Reactive astrocytes promote axonal remodeling and neurological recovery after stroke

Stroke is a leading cause of death and disability in adults worldwide. For decades, the primary approach and goal of therapy for stroke has focused on neuroprotection, namely treating the injured tissue, with interventions designed to reduce the volume of cerebral infarction. Enormous effort in the laboratory has been devoted to the development of neuroprotective agents in an attempt to salvage ischemic neurons in the brain from irreversible injury; however, all these efforts have failed to demonstrate efficacy in clinical trials of stroke. In order to treat stroke, we have to re-con- ceptualize and redefine our therapeutic targets. Acute neu- roprotective treatments for stroke fight a temporal battle of salvaging cerebral tissue before the onset of death, as well as a physiological impediment of delivery of therapy to tissue which has inadequate blood flow.

Role and limitations of rehabilitation-induced neural network remodeling after stroke

There is plenty of evidence that proves the beneficial and reliable effects of rehabilitation therapy,making it the most common treatment for patients with chronic stroke.It is believed that rehabilitation improves functional recovery through neural network remodeling,which is observed as a motor map reorganization or functional connectivity change assessed by intracortical microstimulation or functional magnetic resonance imaging（MRI）.

Efficacy of enhanced extracorporeal counterpulsation combined with atorvastatin in the treatment of cognitive impairment after stroke

BACKGROUND Cerebral apoplexy patients are prone to cognitive impairment,and it is very important to choose appropriate treatment methods to improve their cognitive impairment after stroke.AIM To evaluate the effects of enhanced external counterpulsation(EECP)in con-junction with atorvastatin on cognitive function,neurotransmitter levels,and the repair of brain tissue damage in patients with cognitive impairment due to stroke.METHODS In this retrospective study,data from 60 patients with poststroke cognitive impairment due to stroke who were treated in our hospital from February 2021 to July 2022 were analyzed and divided into a treatment group(n=30)and a control group(n=30)according to the different nursing methods applied.Patients in the treatment group received EECP in addition to atorvastatin,while those in the control group received atorvastatin alone.Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA)and activities of daily living(ADL)scale scores were compared between the two groups.Additionally,the two groups were compared in terms of serum acetylcholine(ACh),acetylcholin-esterase(AChE),nitric oxide(NO),endothelin-1(ET-1),β2-microglobulin(β2-MG),glial fibrillary acidic protein(GFAP),and visinin-like protein 1(VILIP-1)in the serum.Blood flow measurements from the anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA)were compared between the two groups before and after treatment,and the pulsatility index(PI)and resistance index(RI)of each artery were determined.RESULTS MMSE,MoCA,and ADL scores all improved in both groups following treatment,with the study group showing more improvement than the control group(P<0.05).After treatment,there were statistically significant increases in both ACh and NO levels,whereas decreases occurred in AChE,ET-1,β2-MG,VILIP-1,and GFAP,levels and the PI and RI of the left-ACA,right-ACA,left-MCA,right-MCA,left-PCA,and right-PCA.The study group showed greater gains in all metrics than the control group(P<0.05).CONCLUSION EECP combined with atorvastatin is effective in the treatment of cognitive impairment after stroke and can effectively improve the cognitive function,neurotransmitter levels,and brain tissue damage status of patients.

