Stroke Treatment by Chinese Medicine Acupuncture and Decoction
Abstract
Objective
This study was performed to investigate the effect of acupuncture combined with Buyang Huanwu decoction in patients with ischemic stroke.
Methods
In total, 115 patients with ischemic stroke were recruited and divided into 3 groups. The control group received normal treatment, the acupuncture group received additional acupuncture treatment, and the combined group received additional acupuncture combined with Buyang Huanwu decoction treatment. The National Institutes of Health Stroke Scale (NIHSS) and Chinese Stroke Scale (CSS) were used to evaluate the stroke condition, and the Barthel index (BI) was used to measure life quality. Blood lipids and recurrence were also analyzed.
Results
The CSS and NIHSS scores were significantly lower in the acupuncture group and combined group than in the control group; however, the BI score was significantly higher in the acupuncture group and combined group. Similarly, the levels of cholesterol, triglycerides, and low-density lipoprotein were all significantly increased, while the level of high-density lipoprotein showed no significant difference in all groups. The recurrence rate was significantly lower in the combined group than in the other two groups.
Introduction
Stroke is a substantial health threat and one of the leading causes of disability worldwide, representing a huge burden to the patient’s family and to society.1–4 The incidence of stroke in China is high (1.5–2.0 million new cases every year); it is the second most common cause of death in cities, the third most common cause of death in rural areas, and the leading cause of adult disability throughout the whole country.5,6 The treatment strategy for stroke mainly involves administration of antihypertensive drugs, hypoglycemic and antiplatelet aggregation drugs, and constraint-induced movement therapy.7,8However, the treatment efficacy requires improvement.
Acupuncture is an important part of traditional Chinese medicine and has attracted more attention in recent decades.9 The treatment efficacy of acupuncture has been proven for many diseases, including neck disorders,10 postoperative nausea and vomiting,11 and atrial fibrillation.12 Additionally, acupuncture can reportedly be used in the treatment of ischemic stroke and may enhance the clinical outcomes of patients with stroke.13 Buyang Huanwu decoction is a compound Chinese medicine containing raw Astragalus, angelica, longan meat, antler gum, Salvia miltiorrhiza, frankincense, myrrh, and dried pine.14Several studies have shown that Buyang Huanwu decoction can be used in the treatment of neuronal injury.15,16 Others have demonstrated that it is also effective in the treatment of ischemic stroke.17However, no study to date has focused on the efficacy of acupuncture combined with Buyang Huanwu decoction in the treatment of patients with ischemic stroke.
In the present prospective study, we investigated the treatment effect of acupuncture combined with Buyang Huanwu decoction in patients with ischemic stroke. Our goal was to provide more clinical evidence for the application of acupuncture and Buyang Huanwu decoction in the treatment of ischemic stroke.
Materials and methods
Patients
This prospective study included patients with ischemic stroke who presented to our hospital from April 2015 to December 2016. All patients were hospitalized within 72 h and were first diagnosed with ischemic stroke by imaging techniques such as magnetic resonance imaging or computed tomography. The following patients were excluded from the study: patients with a history of stroke; patients with severe infection; patients with other severe organ dysfunction such as severe liver, renal, or heart disease; patients with hemorrhagic cerebrovascular disease or epilepsy; and patients with severe cognitive dysfunction that prevented them from cooperating during the examination.
The patients were divided into three groups: the control group, acupuncture group, and combined group. All patients were treated by normal methods including antihypertensive drugs, hypoglycemic and antiplatelet aggregation drugs, and constraint-induced movement therapy according to the Chinese guideline for the prevention and treatment of cerebrovascular disease.18 Patients in the acupuncture group received acupuncture treatment as described elsewhere.19 Briefly, the main acupoints were Shuigou (DU 26), Baihui (DU20), and Fengfu (DU16), and the auxiliary acupoints were Neiguan (PC6), Shenmen (HT7), Jiquan (HT1), Chize (LU5), Weizhong (BL40), and Sanyinjiao (SP6). Patients with dysphagia were also treated at the acupoints Fengchi (GB20), Yifeng (SJ17), and Wangu (GB12); those with limb disorders were treated at Hegu (LI4), Houxi (SI3), Qiuxu (GB40), Yanglingquan (GB34), and Zulinqi (B41); and those with a language disadvantage were treated at Lianquan (RN23) and Yuye (HN12). The acupuncture treatment was conducted every day during the treatment period, and each session lasted for 30 minutes. Patients in the combined group were treated with Buyang Huanwu decoction every day during the treatment period. The composition of the decoction was raw Astragalus30 g, angelica 15 g, longan meat 15 g, antler gum 10 g, Salvia miltiorrhiza 10 g, frankincense 10 g, myrrh 10 g, and dried pine 5 g. All treatments continued for 4 weeks. Written informed consent was obtained from all patients for publication of their individual details and accompanying images in this manuscript. The consent form is held by the authors and is available for review by the Editor-in-Chief. The present study was approved by the First People’s Hospital of Xuzhou.
Data collection and follow-up
Demographic data such as age and sex and clinical information including complications and medication conditions were recorded. The National Institutes of Health Stroke Scale (NIHSS) score, Chinese Stroke Scale (CSS) score, and Barthel index (BI) score were measured within 24 h after admission as well as after treatment. The levels of cholesterol (CHO), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were also evaluated before and after treatment. All patients were followed up for recurrence by direct visits or phone calls, and the follow-up duration was 1 year.
Statistical analysis
Continuous data are expressed as mean ± standard deviation. The chi square test was used to compare count data and rates. Comparisons between two groups of continuous data were performed using Student’s t-test, and comparisons among three groups were conducted by one-way analysis of variance. A Kaplan–Meier curve was used analyze recurrence at 1 year. A P value of <0.05 was considered statistically significant. All calculations were performed using SPSS 22.0 (IBM Corp., Armonk, NY, USA).
Results
Basic clinical information for all patients
In total, 115 patients with ischemic stroke were included in the present study (control group, n = 38; acupuncture group, n = 39; and combined group, n = 38). The characteristics of all patients are listed in Table 1. The patients’ mean age was 61.6 ± 13.8 years, and the male:female ratio was 63:53. Complications; medication conditions; pretreatment CSS, BI, and NIHSS scores; and pretreatment levels of CHO, TG, HDL, and LDL were not significantly different among the three groups.