In Australia, stroke ranks among the top causes of death and permanent disability. About 87% of stroke cases in adults are ischemic strokes.The brain is exposed to decreased oxygen levels (hypoxia) and/or blood supply (ischemia) during the pathophysiologic processes of brain neural tissue death and vasogenic edema that occur in ischemic stroke. Following the apoptosis and inflammatory damage in the subacute phase, secondary excitotoxicity and oxidative stress occur in the acute phase and cause dyskinesia, aphasia, sensory disturbances, ataxia sequelae symptoms, or even death.
Current stroke treatments include antithrombotic, antiplatelet, and antihypertensive medication for ischemic brain damage caused by an embolism, as well as hypothermia, with the ultimate goal of neuroprotection and recanalizing obstructed cerebral blood vessels. While the reduction of metabolic demands, suppression of excitotoxicity, and inhibition of free radical activity may help these treatments partially prevent brain injury progression, their effectiveness is limited by the 6-hour rescue window, and none of them can encourage neuro-regeneration—the process of replacing damaged neurons with new ones and reestablishing a functional neural network to help improve behavior.
For thousands of years, patients undergoing stroke treatment and post-stroke recuperation have benefited from acupuncture, a type of classical traditional Chinese medicine (TCM). A recent review discovered that in experimental ischemia, acupuncture improved neurological deficits and decreased brain edema. It also found that the mechanisms primarily responsible for promoting endogenous neurogenesis, such as the proliferation, migration, and differentiation of neural stem and progenitor cells. Acupuncture improves shoulder pain, ataxia, dysphagia, aphasia, and post-stroke paralysis, promoting recovery and lowering death rates, according to random controlled clinical trials.
Acupuncture clinical trials have been registered and conducted globally in recent years. These trials have evaluated various aspects of ischemic stroke patients' lives, including their quality of life, cognitive function, limb motor function, limb spasm and pain, swallowing function, activities of daily living, depression, anxiety state, and so forth, during both the acute and recovery phases. Acupuncture was found to be safe for both the acute and subacute phases of ischemic stroke in two multicenter clinical trials. It also improved the neurologic impairments of patients and decreased the chances of long-term death or disability. The research that is currently available indicates that the role of acupuncture in treating strokes varies based on the severity of cerebral ischemia. The choice of acupoints and formula, the operator's manipulation technique, the time of involvement, and the frequency of acupuncture sessions all affect how effective the treatment is. According to a multicenter prospective cohort study, patients with cerebral infarction and limb dysfunction fared better after receiving early intervention in terms of disability and motor dysfunction.
Reference:
Jia, H, J He, L Zhao, CC Hsu, X Zhao, Y Du, L Han, et al. "Combination of Stem Cell Therapy and Acupuncture to Treat Ischemic Stroke: A Prospective Review." Stem cell research & therapy 13, no. 1 (2022): 87.
Lu, L, XG Zhang, LL Zhong, ZX Chen, Y Li, GQ Zheng, and ZX Bian. "Acupuncture for Neurogenesis in Experimental Ischemic Stroke: A Systematic Review and Meta-Analysis." Scientific reports 6 (2016): 19521.
Yu, Y, G Zhang, J Liu, T Han, and H Huang. "Network Meta-Analysis of Chinese Patent Medicine Adjuvant Treatment of Poststroke Depression." Medicine 99, no. 31 (2020): e21375.