Related factors of cognitive impairment after stroke

BACKGROUND: Cognitive impairment after stroke associates with various factors, such as age, educational years, etc. Besides concerning about the recovery of limb function after stroke, we should also focus on the rehabilitation of cognition. Moreover, we’d better pay attention to the control of all the risk factors of stroke, and improve the quality of life in stroke patients. OBJECTIVE: To analyze the factors that affect cognitive impairment after stroke. DESIGN: A related factors analysis. SETTINGS: Department of Neurology of Dalian Port Hospital and Dalian Second People’s Hospital. PARTICIPANTS: Totally 148 stroke inpatients were selected from Department of Neurology, Dalian Port Hospital and Dalian Second People’s Hospital from April 2004 to December 2005, including 100 males and 48 females, aging 45-75 years with an average age of (67±8) years; Their educational years ranged 2-10 years with an average of (6.1±3.7) years; The disease course ranged 15-30 days; All were right-handed. Inclusive criteria: All were accorded with the diagnostic standard set by the Fourth National Academic Meeting for Cerebrovascular Disease; Confirmed by CT or MRI; Informed consents were obtained from all the subjects. METHODS: After the disease conditions were stable, the patients were assessed with Wechsler memory scale (WMS) and Wisconsin card sorting test (WCST). WMS included forward and backward recitation of numbers and short-term memory (verbal memory, visual recognition). The number of times for correct and wrong classifications in WCST and the time to complete the trail making tests A and B were recorded. The focal volume, area and layer were recorded at 24 hours after admission. The general data of the patients were recorded, including name, sex, age, educational years, history of hypertension, history of diabetes mellitus. Electroencepalograph (EEG) was examined to record the wave shape, blood lipids were detected, and the cognition related indexes were analyzed with the Pearson correlation analysis. The correlation between cognitive indexes after stroke and the influencing factors were analyzed with multiple linear regression analysis. MAIN OUTCOME MEASURES: ① Correlation between cognitive indexes and imaging indexes; ② Influencing factors for cognitive indexes after stroke. RESULTS: All the 148 stroke patients were involved in the analysis of results. ① Correlation between cognitive indexes and CT indexes: There were obvious negative correlations between numerical symbol and focal layer (r =-0.234, P < 0.05), as well as between verbal memory and the focal area and volume (r =-0.363, -0.279, P < 0.05); Trail making test A had obvious positive correlation with focal area and volume (r =0.256, 0.256, P < 0.05). Results of multiple linear regression analysis: Correct classification was correlated with triglyceride (partial wave and θ wave (partial regression coefficient=0.231-0.908, P < 0.05); Verbal memory was correlated with EEG α wave, focal volume, sex, educational years and diabetes mellitus (partial regression coefficient=0.219-1.017, P < 0.05-0.01). Visual recognition had correlation with educational years and hypertension (partial regression coefficient=0.326, -1.163, P < 0.01). Trail making tests A and B were correlated with focal volume (partial regression coefficient=4.680, -18.561, P < 0.05). CONCLUSION: The factors that affect the cognitive function after stroke include sex, age, educational years, hypertension, diabetes mellitus, triglyceride, EEG wave shape, and the focal area, volume and layer.

Study on the medication rules of traditional Chinese medicine in the treatment of sleep disorder after stroke based on data mining

Objective:To explore the medication rule of Traditional Chinese Medicine(TCM)in the treatment of sleep disorder after stroke by using data mining technology.Methods:A computer search was used to search the electronic database of clinical literature on the treatment of sleep disorders after stroke by TCM from January 2000 to January 2021.Excel was used to establish the database,and the prescription information was described and analyzed statistically.Using IBM SPSS Modeler 18.0 software,Apriori algorithm was used for TCM association analysis,and IBM SPSS 22.0 software was used for systematic cluster analysis of high-frequency TCM.Results:A total of 67 literatures were included,covering 131 traditional Chinese medicines.The medecines with a higher frequency of sodium use include Ziziphi Spinosae Semen(Suanzaoren),Angelicae Sinensis Radix(Danggui),Ligusticum(Chuanxiong),liquorice(Gancao),Poria cocos(Fuling),and so on.From the effect point of view,deficiency-tonifying medicine,sedative medicine and blood-activating and stasis-removing medicine are commonly used.The medicinal properties are mainly cold,mild and warm.The main medicine flavor are sweet and bitter.The medicines mostly belong to the liver,heart and spleen Meridian.Thirty-three association rules were obtained for medicine pairs and medicine groups from the correlation analysis,and the core combinations were"Ziziphi Spinosae Semen(Suanzaoren)-Tuber fleeceflower stem(Yejiaoteng)","Ziziphi Spinosae Semen(Suanzaoren)-Polygala(Yuanzhi)","Ziziphi Spinosae Semen(Suanzaoren)-Cortex albiziae(Hehuanpi)"and"Angelicae Sinensis Radix(Danggui)-Radix bupleuri(Chaihu)-Radix Paeoniae Alba(Baishao)"and so on.Seven medicine aggregation groups were obtained by medicine cluster analysis.Conclusion:In the treatment of sleep disorder after stroke by TCM,the main method is to calm the heart and mind.Meanwhile,according to different syndrome types,the treatment methods of tonifying the heart and spleen,nourishing the liver and kidney,soothing the liver and softening the liver,clearing heat and resolving phlegm,nourishing the blood and promoting blood circulation are selected,which provide certain reference for clinical treatment.

Characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions

OBJECTIVE: To introduce the characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions. DATA SOURCES: Articles related to stroke, subcortical aphasia, basal ganglia aphasia and language rehabilitation published in Chinese from January 1988 to December 2005 were searched in Chinese journal full-text database (CJFD) using the Keywords of 'stroke, basal ganglia aphasia, language rehabilitation' in Chinese. Meanwhile, English articles about aphasia published from January 1982 to December 2005 were searched in and Pubmed database. Besides, several books associated with the contents were looked through manually. STUDY SELECTION: The data were checked primarily, the articles about the pathomechanism and neurolinguistic characteristics of basal ganglia aphasia, diagnostic methods of aphasia and language rehabilitation were selected, and those had no obvious relation with the above contents were excluded. Inclusive criteria: literatures explain the clinical characteristics of basal ganglia aphasia, neurolinguistic pathogenesis and methods of rehabilitation therapy in details. The repetitive studies were excluded. DATA EXTRACTION: Totally 95 literatures about basal ganglia aphasia were collected, including 31 about the clinical characteristics of basal ganglia aphasia, 45 about its neurolinguistic pathogenesis, 5 about the evaluation and classification of aphasia, and 14 about its rehabilitation therapy. Thirty accorded with the inclusive criteria were used for review, and the other 65 were excluded. DATA SYNTHESIS: Concisely introduced the definition, past investigation of basal ganglia aphasia after stroke, then dwelled on the multiplicity neurolinguistics characteristics. Aphasia evaluation was dependent upon clinical aphasic symptoms. The relationship between symptom and focus of infection was explored, and the mechanism of pathosis language behavior on basal ganglia aphasia patients was understood to provide consequence data that could authenticate the processing of language in brain. On the other hand, the method of rehabilitation on basal ganglia aphasia after stroke was explained. CONCLUSION: Basal ganglia aphasia is manifested as atypical aphasic symptom, the mechanism for the structure of basal ganglia in the speech formation should be further confirmed. It is effective to select pertinent language rehabilitation for basal ganglia aphasia after stroke.

Clinical observation of the effect of acupuncture on constipation after stroke

Objective： To observe the differences in therapeutic effects of acupuncture and lactulose oral solution on constipation after stroke. Method： Sixty patients with constipation after stroke were divided into an acupuncture group and a western medicine group by a random number method, with 30 cases in each group. Based on the the conventional treatment and rehabilitation for function recovery, the acupuncture group was treated at the selected the bilateral acupoints： Daheng （SP15）, Fujie （SP14）, Zhigou （TE6）, Zhaohai （KI6）, Yingxiang （LI20）, and Shaoshang （LU11） while the western medicine group was treated with 30 ml of lactulose oral solution. The clinical symptoms score and clinical efficacy of the treatment provided for constipation in both groups were recorded pre-treatment, at one week of treatment, after treatment for two weeks, and one month after discharge respectively. Results： The clinical symptom scores of constipation in the two groups after one week of treatment, two weeks of treatment, and one month of treatment were significantly lower than those before treatment （P 〈 0.001）. The treatment efficacy in the acupuncture group showed significant improvement when compared with the western medicine group, at one week, two weeks and one month （1.03 ± 1.19 vs 1.43 ± 1.19, P 〉 0.05 ; 0.73 ± 1.01 vs 1.33 ± 1.18, P 〈 0.05; 0.53 ± 0.82 vs 1.27 ± 1.14, P 〈 0.05, respectively）. The efficacy rate was statistically significant at two weeks after treatment and one month after follow-up （86.67% vs 70%,P 〈 0.05; 93.33% vs 73.33%, P 〈 0.05, respectively）. Conclusion： The short-term and long-term efficacy of acupuncture on constipation after stroke is better thanthat of treatment with lactulose oral solution. This method is safe, free of side effects, durable, has high feasibility, and is suitable for clinical application.

