[Post-stroke shoulder-hand syndrome of phlegm-stasis obstruction treated with the combined therapy of eye acupuncture, Tengliao and rehabilitation training: a multi-central randomized controlled trial].

OBJECTIVE: To assess the efficacy on relieving pain and improving the range of motion of shoulder joint in post-stroke shoulder-hand syndrome of phlegm-stasis obstruction in treatment of the combined therapy of eye acupuncture, Tengliao (Chinese herbal warm dressing technique) and rehabilitation training (eye acupuncture + Tengliao + rehabilitation) as compared with the combined treatment of Tengliao and rehabilitation training (Tengliao + rehabilitation) and the simple rehabilitation training (rehabilitation). METHODS: A total of 356 patients with post-stroke shoulder-hand syndrome of phlegm-stasis obstruction were randomized into an eye acupuncture + Tengliao + rehabilitation group (group A, 122 cases, 2 cases dropped off), a Tengliao + rehabilitation group (group B, 120 cases, 3 cases dropped off) and a rehabilitation group (group C, 114 cases, 1 case dropped off). In the group C, the basic treatment was combined with routine rehabilitation training. In the group B, on the base of the treatment as the group C, Tengliao was exerted. A medical bag composed of over 20 Chinese herbal materials was heated and dressed at the affected area, 30 min each time, 5 times weekly. In the group A, besides the treatment as the group B, eye acupuncture was applied to heart region, kidney region, upper jiao region and lower jiao region, 30 min each time, 5 times weekly. The treatment lasted 28 days in all of three groups. Separately, before treatment, in 7, 14, 21 and 28 days of treatment, as well as in 14 days after treatment of follow-up, the score of visual analogue scale (VAS) for pain, the score of guides to evaluation of permanent impairment (GEPI) and the score of National Institutes of Health stroke scale (NIHSS) were observed in each group. RESULTS: The scores of VAS, GEPI and NIHSS were all improved with the treatment lasting in the three groups (P<0.000 1). In 7, 14, 21 and 28 days of treatment and in follow-up as well, VAS scores in the group A were all lower than the group C (P<0.05). After 14 days of treatment, GEPI score showed increasing trend, while NIHSS score showed decreasing trend in the group A compared with the group B. Before treatment, GEPI score was lower and NIHSS score was higher in the group A compared with the group C (P<0.05). It was suggested that the illness was slightly serious in the group A. After propensity score matching, in 14, 21 and 28 days as well as in follow-up, GEPI scores in the group A were higher than the group C respectively (P<0.05). Regarding NIHSS score at each time point, the difference had no statistical significance between the group A and the group C (P>0.05). CONCLUSION: The combined therapy of eye acupuncture, Tengliao and rehabilitation training obtains a better efficacy on post-stroke shoulder-hand syndrome of phlegm-stasis obstruction as compared with rehabilitation training.

[Effect of eye acupuncture on autophagy in brain tissue of rats with cerebral ischemia-reperfusion injury].

OBJECTIVE: to observe the effect of eye acupuncture on cerebral blood flow and autophagy of cerebral tissue in rats with cerebral ischemia-reperfusion injury, so as to explore the mechanism of eye acupuncture underlying improvement of cerebral ischemia-reperfusion injury. METHODS: Fifty SD rats were randomly divided into sham operation, model, eye acupuncture, inhibitor and enhancer groups，with 10 rats in each group. The rat model of cerebral ischemia-reperfusion injury was established by occlusion of the middle cerebral artery for 1.5 h. The rats in the eye acupuncture group were treated with eye acupuncture for 30 minutes immediately, 12 h and 24 h after the modeling. Rats in the inhibitor group and enhancer group were given intracerebroventricular injection of autophagy agonist 3-Methyladenine or autophagy inducer Rapamycin 30 min before modeling. Longa's scoring method was used to evaluate the neurological function. The blood flow velocity of the cerebral cortex was mea-sured with a laser doppler blood flow meter, and the neuron damage in the brain tissue was observed with Nissl staining. The expressions of autophagy-related protein Beclin-1, microtubule-associated protein 1 light chain 3 (LC3), and p62 were measured by Western blot. RESULTS: Compared with the sham operation group, the neurological score of the model group was significantly increased (P<0.01); the blood flow volume and blood flow speed were significantly reduced (P<0.01); the number of Nissl bodies in the ischemic brain tissue decreased (P<0.01); Beclin-1 protein expression level and LC3-II/LC3-I increased, while p62 expression level decreased(P<0.01). After intervention and in comparison with the model group, the neurological scores in the eye acupuncture group and inhibitor group decreased (P<0.01); blood flow volumn and blood flow speed significantly increased (P<0.01); the number of Nissl bodies increased (P<0.01); the expression level of Beclin-1 protein and LC3-II/LC3-I decreased, and the expression level of p62 increased (P<0.01). There was no significant difference between the enhancer and the model groups in the abovementioned indexes(P>0.05). CONCLUSION: Eye acupuncture can improve the neurological function of rats with cerebral ischemia-reperfusion injury, which may be related to accelerating cerebral blood flow and inhibiting autophagy in the ischemic brain.

