The Efficacy and Safety of Ischemic Stroke Therapies: An Umbrella Review

Li, Yongbiao; Cui, Ru-Yi; Fan, Fangcheng; Lü, Yangyang; Ai, Yangwen; Liu, Hua; Liu, Shaobao; Du, Yang; Qin, Zhiping; Sun, Wenjing; Yu, Qing; Liu, Qingshan; Cheng, Yong

doi:10.3389/fphar.2022.924747

Cited by 15 publications

(11 citation statements)

References 64 publications

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“…Regarding neurological function, after 6 weeks of treatment, there was a 2.22-point reduction in the NIHSS scores in the MA group compared with the SA group, indicating a clinical improvement in neurological impairment . The effects of acupuncture in enhancing neurological function in patients with stroke have been validated in clinical studies . Moreover, acupuncture is recommended by clinical practices and treatment guidelines for at least 15 poststroke symptoms worldwide .…”

Section: Discussionsupporting

confidence: 86%

Effect of Acupuncture vs Sham Acupuncture on Patients With Poststroke Motor Aphasia

Li,

Deng,

Zhuo

et al. 2024

JAMA Netw Open

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ImportanceMotor aphasia is common among patients with stroke. Acupuncture is recommended as an alternative therapy for poststroke aphasia, but its efficacy remains uncertain.ObjectiveTo investigate the effects of acupuncture on language function, neurological function, and quality of life in patients with poststroke motor aphasia.Design, Setting, and ParticipantsThis multicenter, sham-controlled, randomized clinical trial was conducted in 3 tertiary hospitals in China from October 21, 2019, to November 13, 2021. Adult patients with poststroke motor aphasia were enrolled. Data analysis was performed from February to April 2023.InterventionsEligible participants were randomly allocated (1:1) to manual acupuncture (MA) or sham acupuncture (SA) groups. Both groups underwent language training and conventional treatments.Main Outcomes and MeasuresThe primary outcomes were the aphasia quotient (AQ) of the Western Aphasia Battery (WAB) and scores on the Chinese Functional Communication Profile (CFCP) at 6 weeks. Secondary outcomes included WAB subitems, Boston Diagnostic Aphasia Examination, National Institutes of Health Stroke Scale, Stroke-Specific Quality of Life Scale, Stroke and Aphasia Quality of Life Scale–39, and Health Scale of Traditional Chinese Medicine scores at 6 weeks and 6 months after onset. All statistical analyses were performed according to the intention-to-treat principle.ResultsAmong 252 randomized patients (198 men [78.6%]; mean [SD] age, 60.7 [7.5] years), 231 were included in the modified intention-to-treat analysis (115 in the MA group and 116 in the SA group). Compared with the SA group, the MA group had significant increases in AQ (difference, 7.99 points; 95% CI, 3.42-12.55 points; P = .001) and CFCP (difference, 23.51 points; 95% CI, 11.10-35.93 points; P &lt; .001) scores at week 6 and showed significant improvements in AQ (difference, 10.34; 95% CI, 5.75-14.93; P &lt; .001) and CFCP (difference, 27.43; 95% CI, 14.75-40.10; P &lt; .001) scores at the end of follow-up.Conclusions and RelevanceIn this randomized clinical trial, patients with poststroke motor aphasia who received 6 weeks of MA compared with those who received SA demonstrated statistically significant improvements in language function, quality of life, and neurological impairment from week 6 of treatment to the end of follow-up at 6 months after onset.Trial RegistrationChinese Clinical Trial Registry: ChiCTR1900026740

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Section: Discussionsupporting

confidence: 86%

Effect of Acupuncture vs Sham Acupuncture on Patients With Poststroke Motor Aphasia

Li,

Deng,

Zhuo

et al. 2024

JAMA Netw Open

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“…Besides, through randomized controlled trials and the meta-analyses, blood-activating TCM combined with western medicine is reported to treat intracranial hemorrhage and ischemic stroke. [95,96] Therefore, this study mainly reviews TCM with the effects of activating blood and resolving stasis and its ingredients. [97] 4.1.…”