Research Progress of Acupuncture and Moxibustion in Treating Constipation After Stroke

Constipation is one of the common gastrointestinal complications of stroke,which not only affects the quality of life of patients,but also easily induces and aggravates the primary disease and delays the recovery of the disease.At present,most of the treatments for constipation after stroke are oral medicine and enema,but the curative effect is poor and unstable.Acupuncture has the advantages of simple operation,remarkable effect,high patient acceptance and a little toxic effect.It is one of the non-drug treatment ways to prevent and treat constipation after stroke,as well as widely used in the treatment of constipation after stroke.Therefore,the clinical research on acupuncture treatment of constipation after stroke in recent years is summarized to provide reference for the subsequent clinical treatment of constipation after stroke.

Bibliometric and visual analysis of limb spasm after stroke based on Citespace software

Background:To apply CiteSpace software to the hotspot,trend and cutting-edge dynamics of limb spasm after stroke in nearly 20 years.Methods:From 2000 to 2018,spasming literature in the Web of Science database were searched,and cooperative analysis of authors'national institutions was conducted by using CiteSpace software,keyword analysis and cluster analysis,citation analysis of authors'literature journals,and visual map.Results:2005 articles were retrieved,and the number of articles increased year by year,and the country with the most articles was the United States.Keyword analysis shows that mechanistic research and clinical treatment of spasticity are research hotspots in this field.The most posts are Northwestern Univ and Univ Verona.Conclusion:Through the CiteSpace software analysis of spasticity literature,it is found that the research focus is embodied in the nerve regeneration technology and the standardized clinical study of botulinum toxin type A application,which has certain reference significance for the future research direction of spasticity.

Warm needling on the four knee acupoints combined with Chinese herb in the treatment of knee pain after stroke

Objective To observe the clinical efficacy of warm needling on the four knee acupoints in the treatment of knee pain after stroke on the basis of Chinese herb. Methods Sixty patients with knee pain after stroke were divided into a group A and a group B by random allocation, with 30 patients in each group. Patients in the group B only received the treatment by Chinese herb, which called Dúhuó Jìshēng Tāng（独活寄生汤 Pubescent Angelica and Mistletoe Decoction, add or remove ingredients depending on conditions）; patients in the group A additionally received warm needling on the basis of Chinese herb. Four knee acupoints were selected as master acupoints and Hèd ng（鹤顶 EXLE 2）, Yánglíngquán（阳陵泉 GB 34） and Zúsānl（足三里 ST 36） as combining acupoints. Perpendicular insertion was conducted on Xuèh i（血海 SP 10） and Liángqiū（梁丘 ST 34） for approximately 1 cun, and oblique insertion on Nèixīy n（内膝眼 EX-LE 4） and Dúbí（犊鼻 ST 35） for approximately 1 cun at 45° in inner and upper direction to push needle tip into joint cavity. After deqi, moxibustion stick was cut to 1.5 cm long, ignited, and inserted into the needle handles in the four knee acupoints. 1–2 strips were applied. After the moxa cones were burned up, needles were retained for 10 min. 7 d was a course of treatment and observation lasted for consecutive four courses. Visual analogue scale（VAS） and Barthel Index（BI） were adopted as observational indices. Clinical efficacy was classified as clinical cured, markedly effective, effective and ineffective according to the standards described in Guidelines of Clinical Research on Chinese New Herbal Medicine. Results After treatment, total effective rate was 93.3% in the group A, including full recovery in 8 cases, markedly effective in 15 cases, effective in 5 cases, and ineffective in 2 cases; while the total effective rate was 73.3% in the group B. The difference between the two groups was statistically significant（P0.05）. In the group A, VAS scores were 6.53 ± 1.39 before treatment and 1.53 ± 0.80 after treatment and BI scores were 58.38±8.67 before treatment and 67.55 ± 12.99 after treatment; in the group B, VAS scores were 6.63 ± 1.81 before treatment and 3.33 ± 0.96 after treatment and BI scores were 57.89 ± 9.65 before treatment and 64.87 ± 12.18 after treatment. Both VAS and BI scores were improved significantly in the two groups after treatment and the improvements were statistically significant（all P0.05）. Furthermore, both VAS and BI scores of group A were superior to that of group B（P0.05）. Conclusion Additional treatment of warm needling on the four knee acupoints on the basis of Chinese herb can enhance the clinical efficacy in treatment of knee pain after stroke, contribute to the rapid recovery of knee function and improve the life quality of stroke patients.