Effects of eye-acupuncture combined with rehabilitation training for poststroke dyskinesia: A protocol for systematic review and meta-analysis.

INTRODUCTION: Poststroke dyskinesia is the most common clinical symptom after stroke, which greatly affects the patients' daily life. Eye-acupuncture is an effective method for stroke. And the rehabilitation training has been widely used for patients suffer from stroke. However, whether eye-acupuncture combined with rehabilitation training has greater clinical efficacy for poststroke dyskinesia is still unknown. Our aim in this systematic review was to evaluate the clinical efficacy of eye-acupuncture combined with rehabilitation training (EACRT) as a treatment for dyskinesia after stroke. METHODS AND ANALYSIS: We will search the following 4 databases of registered trials and 7 electronic databases from inception to March 2021:Cochrane Stroke Group, Cochrane Central Register of Controlled, the World Health Organization International Clinical Trials Registry Platform, the Chinese Clinical Trial Registry; PubMed, MEDLINE, Embase, CNKI, VIP, WanFang, and CBM. All relevant randomized controlled trials focus on EACRT will be included. The primary outcome will be the Fugl-Meyer Assessment. The Secondary outcomes will include Activity of Daily Living, clinical effective rate and the Visual Analogue Score. Two reviewers will independently conduct the Study selection and data extraction. The data synthesis and assessment of risk of bias will be performed by RevMan5.2. ETHICS AND DISSEMINATION: The ethical approval is unnecessary that systematic review is based on published articles other than patients. The results of this meta-analysis will be published in an open access (OA) journal according to the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA). PROSPERO REGISTRATION NUMBER: CRD42020168278.

Chinese Herbal Formula Xuefu Zhuyu for Tension-Type Headache with Qi-Stagnation and Blood-Stasis Pattern (CheruXTH): Study Protocol for a Randomized Controlled Trial.

BACKGROUND: Tension-type headache (TTH) is the most common headache disorder. Current treatments for TTH have been reported to be associated with insufficient long-term benefits and unwanted adverse events (AEs). The Chinese herbal formula Xuefu Zhuyu (XFZY) has been utilized in TTH treatment, but the evidence supporting its efficacy remains unclear. This study will evaluate the efficacy and safety of XFZY for TTH. METHODS: This multicenter, double-blind, randomized, placebo-controlled trial will be undertaken in China. A total of 174 eligible participants will be randomly assigned to either an XFZY group or a placebo group (20 ml each dose, three times daily for 4 weeks) at a ratio of 1 : 1. The primary outcome is the change in mean headache intensity measured by a 10 cm visual analogue scale (VAS). Secondary outcomes include the area-under-the headache curve (AUC), headache frequency, rescue medication use, qi-stagnation and blood-stasis pattern measurement, quality of life measured by the EuroQol-5-Dimensions-5-Level (EQ-5D-5L), global evaluation of medication, and health economic indexes. Discussion. The results of the study are expected to provide evidence of high methodological and reporting quality on the efficacy and safety of XFZY for TTH. This trail is registered with ChiCTR1900026716 (registered on 19 October, 2019).

Eye-acupuncture with rehabilitation therapy for stroke.

