Comprehensive Rehabilitation Therapy of Traditional Chinese Medicine Combined with Modern Rehabilitation Training Improves the Spasticity and Motor Function of Hemiplegia after Stroke

Objective:To analyze the impact of comprehensive rehabilitation therapy of traditional Chinese medicine(TCM)(based on modern rehabilitation training)on the spasticity and motor function in stroke patients with hemiplegia.Methods:Seventy-nine stroke and hemiplegia patients admitted to the hospital from June 2021 to June 2023 were selected and randomly divided into a control group(39 cases)using modern rehabilitation training,and an observation group combined with comprehensive TCM rehabilitation therapy(40 cases),over 1 month.The clinical index data of the two groups were compared.Results:There were differences in the clinical index data between the two groups.The total effective rate after 2 treatment in the observation group(92.50%)was higher than that of the control group(74.36%)(χ^(2)=4.727,P<0.05).All central sensitization inventory(CSI)and stroke quality of life(PRO)scores in both groups were lower after treatment,with the observation group having lower scores as compared to the control group(P<0.05).The scores of FMA(upper limbs,lower limbs),Barthel index scores,and Functional Ambulation Categories(FAC)scores of both groups increased after treatment,with the observation group having higher scores as compared to the control group(P<0.05).Conclusion:Comprehensive TCM rehabilitation therapy had a significant therapeutic effect on patients with hemiplegia after stroke.It improved the patient’s spasticity,limb movement,and walking function.Their daily living abilities and quality of life were also enhanced.

Research Progress in the Treatment of Poststroke Depression with Traditional Chinese Medicine

In recent years,the incidence rate of stroke has increased year by year.Post stroke depres‐sion is one of its main complications,which seriously affects the recovery of physiological functions and quality of life of stroke patients.Traditional Chinese medicine has signifi‐cant therapeutic effects in treating this disease.This article provides a classification and review of traditional Chinese medicine treatment methods for post-stroke depression,and looks forward to the current problems.

Feasibility and simulation model of a pilot scale membrane bioreactor for wastewater treatment and reuse from Chinese traditional medicine

The lack and pollution of water resource make wastewater reuse necessary. The pilot scale long-term tests for submerged membrane bioreactor were conducted to treat the effluents of anaerobic or aerobic treatment process for the high-strength Chinese traditional medicine wastewater. This article was focused on the feasibility of the wastewater treatment and reuse at shorter hydraulic retention time （HRT） of 5.0, 3.2 and 2.13 h. MLSS growth, membrane flux, vacuum values and chemical cleaning periods were also investigated. The experimental results of treating two-phase anaerobic treatment effluent demonstrated that the CODfilt was less than 100 mg/L when the influent COD was between 500-10000 mg/L at HRT of 5.0 h, which could satisfy the normal discharged standard in China. The experimental results to treat cross flow aerobic reactor effluent demonstrated that the average value of CODfilt was 17.28 mg/L when the average value of influent COD was 192.84 mg/L at HRT of 2.13 h during 106 d, which could completely meet the normal standard for water reuse. The maximum MLSS and MLVSS reached 24000 and 14500 mg/L at HRT of 3.2 h respectively. Membrane flux had maximal resume degrees of 94.7% at vacuum value of 0.02 MPa after cleaning. Chemical cleaning periods of membrane module were 150 d. A simulation model of operational parameters was also established based on the theory of back propagation neural network and linear regression of traditional mathematical model. The simulation model showed that the optimum operational parameters were suggested as follows： HRT was 5.0 h, SRT was 100 d, the range of COD loading rate was between 10.664-20.451 kg/（m3.d）, the range of MLSS was between 7543-13694 mg/L.

Assessment and Explorations on the Mechanism of Neuroprotection of Patients in Ischemic Stroke by Traditional Chinese Medicine

ischemic stroke is a common clinical emergency, with thrombolysis and neuroprotection as its cardinal treatment, and nowadays the latter is more and more stressed by stroke researchers. On the basis of pathophysiology and ischemic cascade of ischemic stroke, we now try to analyze the conceivable mechanism of intervention by tradition Chinese medicine （TCM） and hopefully provide experience for experimental and clinical research in the future.