Observation on the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke

Objective To evaluate the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke. Methods Sixty cases were randomly divided into an acupuncture rehabilitation group （33 cases） and a routine treatment group （27 cases）. Both two groups received rehabilitation exercise, acupuncture rehabilitation group was treated with scalp acupuncture and body acupuncture, and in body acupuncture, Pishu（脾俞 BL 20）, Weishu （胃俞 BE 21）, Zusanli （足三里 ST 36）, Fenglong （丰隆 ST 40）, Xuehai （血海 SP 10）, and accompanying points according to the symptoms were selected; in scalp acupuncture, Baihui （百会 GV 20）, Sishencong （四神聪EX-HN 1）, motor area, vascular dilation and constriction area were selected. Routine treatment group was treated with western drugs, including dehydration with mannitol to reduce intracranial pressure, control blood pressure, and brain cell protective agent was given, triamcinolone acetate solution for shoulder pain or cortisone acetate solution for blocking treatment. The treatment was given once a day, four weeks were one course, and four courses were given in all. The hemorheological indices and the clinical effect of two groups were compared. Results The effective rate of acupuncture rehabilitation group was 90.9% （30/33）, better than that of 70.4% （19/27） in routine treatment group （P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment became lowered than those before the treatment in acupuncture rehabilitation group （all P〈0.05）; whole blood viscosity and plasma viscosity after the treatment was also lowered than those before the treatment in routine treatment group （both P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment in acupuncture rehabilitation group were obviously lowered than those of routine treatment group （all P〈0.05）. Conclusion With good therapeutic effect and better efficacy than routine medical treatment, scalp acupuncture and body acupuncture in combination with rehabilitation exercise can improve the movement, sensation and hemorheology of extremities of patients with hemiplegia and shoulder pain after stroke.

Acupuncture of lifting and pressing manipulation for upper limb paralysis after stroke

Objective To compare the difference of clinical efficacy between acupuncture of lifting and pressing manipulation and conventional acupuncture in motor function recovery of hemiplegic upper limb after stroke, so as to provide referential support for clinical application. Method Fifty-nine patients with upper limb hemiplegia after stroke were selected and divided into group A （conventional acupuncture ± lifting and pressing manipulation, 30 cases} and group B （conventional acupuncture, 29 cases} according to random number table method. Upper limb motor function and activity of daily living of patients in the two groups were scored before and after treatment, and the results were analyzed and compared. Results The score of upper limb FugI-Meyer motor function of patients was 22.4 ± 2.83 and 32.97 ± 2.92 before and after treatment in group A, and was 19.89 ± 3.13 and 26.62 ± 3.31 before and after treatment in group B, and the difference between the two groups before and after treatment was significant （P〈0.01}. The score of Barthel index of patients was 60.67 ± 4.65 and 73.00 ± 3.82 before and after treatment in group A, and was 50.52 ± 5.15 and 60.17 ± 4.89 before and after treatment in group B, and the difference between the two groups before and after treatment was not statistcally significant {P〉0.05）. Conclusion Lifting and pressing manipulation combined with conventional acupuncture can better improve upper limb motor function of upper limb paralysis of patients after stroke.

Gabapentinoids for the treatment of stroke

Gabapentinoid drugs(pregabalin and gabapentin) have been successfully used in the treatment of neuro pathic pain and in focal seizure prevention.Recent research has demonstrated their potent activities in modulating neurotransmitter release in neuronal tissue,oxidative stress,and inflammation,which matches the mechanism of action via voltage-gated calcium channels.In this review,we briefly elaborate on the medicinal history and ligand-binding sites of gabapentinoids.We systematically summarize the preclinical and clinical research on gabapentinoids in stroke,including ischemic stro ke,intracerebral hemorrhage,subarachnoid hemorrhage,seizures after stro ke,cortical spreading depolarization after stroke,pain after stroke,and nerve regeneration after stro ke.This review also discusses the potential to rgets of gabapentinoids in stroke;however,the existing results are still unce rtain regarding the effect of gabapentinoids on stroke and related diseases.Further preclinical and clinical trials are needed to test the therapeutic potential of gabapentinoids in stroke.Therefore,gabapentinoids have both opportunities and challenges in the treatment of stroke.