BACKGROUND: Stroke survivors are accompanied by dysfunctions, greatly declining their activities of daily living and bringing burden to families and societies. Although modern rehabilitation therapy has a systematic program in post-stroke motor rehabilitation, numbers of patients still recover slowly. Eye-acupuncture (EA), as an important type of acupuncture, has been widely applied effectively in rehabilitation of stroke for about 50 years. So we combine EA with modern rehabilitation which has achieved successful results. Therefore, we need to adopt an objective and accurate evaluation method to study the effect of this method. METHODS: We aim to design a multi-center, block randomized, parallel control trial to assess the effect of eye-acupuncture combined with rehabilitation training therapy for patients with hemiplegia in the convalescent stage of stroke. 360 patients will be enrolled from 6 centres, with half of them (n = 180) in the control group (routine treatment group) and others (n = 180) in the experimental group (eye-acupuncture combined with routine treatment group). Stratified block randomization will be used in the study and the serial number 001-360 which corresponds to a participant will be assigned to each center randomly. We will use the sequentially sealed envelopes to hide the generating of assignment sequence. The cases of dropouts will be recorded with reasons. And the clinical CRFs will be filled in accurately, completely, and timely for statistical analysis. RESULTS: To verify the clinical effects, we will measure the change of bellows from visit 1 to visit 4. Primary outcomes: activity of daily living (ADL) scales (modified Barthel index); simple Fugl-Meyer motor function score; functional magnetic resonance imaging (fMRI) of the brain in the resting state. SECONDARY OUTCOMES: traditional Chinese medicine (TCM) syndrome score scale; western aphasia battery (WAB); water swallow test; Montreal cognitive assessment (MoCA); growth-associated protein-43 (GAP-43); microtubule-associated protein-2 (MAP-2). CONCLUSION: The results of this study will provide present evidence on assessing effectiveness of EA combined with rehabilitation training for patients with hemiplegia in the convalescent stage of stroke. TRIAL REGISTRATION: This trial has been registrated in Chinese Clinical Trail Registry with the registration number as ChiCTR1900027835 (http://www.chictr.org.cn/).

[Randomized Controlled Clinical Trials of Eye-acupuncture Therapy for Patients with Post-stroke Insomnia].

OBJECTIVE: To observe the therapeutic effect of eye-acupuncture therapy for post-stroke insomnia. METHODS: Sixty patients (45-70 years in age) with post-stroke insomnia were randomized into eye-acupuncture group and routine acupuncture (body acupuncture) group (30 cases in each). Patients of the eye-acupuncture group were treated by acupuncture stimulation of bilateral Shangjiao (Upper-energizer) and Xin (Heart) regions and those of the routine acupuncture group treated by acupuncture stimulation of Baihui (GV 20), Sishencong (EX-HN 1), Anmian (EX-HN 16), etc. After Deqi, the filiform needles were retained for 20 min, and the treatment in both groups was conducted once a day, with 15 days being one therapeutic course and 2 courses altogether. The Pittsburgh Sleep Quality Index (PSQI) including the subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and total PSQI score was used to evaluate the overall sleep quality. The clinical efficacy was assessed according to the "Guiding Principles of Clinical Trials for New Drugs of Traditional Chinese Medicine" formulated by Chinese Ministry of Health. RESULTS: Following the treatment, of the two 30 cases in the eye-and routine acupuncture groups, 21 and 9 experienced a marked improvement in their symptoms, 8 and 17 were effective, and 1 and 4 invalid, with the effective rate being 96.7% and 86.7%, respectively. The PSQI scores of the subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and the total PSQI score were all significantly decreased in comparison with pre-treatment in each group (P<0.01). The therapeutic effect of the eye-acupuncture was markedly superior to those of routine acupuncture in reducing sleep latency, sleep disturbances and daytime dysfunction (P<0.05), but without significant differences between the two groups in the effective rate, sleep quality, sleep duration, sleep efficiency and total PSQI score (P>0.05). CONCLUSIONS: Both eye-acupuncture and routine acupunture are effective in the treatment of post-stroke insomnia, and the eye-acupuncture is better than routine acupuncture in reducing sleep latency, improving sleep disturbances and daytime dysfunction.