Methodological exploration on the construction of a traditional Chinese medicine nursing expert consensus based on evidence--taking stroke as an example

Objective: To explore the methodology of the evidence-based expert consensus formulation process of traditional Chinese medicine(TCM) nursing taking stroke as an example.Methods: First, preliminary and comprehensive presentation of all stroke-related symptoms and corresponding TCM nursing techniques involved were revealed through bibliometric analysis. Then, selection of stroke symptoms and TCM nursing techniques for inclusion in the consensus was performed using an expert consultation method. Next, we determined the search strategy for a precise evidence search;conducted an evaluation of evidence quality and the grade of the evidence;and completed evidence extraction, evidence analysis, and evidence synthesis based on the included symptoms and TCM nursing techniques. The Delphi method was then applied to determine the strength of each recommendation and the choice of nursing care points by referring to the Grading of Recommendations, Assessment, Development, and Evaluations grid. Finally, we conducted an external expert validation of the Delphi results to form an expert consensus guideline.Results: Through the bibliometric analysis, 22 stroke symptoms and 18 TCM nursing techniques were identified in the literature. Then, after expert consultation, 22 symptoms and 111 pairs of symptoms combined with TCM nursing techniques were selected for the evidence search. Evidence integration yielded 10 stroke symptoms corresponding to 29 bodies of evidence;these 10 symptoms were retained through the Delphi consultation, and recommendation strength results for 26 recommendations were obtained. A total of 9 symptoms were further retained for expert external validation to form 24 recommendations, with a recommendation process score range of 7.64-9.99 points and a more scientific and standardized recommendation-formation process.Conclusion: Owing to the current limited conditions of evidence-based resources for TCM nursing, the present consensus-building process represents only a preliminary exploration of an evidence-based expert consensus for TCM nursing to provide a reference for a more scientific and standardized methodology.

Effects of Progressive Muscle Relaxation Training Combined with Emotion Nursing of Traditional Chinese Medicine on Motor Function and Quality of Life in Patients with Cerebral Stroke Complicated with Hemiplegia

OBJECTIVE: To explore the effects of progressive muscle relaxation training combined with emotion nursing of traditional Chinese medicine(TCM) on the motor function and quality of life in patients with cerebral stroke complicated with hemiplegia. METHODS: A total of 100 cases of patients with cerebral stroke complicated with hemiplegia who were admitted to Rehabilitation Medicine Department of Suzhou Municipal Hospital from May 2016 to May 2017 were selected and randomly divided into study group(50 cases) and control group(50 cases), and they were nursed for 1 month. Control group was given routine nursing, and study group was given progressive muscle relaxation training combined with TCM emotion nursing on the basis of routine nursing. The scores of all items were obtained by nurses through questionnaires, and the motor function and quality of life were analyzed and compared between the 2 groups. RESULTS: After nursing, the scores of muscle strength, Barthel index(BI) and Fugl-Meyer motor function scales in study group were higher than those in control group(P < 0.05). The facing scores of coping style in study group were higher than those in control group, and the avoidance score and yielding score were lower than those in control group(P < 0.05). The scores of depression and anxiety in study group were lower than those in control group(P < 0.05). The scores of items in SF-36 life scale in study group were higher than those in control group(P < 0.05). CONCLUSION: Progressive muscle relaxation training combined with TCM emotion nursing is conducive to the recovery of motor function and improvement of quality of life in patients with cerebral stroke complicated with hemiplegia.

Clinical Efficacy and Therapeutic Mechanisms of Traditional Chinese Medicine for Neuroprotection and Neurogenesis in Stroke Treatment

Stroke is the leading cause of human disability with limited effective drugs availability. The disruption of multiple signaling pathways in stroke makes developing new drugs be difficult. Traditional Chinese medicine(TCM) has its unique advantage in targeting multiple signaling pathways with multiple components. Many TCM formulas have the potential for neuroprotection and neurogenesis, but well-designed clinical trials are insufficient and underlying mechanisms unclear. Herein, we introduce the commonly used TCM formulas for stroke treatment and selectively introduce two classic formulas, An Gong Niu Huang(AGNH) pill and Bu Yang Huan Wu Decoction(BYHWD) for neuroprotection and neurogenesis, respectively. Current scientific evidence and clinical trials indicate AGNH pill could be an effective neuroprotective formula as adjunct therapy with relative safety. On the other hand, as a representative TCM formula for post stroke disability, BYHWD could improve the neurological outcome with its neuroprotective and neurogenic effects. The underlying mechanisms could be attributed to the modulation of multiple molecular targets with its multiple components. In conclusion, TCM formulas could be potential adjunct therapies for stroke treatment. The clinical efficacies and molecular mechanisms of promoting neuroprotection and neurogenesis remain to be further studies.

