How can we help stroke sequelae & rehabilitation?

Tiejun Tang

In the UK, strokes are a major health problem. Every year, around 110,000 people have a stroke in England and it is the third largest cause of death^[1]. The treatment of and productivity loss arising from stroke results in total societal costs of £8.9 billion a year, with treatment costs accounting for approximately 5% of total UK NHS costs^[2]. More than half of the costs are incurred on rehabilitation of following strokes.

After survival from the acute stage, stroke patients usually will be discharged from hospital. Patients still have hemiplegia, numbness in one side of the body, distortion of the face and tongue, slurred speech or dysphasia. A long term rehabilitation care and treatment is very necessary. Good treatment can greatly improve the symptoms of stroke sequelae, in many cases patients can return completely back to normal. If there is no treatment or inappropriate treatment in sequelae stage, patients will have a high risk of a second and even worse stroke.   

There are two main causes of stroke:  The ischemic cerebrovascular disease accounts for 85% of all cases, others are hemorrhagic cerebrovascular disease. Some risk factors are main reasons of these two acute cerebrovascular attacks. Include: high blood pressure, high cholesterol, diabetes, obesity, smoking, drinking excessive alcohol, lack of exercise and emotional stimulation which may cause a temporary rise in blood pressure.

TCM Perspective

Stroke in TCM is called Zhong Feng. It means attacked by wind. It is an internal wind, which is caused by liver yang excess and/or kidney yin deficiency. In some cases healthy qi deficiency and blood stasis or wind phlegm obstruction can became the main reasons.

Acupuncture especially electric acupuncture and scalp acupuncture can help to reduce muscular atrophy and improve the myodynamia. A randomized controlled clinical trial showed acupuncture can significantly increase cerebral blood flow velocity of post stroke patients^[3]. Another 3 clinical studies also suggest that acupuncture increases quality of life and improves mobility and activities of daily living ^[4].

Buyang Huanwu Decoction is a famous traditional Chinese medicine formula, and has been used extensively in the treatment of stroke for centuries. Many clinical trial and experimental studies suggest this decoction can benefit strike sequelae through many molecular mechanisms^[5].

In the acute stage of stroke, western medicine must be the first choice, but in the sequelae stage Chinese medicine should be a better choice. The effect of acupuncture and herbs can enhance each other.  Chinese Tuina massage or acupressure also can help a lot in the rehabilitation of hemiplegia.

Reference:

1.      http://www.nhs.uk/conditions/Stroke/Pages/Introduction.aspx

2.      Omer Saka. Cost of stroke in the United Kingdom. Age Ageing (2009) 38 (1): 27-32.

3.      Ratmansky M. The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial. J Altern Complement Med. 2015 Nov 16

4.      Farmer C. Bringing holistic treatments to the attention of medicine: acupuncture as an effective poststroke rehabilitation J Evid Based Complementary Altern Med. 2015; 20 (2):120-5

5.      Guo Q.  A Systems Biology Perspective on the Molecular Mechanisms Underlying the Therapeutic Effects of Buyang Huanwu Decoction on Ischemic Stroke. Rejuvenation Res. 2015; 18(4):313-25.