Stroke and Acupuncture
The development of Western medicine has significantly improved the diagnosis and rescue level of stroke disease and reduced the mortality rate, but the disability rate is still high, and the different degrees of motor, sensory, speech and cognitive dysfunction seriously affect the survival ability of patients, which has become an important problem to be solved in the rehabilitation of stroke disease. The principle of acupuncture treatment for stroke disease is to treat the disease with a holistic concept, and it is proved that the combination of Chinese and Western medicine and acupuncture and physical therapy methods for stroke disease is a more effective treatment method.
1, the time of acupuncture intervention in stroke disease.
The timing of acupuncture treatment after stroke is controversial, many hospitals still take the early onset of drug treatment, to the so-called “recovery period”, “stable period”, “recovery period “This treatment model I think is not scientific, acupuncture early intervention can reduce the “half dark belt The early intervention of acupuncture can reduce the pathological damage of brain nerve cells in the “semi-dark zone”, which can reduce the degree of disability.
As a suitable peripheral stimulation, acupuncture therapy adjusts the excitability of individual neurons in the neuroreflex circuit through the special peripheral sensory afferent mode of acupuncture, realizes the functional reorganization and functional compensation of the cerebral cortex, thus restoring the normal motor pattern and regulating the body functions as a whole. In other words, only when acupuncture is used at the best time will the best results be obtained, without delaying the disease and minimizing the sequelae of the patient.
For early ischemic stroke, acupuncture intervention can promote blood flow as soon as possible, restore blood supply, and reduce paralysis and necrosis of brain nerve tissue caused by ischemia. Most physicians are cautious about the timing of acupuncture interventions for hemorrhagic stroke. It is generally believed that acupuncture should not intervene immediately during the acute phase of the attack, and acupuncture should only intervene 3 to 5 days after the stabilization of vital signs. However, as the ancients said, “If it is urgent, use acupuncture; if it is slow, use medicine.” The “Acupuncture and Moxibustion Dacheng” also says: “Whenever a stroke falls to a faint and violent stroke, acupuncture is urgently used to pierce the twelve well points with a trigeminal needle.”
It is evident that the ancients advocated early treatment of stroke with acupuncture, as traditional Chinese medicine does not distinguish between hemorrhagic and ischemic strokes, so acupuncture for stroke is not opportune. The vast majority of deaths caused by cerebral hemorrhage itself are in the early stage of onset, and the key to the treatment of such patients is to reduce the death rate and increase the cure rate in the acute stage, and there is no excuse for appropriate acupuncture treatment to be taken in the acute stage. The acupuncture points all have good two-way regulation, and reasonable treatment will not trigger further aggravation of bleeding or re-bleeding.
The earlier the acupuncture, the better the prognosis, the better the recovery of autonomic consciousness, the lighter and less the sequelae, and the shorter the course of treatment. Early acupuncture treatment can effectively stop the development of the disease, improve the self-repairing and compensating ability of the nervous system, significantly improve the motor and cognitive functions, accelerate the natural recovery process, shorten the course of the disease, lay a good foundation for future functional recovery, and thus improve the quality of life of patients.
Patients with stroke disease should not neglect acupuncture as an important tool, no matter in the acute, recovery and post-stroke periods.
2.Introduction of different acupuncture methods for the treatment of stroke disease.
(1) Traditional meridian identification acupuncture method, wide treatment area, flexible acupuncture points, can be easily combined with warm acupuncture moxibustion method and electroacupuncture therapy, the most widely used.
(2) Head acupuncture method, including Jin San acupuncture method and national standard head acupuncture method, can be used with electric acupuncture, and can be used with limb exercise and activities, treatment directly targeting the brain disease foci, the treatment of brain disease is widely used and convenient, in the recovery of stroke disease intelligence, emotional disorders, swallowing disorders, speech disorders, motor disorders treatment is commonly used.
(3) The acupuncture method of waking up the brain and opening up the body, with clear standards of acupuncture points and the amount of stimulation of acupuncture points, is the only treatment for stroke disease with quantitative standards that have been verified by a large amount of scientific research and clinical verification.