Research Progress of Traditional Chinese Medicine in Treating Dysphagia After Stroke

Dysphagia is a common complication after stroke,which does not only affect the quality of life of patients,but also increase the risk of death.Traditional Chinese medicine(TCM)treatment has always played an important role in the clinical treatment of dysphagia after stroke,but its mechanism has not been fully elucidated.Literatures on the use of TCM for the disease in the recent 5 years have been reviewed,and the problems existing in the development and treatment of the disease are discussed in this article,in an attempt to provide new ideas for the treatment of the disease.This paper presents a summary of traditional Chinese medicine treatment for the disease in the past five years,including traditional Chinese medicine compound and acupuncture.

Analysis on the rules of prescriptions for ischemic stroke based on the traditional Chinese medicine inheritance auxiliary system

In China,traditional Chinese medicine is widely used in the treatment of ischemic stroke,but its prescription rules needs to be further studied.This paper uses the traditional Chinese medicine inheritance auxiliary system(a software)to analyze the composition rules of a large number of prescriptions for the treatment of ischemic stroke,and discusses the clinical rationality of the new prescriptions.We found that the prescriptions for the treatment of ischemic stroke are mainly composed by herbs for promoting blood circulation and removing blood stasis,dredging collaterals and tonifying deficiency,and some of the new prescriptions are also in line with this characteristic.This paper can provide reference for clinical prescription in the treatment of ischemic stroke and the development of related new drugs.

Pharmaceutical Rules of Traditional Chinese Medicine For Stroke Based on Dictionary of Prescriptions and Complex Network Analysis

Objective:Taking the Dictionary of Prescriptions as a clue,we collected effective prescriptions for treating Stroke,and systematically summarized the medication and compatibility rules of the core Chinese medicines for treating Stroke.Methods:A database of prescriptions for stroke based on complex relationship analysis system of traditional Chinese medicine was established.From the point of view of complex network,the hierarchy of drug compatibility rules of compound prescriptions(such as courtiers and envoys)was analyzed,the statistical characteristics of complex networks were analyzed,and an attempt was made to explain the characteristics of complex networks of drugs for stroke.Results:A total of 974 prescriptions were collected,including 1040 Chinese herbs.The core Chinese herbal medicines with nodal degree(>500)for Stroke were divaricate saposhnikovia root,liquorice root,Chinese angelica,tall gastrodia tuber,incised notopterygium rhizome and root.The compatibility relationship of the core Chinese medicines in the treatment of stroke is divaricate saposhnikovia root-liquorice root,ephedra-divaricate saposhnikovia root,divaricate saposhnikovia root-sichuan lovage rhizome,divaricate saposhnikovia root-Chinese angelica in order of frequency.Conclusion:Through the analysis of the common network structure of effective prescriptions for Stroke,the core prescription compatibility structure reflecting the prescription thinking and clinical characteristics was found.

Therapeutic potential of natural compounds from Chinese medicine in acute and subacute phases of ischemic stroke

Stroke is one of the leading causes of death and disability in adults worldwide,resulting in huge social and financial burdens.Extracts from herbs,especially those used in Chinese medicine,have emerged as new pharmaceuticals for stroke treatment.Here we review the evidence from preclinical studies investigating neuroprotective properties of Chinese medicinal compounds through their application in acute and subacute phases of ischemic stroke,and highlight potential mechanisms underlying their therapeutic effects.It is noteworthy that many herbal compounds have been shown to target multiple mechanisms and in combinations may exert synergistic effects on signaling pathways,thereby attenuating multiple aspects of ischemic pathology.We conclude the paper with a general discussion of the prospects for novel natural compound-based regimens against stroke.

Mechanisms and status of research on the protective effects of traditional Chinese medicine against ischemic brain injury

Ischemic brain injury occurs when the metabolic needs of brain tissue cannot be met due to insufficient blood supply to the brain.It is one of the main causes of death and adult disability worldwide.The recurrence rate of ischemic brain injury is high.It places a heavy economic burden on families and society,and seriously affects human health and quality of life.In traditional Chinese medicine,ischemic stroke belongs to the category of“stroke”.The use of traditional Chinese medicine to treat stroke has a long history.After years of experimental research,a large amount of theoretical knowledge and practical experience have been accumulated.Promoting blood circulation and removing blood stasis is the basis of traditional Chinese medicine theory on the treatment of ischemic stroke.Commonly used single Chinese medicines include Chuangxiong(Ligusticum chuanxiong hort),Danggui(Angelica sinensis),Danshen(Salvia miltiorrhiza Bunge),Honghua(Carthamus tinctorius L.),Mudanpi(Moutan Cortex),and Huangqi(Astragali Radix).Buyang Huanwu decoction,Xinglou Chengqi decoction,Taohong Siwu decoction,and other traditional Chinese medicine prescriptions are believed to have a protective effect against brain damage caused by ischemic stroke.With the development of modern medical technology,the mechanism of traditional Chinese medicine treatments for ischemic brain injury has gradually been explored.This article reviews the mechanisms of traditional Chinese medicine’s protection against ischemic brain injury and its current clinical application.

