1.Western medical treatment of stroke disease
Acute stroke (cerebrovascular disease) comes rapidly, and time is life. Untimely treatment, improper methods, improper treatment and medication can cause irreversible consequences. Studies have found that for every minute of delay, 1.9 million brain cells die, leaving varying degrees of disability in mild cases and life-threatening in severe cases.
Treatment of ischemic stroke: Acute stroke and transient ischemic attack are emergencies in encephalology and neurology. Early clinical diagnosis and ultra-early treatment are very important.
(1) Ultra-early stage (i.e. within 6 hours of onset)
Treatment: First of all, we should raise awareness of acute emergency treatment for stroke, understand the importance of ultra-early treatment, and seek immediate medical attention at the onset, striving for the best thrombolytic treatment time window of 3-6 hours to reduce brain metabolism, control brain edema and protect brain cells, and save the ischemic semidark areas.
(2) Individualized treatment: that is, the most appropriate treatment according to the patient’s age, type of stroke, condition and underlying disease.
(3) Prevention and control of complications: such as infection, brain-heart syndrome, post-stroke anxiety, etc.
(4) Holistic treatment: such as taking supportive therapy, symptomatic treatment and early rehabilitation.
Treatment of hemorrhagic stroke.
Internal treatment.
(1) General treatment: Keep safe, bed rest, keep the airway open, and administer oxygen, etc.
(2) Regulation of blood pressure: maintain blood pressure slightly above the pre-onset level or diastolic blood pressure of about 100 mmHg.
(3) Reduce intracranial pressure: elevated intracranial pressure is the main cause of death in patients with cerebral hemorrhage, so reducing intracranial pressure is an important task in the treatment of cerebral hemorrhage. The treatment of cerebral hemorrhage to lower the intracranial pressure is firstly based on hypertonic dehydrating drugs, such as mannitol or glycerol fructose, glycerol sodium chloride, etc. When applying dehydrating drugs, attention should be paid to water and electrolyte balance.
(4) Ensure nutrition and electrolyte balance.
(5) Treatment of complications.
2.Chinese medicine treatment of stroke disease
Chinese medicine considers blood deficiency, blood stasis and phlegm as the source of stroke, liver and kidney yin deficiency, external evil invading the meridians, evil Qi stagnation, phlegm-heat disturbance, wind and phlegm blocking the channels, and the flow of meridians not allowed to cause stroke. Treatment is based on the principles of unblocking the meridians, removing phlegm, activating blood circulation, harmonizing qi and blood, and promoting the improvement of the function of the affected limbs.
Commonly used Chinese medicine preparations: Salvia, Safflower, Chuanxiongzin, Panax notoginseng and Ginkgo biloba can reduce platelet aggregation, anticoagulation, improve cerebral blood flow and reduce blood viscosity.
Acupuncture therapy is one of the main elements of traditional Chinese medicine, with a long history of thousands of years. The treatment of stroke with acupuncture has been documented in the Nei Jing, the Jia Yi Jing of Acupuncture and Moxibustion, and the Dacheng of Acupuncture. Recent surveys have shown that the number of people receiving acupuncture treatment at home and abroad is increasing year by year. Acupuncture has become one of the ideal methods to treat stroke. Acupuncture treatment for stroke is based on the doctrine of internal organs and meridians to achieve the purpose of unblocking the meridians, running qi and blood, harmonizing yin and yang, and promoting the recovery of paralyzed limbs.
In clinical practice, stroke is often divided into acute, recovery and post-stroke periods. In the acute phase, the treatment focuses on saving lives and controlling the progress of the disease. During the recovery period, TCM acupuncture rehabilitation is the focus of this period. This period has a greater chance of further improvement, and most patients recover to a better condition during this phase, while a small number of them continue to have some symptoms and signs and turn into the sequelae phase. The sequelae phase is generally stable, and the lost functions enter a slow recovery phase.
In the acute stage, there is no random muscle contraction or joint reaction, and the body is basically in a state of total relaxation. Acupuncture is used to treat the patient’s clinical signs and symptoms with head acupuncture and body acupuncture, and bedside treatment is the main rehabilitation treatment to improve the control of the trunk and proximal joints on the patient’s side, to turn over in bed, to protect the joints, and to maintain the range of motion of the joints. The treatment is designed to improve the control of the trunk and proximal joints on the patient’s side, to turn in bed, to protect the joints, to maintain the range of motion of the joints, to improve the tone and strength of the paralyzed muscles, to improve the ability of daily activities, and to enable the patient to move in a normal or near-normal movement pattern.
The recovery period is very important for patients with moderate to severe stroke. During this period, patients can clearly show the synergistic movement of the flexors of the upper limbs and the extensors of the lower limbs, and gradually achieve independent movement of some muscles and joints. In addition to continuous medication, patients should also strengthen acupuncture and rehabilitation therapy to further balance muscle tone and promote the emergence of more dissociated movements, in order to strengthen the ability to control the activities of the affected limb and complete more complex life activities, and correct abnormal gait. At the same time, under the guidance of a TCM physician, patients can use Chinese herbal tonics to treat their condition and physique according to the evidence. The clinical efficacy of acupuncture can be improved by combining acupuncture and medication.
Patients with sequelae will enter the chronic recovery period of the affected limb function, so it is necessary to pay attention to strengthen the passive activities of that side of the limb, prevent the joint, tendon and ligament contracture caused by the joint range of motion limitation, regular Chinese medicine rehabilitation treatment, maximize the auxiliary function of the affected limb, make full use of orthopedic devices, aids, protective gear to improve the patient’s mobility, as far as possible to improve the patient’s ability to take care of themselves in daily life, so that they can return to To improve the patient’s ability to take care of themselves in daily life, so that they can return to their families, return to society and improve their quality of life.