Clinical study on tri-tongue acupuncture combined with lowfrequency electrical stimulation for treating post-stroke dysarthria

BACKGROUND Few studies have investigated low-frequency electrical stimulation combined with tri-tongue acupuncture for the treatment of post-stroke dysarthria.This randomized clinical study assessed the correlation between the clinical efficacy of low-frequency electrical stimulation combined with tri-tongue acupuncture in patients with post-stroke dysarthria.AIM To investigate the clinical effects of tri-tongue acupuncture combined with lowfrequency electrical stimulation for treating post-stroke dysarthria.METHODS Ninety patients with post-stroke dysarthria,who were admitted to our hospital from December 2019 to June 2021,were selected and equally divided into two groups(n=45/group)according to the random number table method.Tri-tongue acupuncture was administered in the control group.The treatment group received both tri-tongue acupuncture and low-frequency electrical stimulation.The clinical efficacy,Western Aphasia Battery(WAB)score,general quality of life inventory(GQOLI-74)score,Frenchay Dysarthria Assessment score,and speech function grades were compared and analyzed between both groups.RESULTS The overall efficacy in the treatment group was better than that in the control group(P<0.05).Before treatment,the WAB,Frenchay Dysarthria Assessment,or GQOLI-74 scores(P>0.05)did not differ between the groups.After therapy,the WAB,Frenchay Dysarthria Assessment,and GQOLI-74 scores in both groups increased significantly(P<0.05),and the treatment group exhibited a significantly greater increase than that of the controls(P<0.05).Moreover,the classification of speech function did not differ between the two groups before treatment(P>0.05),whereas significant improvements were observed in both groups after treatment(P<0.05).The degree of improvement in the treatment group was greater than that in the control group(P<0.05).CONCLUSION Low-frequency electrical stimulation,in conjunction with tri-tongue acupuncture,exhibits a good clinical effect on post-stroke dysarthria.

基于Cite Space中医药领域治疗卒中后睡眠障碍的可视化分析

目的中医药治疗卒中后睡眠障碍领域的研究热点前沿及发展趋势分析。方法通过检索中国知网、万方、维普三大中文数据库,以建库至2024年07月收录的中医药治疗卒中后睡眠障碍相关文献为研究基础,应用Cite Space6.3.R1软件对发文量、作者、研究机构、关键词进行分析,绘制可视化知识图谱。结果总纳入853篇文献,在该领域年度发文量总体呈逐渐上升态势;其中核心作者15名;研究机构226家,以黑龙江中医药大学发文量最多;研究热点主要包括临床疗效及作用机制、中医内外治法、病因病机探究、疾病心理因素方面的研究。结论近几年来中医药治疗卒中相关睡眠障碍的研究处于蓬勃发展态势,运用高质量循证方法为临床提供更为规范的科学依据,提高患者康复质量及生活水平是今后该领域研究趋势。

自拟温经通络汤联合针刺对脑卒中后眩晕患者脑灌注状态及血清MFG-E8水平的影响

目的 分析自拟温经通络汤联合针刺对脑卒中后眩晕患者脑灌注状态及血清乳脂肪球表皮生长因子-8(MFG-E8)水平的影响。方法 选取2018年8月至2020年8月该院收治的80例脑卒中后眩晕患者为研究对象,按照随机数字表法将其分为对照组和治疗组,各40例。对照组采用常规西药治疗,治疗组在对照组的基础上采用自拟温经通络汤联合针刺治疗。比较两组疗效及治疗前后中医证候积分、各脑动脉平均血流速度、血清学指标,并统计治疗期间两组不良反应发生情况。结果 治疗组总有效率高于对照组(P<0.05)。治疗2周后,两组血清可溶性CD40配体(sCD40L)、MFG-E8、脂蛋白相关磷脂酶A2(Lp-PLA2)水平及中医证候积分低于治疗前,且治疗组低于对照组,差异均有统计学意义(P<0.05);治疗两周后,两组基底动脉及左、右椎动脉平均血流速度均高于治疗前,且治疗组高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗期间均未出现严重不良反应。结论 在基于针刺治疗脑卒中后眩晕患者的基础上,给予自拟温经通络汤进行联合治疗的效果显著,能够明显改善患者临床症状及脑灌注状态,调节血清MFG-E8水平。

