[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.

[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.