Machine learning models for stroke detection by observing the eye-movement features under five-color visual stimuli in traditional Chinese medicine

Objective:To develop a novel diagnostic modality to identify and diagnose stroke in daily life scenarios for improving the therapeutic effects and prognoses of patients.Methods:In this study,16 stroke patients and 24 age-matched healthy participants as controls were recruited for comparative analysis.Leveraging a portable eye-tracking device and integrating traditional Chinese medicine theory with modern color psychology principles,we recorded the eye movement signals and calculated eye movement features.Meanwhile,the stroke recognition models based on eye movement features were further trained by using random forest(RF),k-nearest neighbors(KNN),decision tree(DT),gradient boosting classifier(GBC),XGBoost,and CatBoost.Results:The stroke group and the healthy group showed significant differences in some eye movement features(P<.05).The models trained based on eye movement characteristics had good performances in recognizing stroke individuals,with accuracies ranging from 77.40%to 88.45%.Under the red stimulus,the eye movement model trained by RF became the best machine learning model with a recall of 84.65%,a precision of 86.48%,a F1 score of 85.47%.Among the six algorithms,RF and CatBoost performed better in classification.Conclusion:This study pioneers the application of traditional Chinese medicine's five-color stimuli to visual observation tasks.On the basis of the combined design,the eye-movement models can accurately identify stroke,and the developed high-performance models may be used in daily life scenarios.

Nursing perspective of expert consensus on the diagnosis and treatment of cerebral infarction with integrated traditional Chinese and Western medicine

Cerebral infarction(CI)is also known as ischemic stroke.It is one of the most common cerebrovascular diseases,with high mortality and disability rate,which has seriously threatened human health.To better apply the diagnosis and treatment plan of integrated traditional Chinese and Western medicine to the treatment of patients with CI,the Chinese Association of Integrative Medicine issued the Expert Consensus on the Diagnosis and Treatment of Cerebral Infarction with the Integrated Traditional Chinese and Western Medicine in 2021.It involves etiology and pathogenesis of CI,diagnosis and treatment standards of Traditional Chinese Medicine(TCM)and Western Medicine,syndrome elements of TCM,as well as rehabilitation nursing of CI with integrated traditional Chinese and Western medicine during acute period and recovery period.This study interprets the consensus from routine nursing,dietary nursing,emotional nursing,complication nursing,rehabilitation nursing,and continuous nursing,aiming to provide evidence-based support for clinical TCM nursing practice.

Quality Evaluation on Traditional Chinese Medicine Nursing Plan for Stroke in Acute and Recovery Phases

OBJECTIVE: To formulate the quality evaluation questionnaire of Traditional Chinese Medicine(TCM) nursing plan for stroke in acute and recovery phases, and to evaluate the quality of TCM nursing plan for stroke by clinical nurses. METHODS: The questionnaire was designed by referring to the Applicability Questionnaire of TCM Clinical Diagnosis and Treatment Guideline, and the expert consultation was used to assess the content validity. In addition, the results of the questionnaire were processed and analyzed with SPSS20.0 software. RESULTS: The content validity of the self-designed questionnaire was 0.94 for the S-CVI/Ave score. The results of the questionnaire demonstrated that the overall content of the plan was "better than the original routine nursing plan"(59.18%); the recognition degree of "common symptoms"(36.70%) and "syndrome classification"(36.70%) of the plan was the lowest. CONCLUSION: The plan is supposed to be further improved in the future in order to be coincident with clinical reality.

Traditional Chinese medicine for vascular protection in ischemic stroke

Although new drugs and intervention strategies have emerged from recent studies of neuroprotection, compared with haemodynamic and hemorheologic factors, knowledge of vascular factors of ischemic stroke is rather limited. In practical terms, any strategy shown to reduce the incidence of fatal and nonfatal vascular events can be termed ＂vascular protection＂, including anti-thrombotic and anti-hypertensive therapies, as well as agents that directly benefit vascular endothelium. Vascular events include myocardial infarction, stroke, and claudication. Factors involved in these events include statins, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers. In traditional Chinese medicine, the principles of ＂activating blood circulation to remove stasis＂, ＂tonifying the kidney and replenishing the essence＂, ＂dispelling pathogenic wind and removing obstruction from the meridians＂, and ＂warming Yang and promoting water metabolism＂ are possibly related to vascular protection. However, more evidence is needed to correlate these positive effects with vascular protection.

