Clinical study on early acupuncture for acute ischemic stroke

Effect of electroacupuncture treatment combined with rehabilitation care on serum sirt3 level and motor function in elderly patients with stroke hemiparesis

OBJECTIVE

Acupuncture treatment helps to improve neurological and motor function in elderly patients with stroke hemiplegia. However, the exact mechanism by which electroacupuncture improves stroke hemiparesis is uncertain. The aim of this study was to determine the effect of electroacupuncture care on sirt3 levels in elderly patients with stroke hemiparesis.

METHODS

One hundred and ten elderly patients with hemiplegia after first stroke were divided into an experimental group and a control group (n = 55 in each group). The control group was given conventional rehabilitation care by a rehabilitation therapist. In the experimental group, on the basis of conventional rehabilitation care, electroacupuncture was performed once a day for 28 days.

RESULTS

Fugl-Meyer assessment (FMA) and barthel index (BI) scores were significantly higher, while neurologic deficit scale (NDS) and physiological state scores were significantly lower in both groups after 14 and 28 days of intervention compared to preintervention. The Generalized estimating equation (GEE) model also showed that the experimental group showed more favorable improvements in all outcomes at postintervention time points compared to the control group. After the intervention, serum sirt3 levels increased significantly in both groups compared to preintervention, and the increase was more pronounced in the experimental group. Consistently, the GEE model showed that serum sirt3 levels were significantly higher in the experimental group compared to the control group at postintervention time points. Correlation analysis revealed that serum sirt3 levels in the experimental group were negatively correlated with FMA and BI pre- and postintervention, while showing a significant positive correlation with NDS and physiological state scores.

CONCLUSION

Electroacupuncture intervention led to significant improvements in motor function, activities of daily living and neurological function in elderly patients with stroke hemiplegia, which may be associate with increased serum sirt3 levels.

An updated meta-analysis of the efficacy and safety of acupuncture treatment for cerebral infarction

BACKGROUND

Ischemic stroke is the second most common cause of death and the primary cause of disability throughout the world. Acupuncture is frequently advocated as an adjunct treatment during stroke rehabilitation. The aim of this study was to update the clinical efficacy and safety of acupuncture for cerebral infarction.

METHODS

Randomized controlled trials (RCT) on acupuncture treating cerebral infarction were searched from the following databases: PubMed, EMBASE, Cochrane Library, CNKI, CMB and VIP from inception to October 2013. The data of RCTs meeting the inclusive criteria were extracted according to Cochrane methods. The meta-analyses were conducted using Rev Man 5.0 software.

RESULTS

A total of 25 trials involving 2224 patients were included. The results of this meta-analysis showed that the groups receiving acupuncture (observation group) were superior to the comparison groups (control group), with significant differences in the Clinical Efficacy Rates [OR = 4.04, 95%CI (2.93, 5.57), P<0.001], Fugl-Meyer Assessment [MD = 11.22, 95%CI (7.62, 14.82), P<0.001], Barthel Index Score [MD = 12.84, 95%CI (9.85, 15.82), P<0.001], and Neurological Deficit Score [MD = -2.71, 95% CI (-3.84, -1.94), P<0.001]. Three trials reported minor adverse events.

CONCLUSION

Current evidence provisionally demonstrates that acupuncture treatment is superior to either non-acupuncture or conventional therapy for cerebral infarction. Despite this conclusion, given the often low quality of the available trials, further large scale RCTs of better quality are still needed.

Acupuncture attenuates neuronal cell death in middle cerebral artery occlusion model of focal ischemia

OBJECTIVES

This study was designed to investigate the neuroprotective effect of acupuncture in the middle cerebral artery occlusion-induced ischemia model.

METHODS

Sprague-Dawley rats were randomly divided into two experimental groups: middle cerebral artery occlusion group (MCAO, n=8), and middle cerebral artery occlusion plus acupuncture group (MCAO + Acu, n=8). Acupuncture stimulation was given immediately after reperfusion. The effect of its stimulation to both GB34 and GB39 on the size of the brain infarct and the functional status of the brain cells after middle cerebral artery occlusion was examined by nissl staining and neuron-specific nuclear protein immunohistochemistry.

RESULTS

The infarction volume was significantly decreased in the MCAO + Acu group (16.4 +/- 4.8%), compared with the MCAO group (39.9 +/- 10.2%). The number of neuron-specific nuclear protein-positive cells in the MCAO group was significantly decreased by 42.3 +/- 12.6% in the striatum and by 45.8 +/- 5.8% in the motor cortex, but the neuron-specific nuclear protein-positive cells in the MCAO + Acu group were rescued by 67.0 +/- 3.8% in the striatum and by 68.1 +/- 4.5% in the motor cortex, compared with the contralateral side (100%).

DISCUSSION

This study showed that acupuncture had neuroprotective effects against focal ischemia in the middle cerebral artery occlusion model.