Section: Ciri Targets the Jak/stat Pathway To Boost Cell Proliferatio...mentioning

confidence: 99%

The role of JAK/STAT signaling pathway in cerebral ischemia-reperfusion injury and the therapeutic effect of traditional Chinese medicine: A narrative review

Song,

Zhang,

Zhu

et al. 2023

Medicine

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Cerebral ischemia is a cerebrovascular disease with symptoms caused by insufficient blood or oxygen supply to the brain. When blood supplied is restored after cerebral ischemia, secondary brain injury may occur, which is called cerebral ischemia-reperfusion injury (CIRI). In this process, the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway plays an important role. It mediates neuroinflammation and participates in the regulation of physiological activities, such as cell proliferation, differentiation, and apoptosis. After CIRI, M1 microglia is activated and recruited by the damaged tissue. The inflammatory factors are produced by M1 microglia through the JAK/STAT pathway, eventually leading to cell apoptosis. Meanwhile, the JAK2/STAT3 signaling pathway and the expression of lipocalin-2 and caspase-3 could increase. In the pathway, phosphorylated JAK2 and phosphorylated STAT3 function of 2 ways. They not only promote the proliferation of neurons, but also affect the differentiation direction of neural stem cells by further acting on the Notch signaling pathway. Recently, traditional Chinese medicine (TCM) is a key player in CIRI, through JAK2, STAT3, STAT1 and their phosphorylation. Therefore, the review focuses on the JAK/STAT signaling pathway and its relationship with CIRI as well as the influence of the TCM on this pathway. It is aimed at providing the basis for future clinical research on the molecular mechanism of TCM in the treatment of CIRI.

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“…A previous systematic review and meta-analysis of 56 publications that evaluated the effect of acupuncture on rehabilitation after IS in terms of exercise rehabilitation, analgesic effects, and perfusion volume around the infarct and ischemic penumbra, indicated a positive effect of acupuncture on rehabilitation [20] . A recent systematic review indicated that acupuncture is a safe and effective treatment for IS, improving neurological function, cognition, and activities of daily living in patients [21] . A randomized single-blind clinical study of 74 patients with IS also demonstrated significant improvements in neurological function, motor function, and activities of daily living [22] .…”

Section: Introductionmentioning

confidence: 99%

Acupuncture for ischemic stroke: Where are we now?

Zhu,

Jia,

Ferreira

et al. 2024

Acupuncture and Herbal Medicine

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Acupuncture is an effective treatment for ischemic stroke (IS) and plays a key role in neurological rehabilitation after IS. Acupuncture can improve the clinical symptoms of various complications after IS, including motor dysfunction, swallowing disorders, speech disorders, cognitive impairment, depression, insomnia, and fatigue. However, the mechanisms underlying the effects of acupuncture in IS remain unclear. Available evidence suggests that acupuncture may exert neuroprotective effects through neuroplasticity (neurogenesis and synaptogenesis), angiogenesis, cell proliferation and apoptosis, and regulation of oxidative stress, inflammation, and immunity. Further studies should be conducted to improve the high-quality evidence-based system of acupuncture intervention for IS, by focusing on the clinical and basic research design, increasing the sample size, standardizing and quantifying the standards of acupuncture operations, using multidisciplinary techniques and methods to systematically explore the key targets of acupuncture intervention for IS, and reveal the efficacy and mechanism of acupuncture in the treatment of IS.

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The Efficacy and Safety of Ischemic Stroke Therapies: An Umbrella Review

Cited by 15 publications

References 64 publications

Effect of Acupuncture vs Sham Acupuncture on Patients With Poststroke Motor Aphasia

Effect of Acupuncture vs Sham Acupuncture on Patients With Poststroke Motor Aphasia

The role of JAK/STAT signaling pathway in cerebral ischemia-reperfusion injury and the therapeutic effect of traditional Chinese medicine: A narrative review

Acupuncture for ischemic stroke: Where are we now?

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