RESUMEN
Background: To systematically collate, appraise, and synthesize evidence of electroacupuncture (EA) as an adjunct therapy for poststroke aphasia (PSA) from randomized controlled trials (RCTs) through a systematic review and meta-analysis. Methods: An electronic search was conducted in eight databases to identify RCTs evaluating EA adjuvant therapy versus speech and language therapy (SLT). Methodological quality of the included trails was assessed by the Cochrane risk of bias. The software Review Manager 5.4 was used for data analysis. Results: Nineteen RCTs enrolling a total of 1263 subjects were identified. The use of EA combined with speech and language therapy (SLT) showed significant improvements in effective rate (RR 1.31, 95% CI [1.21, 1.41]), oral expression score (SMD 1.34, 95% CI [1.13, 1.56]), comprehension score (SMD 1.95, 95% CI [0.88, 3.03]), repetition score (SMD 1.84, 95% CI [0.75, 2.93]), naming score (SMD 1.97, 95% CI [0.81, 3.13]), and reading score (SMD 1.55, 95% CI [1.07, 2.04]) compared to the use of SLT alone. Conclusions: The pooled data indicate that EA combined with SLT for the treatment of PSA may improve clinical effectiveness, compared with SLT alone. Future high quality RCTs with large samples are still needed to confirm and expand our findings.
RESUMEN
OBJECTIVE: To observe the effect of electroacupuncture (EA) of "Dazhui" (GV 14), "Baihui" (GV 20), etc. on learning-memory ability and expression of vascular endothelial growth factor (VEGF) mRNA, VEGF receptor 1 (VEGFR-1/Flt-1) mRNA, and VEGFR-2 (Flk-1) mRNA in the hippocampus in vascular cognitive impairment (VCI) rats so as to reveal its mechanism underlying improvement of VCI. METHODS: A total of 60 Wistar rats were randomly divided into sham operation, VCI model, EA and medication groups (n=12 in each group). The VCI model was established by occlusion of the bilateral vertebral arteries and bilateral cervical arteries. EA (2 Hz/20 Hz) was applied to "Baihui" (GV 20), "Dazhui" (GV 14), "Shuigou" (GV 26) and "Shenting" (GV 24) for 20 min, once daily for 20 days. Rats of the medication group were treated by intragastric perfusion of Aniracetam capsules (0.0625 g/kg),once daily for 20 days. The rats' learning-memory ability was detected by step-down test. The expression levels of VEGF mRNA, Flt-1 mRNA and Flk-1 mRNA in the hippocampus were detected by RT-PCR, and the neurological deficit scores were assessed by Zea Longa (0-4 scaling) method. RESULTS: Compared with the sham operation group, rats of the model group showed a significant increase in reaction time and error number and decrease of escape latency (reduction of learning-memory ability), and increase in neurological deficit score, and in expression levels of hippocampal VEGF mRNA, Flt-1 mRNA and Flk-1 mRNA (all P<0.01). After EA treatment, in comparison with the model group, the learning-memory ability and hippocampal VEGF mRNA, Flt-1 mRNA and Flk-1 mRNA were apparently increased, neurological deficit score were markedly decreased in the EA group (all P<0.01). The effects of EA treatment was obviously superior to those of medication in raising learning-memory ability and up-regulating hippocampal VEGF mRNA and Flt-1 mRNA expression levels, and in reducing neurological deficit score (all P<0.05). CONCLUSION: EA intervention can apparently up-regulate hippocampal VEGF mRNA, Flt-1 mRNA and Flk-1 mRNA expression in VCI rats, which may contribute to its effect in improving learning-memory ability, possibly by promoting neovasculization.
Asunto(s)
Trastornos del Conocimiento/terapia , Electroacupuntura , Hipocampo/metabolismo , Factor A de Crecimiento Endotelial Vascular/genética , Receptor 1 de Factores de Crecimiento Endotelial Vascular/genética , Receptor 2 de Factores de Crecimiento Endotelial Vascular/genética , Animales , Trastornos del Conocimiento/genética , Trastornos del Conocimiento/metabolismo , Trastornos del Conocimiento/patología , Humanos , Masculino , Memoria , Ratas , Ratas Wistar , Factor A de Crecimiento Endotelial Vascular/metabolismo , Receptor 1 de Factores de Crecimiento Endotelial Vascular/metabolismo , Receptor 2 de Factores de Crecimiento Endotelial Vascular/metabolismoRESUMEN
Introduce Professor Zhang Dao-zong's studies on the Governor Vessel and its academic thought of dredging the Governor Vessel and regulating mentality, and clinical experiences of dredging the Governor Vessel and regulating mentality therapy for apoplexy, epilepsy, vertigo, ankynosing spondylitis, traumatic paraplegia, child Tourette's disease, etc....