatment (10.8 per 1000 person-years), with an HR of 0.86 (95 % CI, 0.80–0.93) after adjusting for age, sex, low income, coexisting medical conditions and medications. The relationship between acupuncture treatment and AMI risk was investigated in female stroke patients (HR, 0.85; 95 % CI, 0.76–0.95), male stroke patients (HR, 0.87; 95 % CI, 0.80–0.95), patients from 50 to 59 years of age (HR, 0.75; 95 % CI, 0.63–0.90), patients from 60 to 69 years of age (HR, 0.85; 95 % CI, 0.75–0.95), patients suffering from ischemic stroke (HR, 0.87; 95 % CI, 0.79–0.95), and patients suffering from hemorrhagic stroke (HR, 0.62; 95 % CI, 0.44–0.88). Conclusions We raised the possibility that acupuncture may be effective in lowering the risk of AMI in stroke patients aged 50–69 in this study, which was limited by a lack of information regarding stroke severity and acupuncture points. Our results suggest that prospective randomized trials are needed to establish the efficacy of acupuncture in preventing AMI.
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Zhang Y, Ning Y, Liu H, Zhou L, Zou Y, Li Z. Current trends in tai chi for stroke rehabilitation. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2015. [DOI: 10.1016/j.jtcms.2014.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Zhang Y, Liu H, Zhou L, Chen K, Jin H, Zou Y, Li Z. Applying Tai Chi as a rehabilitation program for stroke patients in the recovery phase: study protocol for a randomized controlled trial. Trials 2014; 15:484. [PMID: 25496342 PMCID: PMC4295286 DOI: 10.1186/1745-6215-15-484] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 11/24/2014] [Indexed: 02/02/2023] Open
Abstract
Background As the second commonest cause of death and a major cause of disability worldwide, stroke has greatly influenced patients’ quality of life and created a huge public health burden. As a special form of physical activity that has been widely practiced in China, and even throughout the world, Tai Chi may be favorable for the rehabilitation of stroke patients. Several studies have been conducted to investigate the rehabilitative effects of Tai Chi for stroke patients, but none of them have been focused on the recovery phase (2 to 24 weeks) of stroke. Methods/design This study is an assessor-blinded randomized controlled trial. A total of 50 eligible participants will be randomly assigned to either a control group or a Tai Chi group. Patients in the control group will receive standard, conventional rehabilitation therapies, and a combination of Tai Chi and conventional rehabilitation programs will be applied in the Tai Chi group. The recovery of motor impairment, functional activity and balance abilities as measured with the Fugl-Meyer Assessment, Barthel Index and Berg Balance Scale will be assessed as primary outcome measures. The secondary outcome measures to be used are the scores on the Stroke-Specific Quality of Life Scale, the National Institutes of Health Stroke Scale and the objective parameters of the RSscan footscan gait system. All assessments will be conducted at baseline, 4 weeks after the rehabilitation course and at the end of 3-month follow-up. Discussion The results of this study will provide preliminary evidence regarding the efficacy and feasibility of Tai Chi as an additional rehabilitative program for stroke patients in the recovery phase. Trial registration Chinese Clinical Trial Register ID: ChiCTR-TRC-13003661 (7 October 2013) Electronic supplementary material The online version of this article (doi:10.1186/1745-6215-15-484) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | | | - Zongheng Li
- Department of Rehabilitation, Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine, No, 5, Haiyuncang, Dongcheng District, Beijing 100700, China.
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Appraisal of clinical practice guidelines for ischemic stroke management in Chinese medicine with appraisal of guidelines for research and evaluation instrument: A systematic review. Chin J Integr Med 2014; 21:707-15. [PMID: 24938446 DOI: 10.1007/s11655-014-1834-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To systematically review the clinical practice guidelines (CPGs) for ischemic stroke in Chinese medicine (CM) with the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. METHODS CM CPGs for ischemic stroke were searched in 5 online databases and hand-searches in CPGrelated handbooks published from January 1990 to December 2012. The CPGs were categorized into evidence based (EB) guideline, consensus based with no explicit consideration of evidence based (CB-EB) guideline and consensus based (CB) guideline according to the development method. Three reviewers independently appraised the CPGs based on AGREE II instrument, and compared the CPGs' recommendations on CM pattern classification and treatment. RESULTS Five CM CPGs for ischemic stroke were identified and included. Among them, one CPG was EB guideline, two were CB guidelines and two were CB-EB guidelines. The quality score of the EB guideline was higher than those of the CB-EB and CB guidelines. Five CM patterns in the CPGs were recommended in the EB CPG. The comprehensive protocol of integrative Chinese and Western medicine recommended in the EB CPG was mostly recommended for ischemic stroke in the CPGs. The recommendations varied based on the CM patterns. CONCLUSION The quality of EB CPG was higher than those of CB and CB-EB CPGs in CM for ischemic stroke and integrative approaches were included in CPGs as major interventions.
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Acupuncture modulates the functional connectivity of the default mode network in stroke patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:765413. [PMID: 24734113 PMCID: PMC3963376 DOI: 10.1155/2014/765413] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 01/23/2014] [Accepted: 01/27/2014] [Indexed: 01/18/2023]
Abstract
Abundant evidence from previous fMRI studies on acupuncture has revealed significant modulatory effects at widespread brain regions. However, few reports on the modulation to the default mode network (DMN) of stroke patients have been investigated in the field of acupuncture. To study the modulatory effects of acupuncture on the DMN of stroke patients, eight right hemispheric infarction and stable ischemic stroke patients and ten healthy subjects were recruited to undergo resting state fMRI scanning before and after acupuncture stimulation. Functional connectivity analysis was applied with the bilateral posterior cingulate cortices chosen as the seed regions. The main finding demonstrated that the interregional interactions between the ACC and PCC especially enhanced after acupuncture at GB34 in stroke patients, compared with healthy controls. The results indicated that the possible mechanisms of the modulatory effects of acupuncture on the DMN of stroke patients could be interpreted in terms of cognitive ability and motor function recovery.
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