Effects of Chiropractic and Traditional Chinese Medicine in Treating Patients with Acute Postpartum Pubis Symphysis Pelvic Girdle Pain

[Objectives]To analyze and study the effects of chiropractic and traditional Chinese medicine on pain score and functional ambyiation category scale rating in patients with cervical spondylosis.[Methods]41 postpartum patients with acute pubic symphysis pelvic girdle pain were treated by Xiao Huoluodan Granules(orally taking one bag of Xiao Huoluodan Granules 20 g three times daily with 120-150 mL warm water after each meal),and combined with sacroiliac joint manipulation,muscle posture relaxation and muscle energy technique.[Results]After treatment,the pain score(VAS)was decreased and Holden walking function rating was improved(all P<0.001).[Conclusions]Chiropractic and traditional Chinese medicine therapy has a significant effect on the treatment of postpartum acute pubic symphysis pelvic girdle pain,and it can effectively relieve pain,improve postpartum quality of life and prevent postpartum complications.Due to its benefits,it is worthy of clinical promotion and application.

Unsatisfied methodological qualities assessment of systematic reviews/Meta-analyses on Chinese medicine for stroke and their risk factors

Background:Stroke is not only high in morbidity and mortality but also poses a great burden of disease and it is also the most reported disease in Chinese medicine systematic reviews.Therefore,the quality of such evidence couldn’t be ignored.This study aims to use a measurement tool to assess systematic reviews(AMSTAR)to assess the methodological qualities of SR/Meta-analyses of Chinese medicine on stroke.Methods:Systematic searching of seven electronic databases and PROSPERO registration platform was carried out.Two researchers separately selected studies,extracted bibliographical characteristics and scored every included study independently after training.Total score and the proportion of each item completion were explored in different subgroup comparisons.Spearman rank correlation and multivariable logistic regression were used to measure the association between bibliographical characteristics and total score or each item.Results:Total average score of AMSTAR 1.0 checklists of 234 systematic reviews/Meta-analyses was 4.47(95%CI 4.27–4.68)and the qualities were unsatisfied especially in terms of priori setting(2.14%),grey literature inclusion(5.13%),providing a list of excluded studies(2.14%)and conflict of interest(0.00%).No improvement was found in 3 years even after the publication of AMSTAR.Chinese or nonregistered systematic reviews/Meta-analyses showed even worse methodological qualities(P<0.01).Positive correlation was found between individual items and number of pages,number of authors,research questions,languages or Meta-analyse separately(P<0.05).Conclusion:The methodological qualities of systematic reviews/Meta-analyses of Chinese medicine on stroke are poor especially Chinese studies,non-registered studies,brief studies and studies without Meta-analyse or cooperation.There is no obvious improvement over these years even after the publication of AMSTAR tool,so it is urgent to promote the use of AMSTAR or develop other efficient methods to control the quantity and monitor the quality in future.

Inhibiting the formation of neutrophil extracellular trapping: a potential mechanism of Chinese medicine in the treatment of ischemic stroke

Ischemic stroke(IS)is the main killer that endangers the health and life of middle-aged and elderly people worldwide.Inflammatory response plays a key regulatory role in the pathogenesis of IS.After cerebral ischemia,leukocytes rapidly accumulate,penetrate blood vessels and infiltrate brain tissue,thereby activating pro-inflammatory factors in the infarct area to exacerbate nerve damage.Neutrophil extracellular traps(NETs)are fibrous mesh structures released by activated neutrophils outside the cell,which can clear pathogens and cell debris,induce inflammatory responses and exacerbate cerebral ischemia-reperfusion(CI/R)injury.Various traditional Chinese medicines and their main components can improve neurological function defects after IS,and inhibit the formation of NETs,which opens up a new direction for the study of traditional Chinese medicines in the prevention and treatment of IS.

Chinese herbal extract dl-3n-butylphthalide A commonly used drug for the treatment of ischemic stroke as a novel therapeutic approach to treat neurodegenerative diseases

DI-3n-butylphthalide is the active component isolated from the seeds of Apium graveolens Linn. A number of pharmacological and clinical studies have proven that dl-3n-butylphthalide is highly potent and multi-targeted with low toxicity and has a long time-window for the treatment of ischemic cerebrovascular disease. The mechanisms underlying dl-3n-butylphthalide include improving mitochondrial function and microcirculation, inhibiting apoptosis and reducing oxidative stress. Furthermore, dl-3n-butylphthalide may also be promising for the treatment of neurodegenerative diseases, such as Alzheimer＇s disease, vascular dementia and Parkinson＇s disease.