(4) Fire acupuncture, a strong method of circulation, has a strong warming effect on the meridians, and is effective in the recovery of limb function in stroke disease, and the complications of shoulder-hand syndrome and limb edema.
(5) Umbilical needle, eye needle, wrist and ankle needle and other micro-needle therapy can be carried out with needle activities, the comprehensive treatment effect is powerful. Small therapy with big effect.
3, acupuncture treatment of stroke disease mechanism of action introduced
Increased blood viscosity and slowed blood flow is the main cause of stroke disease, which leads to insufficient blood supply to the brain and even causes local tissue necrosis. There is experimental evidence that acupuncture treatment can improve many indicators of blood rheology, among which there is a very significant difference in the improvement of whole blood specific viscosity, red blood cell pressure volume, plasma viscosity, reducing viscosity, and red blood cell electrophoresis time, and with the improvement of blood rheology indicators, the paralyzed limbs gradually recover.
The observation of the changes of blood rheological indexes before and after acupuncture in the anterior and posterior oblique lines of the parietal temporal head, the first and second lines of the parietal parietal, and the anterior temporal line showed that scalp acupuncture had a significant improvement effect on ischemic stroke hemiparesis, but not on hemorrhagic stroke hemiparesis. This demonstrates that acupuncture has the effect of unblocking the meridians and regulating qi and blood, improving the pathological state of “internal stagnation of blood” and improving several indexes of blood rheology. Cerebral hemogram is a method that reflects the state of pulsating blood in the head, and it can objectively determine the elasticity, tension and peripheral resistance of blood vessels. In recent years, most studies have shown that acupuncture can increase the wave amplitude on the side of stroke patients and improve cerebral blood circulation.
This indicates that acupuncture can improve the elasticity of cerebral arteries, causing a decrease in their tension, vasodilation, and increased blood flow, which improves the blood supply to the brain and the ischemia and hypoxia of brain cells around the lesion, and promotes the recovery of stroke patients. The dynamic changes of EEG have a certain reference value for the prognosis judgment of patients with cerebrovascular disease. Acupuncture can make the EEG α wave amplitude increase, δc/s slowing wave improve, abnormal β, Q and δ waves decrease, modulation amplitude, modulation rate and symmetry improve, and the indexes gradually approach the normal level, especially for the patients with stroke combined with multiple cerebral infarction dementia after acupuncture, the brain wave level tends to increase faster, the wave amplitude tends to increase, the α wave index increases significantly, the β wave index tends to increase, and the Q wave index decreases slightly. This indicates that the excitability of the cerebral cortex is increased, which can effectively improve the patient’s intelligence and memory.
It was confirmed that acupuncture could regulate the inhibitory state of the cortex in stroke patients in order to increase its compensatory function, promote the ordering of the patients’ cerebral electrical activity, increase and improve the basic electrical activity of the cortical cells, and make the stroke patients’ clinical symptoms improve rapidly. Through the observation of patients with cerebral infarction, it was found that whole blood viscosity, cell electrophoresis, sedimentation, fibrinogen, FDP, β-lipoprotein and cholesterol were significantly higher than those in the healthy group, while serum HDL-C was significantly lower than that in the healthy group.
After acupuncture treatment, serum HDL-C increased significantly, β-lipoprotein and atherosclerotic index decreased significantly, and fibrinogen and whole blood viscosity and venous blood ammonia decreased compared with those before acupuncture. It indicates that acupuncture can significantly affect lipid metabolism and regulate its ratio, so that the fibrinolytic system tends to stabilize acupuncture has the effect of regulating serum lipid metabolism, in which T helper cells are significantly increased and T suppressor cells are relatively decreased, while the immune function of the body is enhanced. Acupuncture treatment can improve microcirculation and thus facilitate blood supply to the lesioned tissues and establish collateral circulation. It has a protective effect on neurons after cerebral ischemia, which can reduce cerebral edema and infarct volume. Acupuncture can inhibit apoptosis of ischemic neurons and increase the synthesis or release of endogenous neurotrophic factors in the post-ischemic brain.