活血通络汤联合利脑通络针刺法治疗气虚血瘀型卒中后肩手综合征对运动功能和血流动力学的影响

目的探讨活血通络汤联合利脑通络针刺法治疗气虚血瘀型卒中后肩手综合征对运动功能和血流动力学的影响。方法选取2021年1月至2022年12月南阳市第二人民医院收治的90例气虚血瘀型卒中后肩手综合征病人,利用随机数字表法分为联合组、中药组、针刺组,每组各30例,中药组予活血通络汤治疗,针刺组予利脑通络针刺法治疗,联合组予活血通络汤联合利脑通络针刺法治疗,比较三组治疗前后疼痛程度[视觉模拟评分法(VAS)]、肩手综合征量表(SHSS)、运动功能[上肢Fugl-Meyer评定(FMA)]、日常生活能力[Barthel指数(BI)]、炎症因子[降钙素基因相关肽(CGRP)、缓激肽(BK)]及血流动力学[峰值血流速度(PBFV)、循环系统外周阻力(PR)]。观察三组临床疗效。结果联合组总有效率(93.33%)较中药组(63.33%)、针刺组(67.67%)高(P=0.017);三组治疗后VAS评分、SHSS评分均较治疗前降低,且联合组较中药组、针刺组低(P<0.05);三组治疗后FMA评分、BI评分均较治疗前升高,且联合组较中药组、针刺组高(P<0.05);三组治疗后CGRP、PBFV均较治疗前升高,且联合组较中药组、针刺组高(P<0.05);三组治疗后BK、PR较治疗前降低,且联合组较中药组、针刺组低(P<0.05)。结论活血通络汤联合利脑通络针刺法治疗气虚血瘀型卒中后肩手综合征疗效确切,可缓解临床症状及疼痛程度,提高运动功能和日常生活能力,改善血流动力学,减轻炎症反应。

细银质针治疗脑卒中后复杂性区域性疼痛综合征Ⅰ型患者的临床研究

目的:探讨细银质针治疗脑卒中后复杂性区域性疼痛综合征Ⅰ型(complex regional pain syndrome type Ⅰ,CRPS-Ⅰ)患者的效果,通过检测血浆中降钙素基因相关肽(calcitonin gene-related peptide,CGRP)、P物质(substance P,SP)含量,探讨其可能的作用机制。方法:选择2022年1—12月在珠海市斗门区侨立中医院针灸康复门诊及住院,且被确诊为脑卒中后CRPS-Ⅰ的110例患者作为研究对象,将患者按就诊顺序随机分为细银质针组(治疗组)和普通针刺组(对照组),各55例。对照组采用传统针刺治疗,治疗组采用细银质针导热疗法治疗。比较两组临床疗效、血浆中CGRP、SP及视觉模拟评分法(visual analogue scale,VAS)评分。结果:治疗组总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组CGRP水平高于治疗前,治疗组高于对照组,两组SP水平、VAS评分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。结论:细银质针治疗脑卒中后CRPS-Ⅰ型患者效果显著,缓解疼痛及相关炎症反应。

以患者需求为导向的临床护理路径在卒中后偏瘫患者中的应用效果

目的:观察以患者需求为导向的临床护理路径在卒中后偏瘫患者中的应用效果。方法:选取2020年1月至2022年3月该院收治的75例卒中后偏瘫患者进行前瞻性研究,按随机数字表法将其分为对照组37例与观察组38例。对照组采用常规护理,观察组采用以患者需求为导向的临床护理路径。比较两组护理前后肢体运动能力[Fugl-Meyer运动功能评估量表(FMA)]评分、日常生活能力[Barthel指数(BI)]评分、焦虑情绪[焦虑自评量表(SAS)]评分、神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]评分,以及护理满意度[纽卡斯尔护理服务满意度量表(NSNS)]评分。结果:护理后,两组FMA、BI评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);两组SAS评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);两组NHISS评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组NSNS评分高于对照组,差异有统计学意义(P<0.05)。结论:以患者需求为导向的临床护理路径可提高卒中后偏瘫患者肢体运动功能、日常生活能力和护理满意度评分,以及降低焦虑情绪和神经缺损程度评分的效果优于常规护理。