Acupuncture and Chinese herbal medicine alleviate cerebral infarctions (strokes). Using MRIs, Guangyuan City Third People’s Hospital researchers conclude that acupuncture plus Bu Yang Huang Wu Tang improves brain functional connectivity in cerebral infarction patients. Results were especially pronounced in the central-cerebellar and central-contralateral anterior gyrus regions. In addition, the acupuncture and herbal medicine combination reduced risk factors by lowering total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels. In addition, CD62P and CD63 expression significantly reduced. These proteins are platelet activation markers indicative of cerebral infarction intensity levels.
The research team determined that acupuncture plus the herbal formula Bu Yang Huang Wu Tang is more effective than deproteinized calf blood serum injections plus atorvastatin. Deproteinized calf blood serum injections are the deproteinized extract of calf blood, which contain bioactive components and facilitates tissue repair and regeneration. Atorvastatin (brand name Lipitor) is an HMG-CoA reductase inhibitor used to lower high cholesterol levels and decrease the risk of cerebral infarctions.
It was determined that acupuncture plus Chinese herbal therapy produced a 91.7% total effective rate for the treatment of cerebral infarctions. A group receiving standard drug therapy achieved a 72.2% total effective rate. The acupuncture plus herbs group outperformed the drug group by 19.5%. The laboratory data demonstrates that acupuncture produces significant decreases in blood lipid levels when combined with Bu Yang Huang Wu Tang. Additionally, resting state fMRIs demonstrated that acupuncture improves functional connectivity of brain networks. [1]
Laboratory indicators included total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), CD62p, and CD63 levels. TC, TG, and LDL-C quantified blood lipid levels. High TC, TG, and LDL-C levels can hinder the recovery process and increase the reoccurrence rate of cerebral infarctions. [2]
CD62p and CD63 are two widely used markers of platelet activation. Lower levels of CD62p and CD63 indicate lower cerebral infarction severity. The researchers determined that the expressions of CD62P and CD63 dropped significantly after treatment in both groups, and the between-group differences were statistically significant. The levels of TC, TG, and LDL-C decreased significantly after treatment in the two groups, and the between-group differences were statistically significant.
Using resting state fMRIs (functional magnetic resonance imaging), the research team discovered that acupuncture “restores the functional connectivity of cerebral infarction patients, especially in the central-cerebellar and central-contralateral anterior gyrus regions.” [3] In both groups, the central-cerebellar and central-contralateral anterior gyrus functional connectivity coefficients on the affected side improved significantly. The between-group differences were statistically significant, with acupuncture plus herbs outperforming the medication group. Given the success of both protocols, a study investigating the combination of acupuncture, herbs, and medications would help to clarify whether or not synergistic or additive therapeutic effects may be achieved in an integrative medicine protocol.
Design
The researchers (Tang et al.) used the following study design. A total of 72 patients were treated in this study. The patients were diagnosed with acute cerebral infarction between April 2016 and April 2018. They were randomly divided into an acupuncture group and a drug control group, with 36 patients in each group.
For the control group patients, deproteinized calf blood serum injections and atorvastatin were administered. The treatment group received acupuncture in addition to an herbal formula called Bu Yang Huang Wu Tang. Modern research confirms that this herbal formula reduces neuronal apoptosis and free radical damage by protecting mitochondria and promoting superoxide dismutase (SOD) expression. In addition, it exerts an antithrombotic effect by regulating platelet activity. [4]
The treatment group was comprised of 23 males and 13 females. The average age in the treatment group was 56 years. The control group was comprised of 24 males and 12 females. The average age in the treatment group was 56 years. There were no significant statistical differences in gender, age, and or demographics relevant to patient outcome measures for patients admitted to the clinical trial.
Acupuncture and Medications
For the drug group, patients received 20–50 ml of deproteinized calf blood serum injections (once per day) and 10 mg doses of orally administered atorvastatin (once per day), for 30 consecutive days. The acupuncture group received body acupuncture at the following acupoints:
- GV20 (Baihui)
- EX-HN1 (Sishencong)
- LI11 (Quchi)
- LI4 (Hegu)
- GB31 (Fengshi)
- ST36 (Zusanli)
- GB34 (Yanglingquan)
- SP6 (Sanyinjiao)
- BL60 (Kunlun)
Notably, Baihui and Sishencong were included in the acupuncture point prescription. These are scalp acupuncture point selections common in modern acupuncture neurology applications. Acupuncture treatments commenced with patients in a supine position.
After disinfection of the acupoint sites, a 0.25 mm x 25 mm sterile, disposable filiform needle was inserted perpendicularly into each acupoint with a high needle entry speed. After achieving a deqi sensation, the Xu Bu Shi Xie (deficiency-tonifying and excess-attenuating) manipulation technique was applied. A 30-minute needle retention time was observed. One acupuncture session was conducted daily, for 30 consecutive days. The herbal decoction used in the study was comprised of the following ingredients:
- Huang Qi 30 g
- Tao Ren 15 g
- Dang Gui 15 g
- Chuan Xiong 10 g
- Hong Hua 10 g
- Chi Shao 10 g
- Di Long 5 g
The ingredients were decocted in water. The herbal medicine was ingested 2 times per day, 200 ml each time, for 30 days. Classical Chinese medicine indications for use of this formula include stroke, hemiplegia, leg atrophy, urinary incontinence, aphasia, and deviation of the mouth. The traditional functions of this formula are to tonify qi, invigorate the blood, and unblock the channels.
Summary
Blood tests and imaging results verify that acupuncture plus herbs is effective for the treatment of cerebral infarctions. According to the research covered in this article, common benefits of TCM (Traditional Chinese Medicine) treatment protocols include lowering blood lipid levels and recovering functional connectivity of brain networks for patients with post-stroke syndrome.
References:
[1] Tang SM, Zhang W, Yuan Q, Yang LS, Yu BL. Effect of Acupuncture plus Buyang Huanwu Decoction on the Functional Connectivity of Brain Networks, CD62P and CD63 in Acute Cerebral Infarction [J/OL]. Shanghai Journal of Acupuncture and Moxibustion, 2019 (10):1093-1097 [2019-10-15].
[2] Guan DN, Hu YN, Zhang Y, et al. Effect of intensive lipid-lowering therapy on inflammatory factors and fibrinolysis system in patients with acute cerebral infarction[J]. Journal of Hainan Medical College, 2016,22(16):1887-1890
[3] Tang SM, Zhang W, Yuan Q, Yang LS, Yu BL. Effect of Acupuncture plus Buyang Huanwu Decoction on the Functional Connectivity of Brain Networks, CD62P and CD63 in Acute Cerebral Infarction [J/OL]. Shanghai Journal of Acupuncture and Moxibustion, 2019 (10):1093-1097 [2019-10-15].
[4] Wei JH, Zhang JJ, Zhang HP, et al. Effect of Buyang Huanwu Decoction on Neurological Function and Cardiac Serological Markers in Patients with Acute Cerebral Infarction [J]. Journal of Emergency in Traditional Chinese Medicine, 2016,25(11):2136-2138.
Source: HealthCMI
