The sooner the better - Traditional Chinese Medicine (TCM) clinical study on stroke sequela 1

Introduction:

As time flies, it is almost summer in South Africa. Yang energy is arising gradually alongside with the temperature.

Our clinic received three post-stroke patients in the last three months. The age ranges from young, middle-age and senior. Two of them suffered from twice stroke within two months; some of them were right brain while one of them was left brain.One of them accepted both Chinese herbal medicine and acupuncture treatments within one week after onset, while the other two patients accepted Chinese herbal medicine and/or acupuncture treatments nearly 6-8 weeks after stroke onset. Some of them also suffered from other chronic diseases such as hypertension and diabetics.

They are truly quite representative in terms of TCM rehabilitation treatment on stroke sequela. So we are planning to share these three series articles on TCM treatments of stroke sequela for your reference.

Stroke includes both hemorrhagic and ischemic cerebrovascular diseases, such as intracerebral hemorrhage, subarachnoid hemorrhage as well as cerebral infarction. The most common symptoms are as follows: sudden fainting, unconsciousness, hemiplegia, facial disorder and/or speech disorder.

As a common and frequently occurring disease of the neurological diseases, cerebrovascular disease is one of the three major diseases leads to death. Further more, 50-70% of the survivors will be disabled and would require care from others.

Case 1: male, 50 + years old, smoking history for more than 40 years, diagnosed with "hypertension" for two years, has not gone through routine treatment; diagnosed "diabetes" for two months,has not gone through routine treatment. He has a family history of “hypertension and diabetes".

On 29th of October,2017, the patient suffered from sudden facial disorder and left limbs (both upper and lower limbs) weakness after continuous sneezing for several times. He was sent to Life Bedford Garden Hospital. Brain CT scan was addressed immediately. The feedback from the CT scan indicated that the patient might have suffered from ischemic stroke due to the fact that no intracerebral heamorrhage had been noted.

He has gone through conventional treatment with the guideline of ischemic stroke on the same day. After one day conventional treatment, he was transferred to Edenvale public hospital. There was not significant improvement after seven days treatment in the hospital. He was discharged on the 7th day after stroke.

He came to our clinic on the same day, the 7th day, after stroke. He could not balance himself and could not stand without another person’s support. When he walked with a crutch, there must always be someone helps him to keep the balance. His left upper limb could not move at all. He also suffered from left facial disorder.

The first day treatment: acupuncture points ST4, LI4, LU9, LI1, Du26... were chosen to stimulate the circulation and unblock the meridian. Acupuncture treatment was applied 30 min with electric acupuncture. Formula Bu Yang Huan Wu Tang also was applied to restore the yang energy as well as improve blood circulation. After the first treatment, he could not only move his left upper limb side to side but also lift up and down slowly. He was also able to walk slowly independently although the posture did not look good. He could lift his left arm onto the left thigh when sitting in the car.

The second day treatment: continue the acupuncture treatment and formula as above. His left facial disorder recovered gradually. The left facial muscles could move quite well. He also could blow and hold air in the mouth. His walking posture is better than the first day but still would need a crutch to assist.

The third day treatment: continue the treatment plan as above, patient’s facial disorder was almost recovered. Continue to practice walking.

The forth day treatment: continue the acupuncture treatment. Patient suffered from constantly hiccup from last night. He was requested to take fresh ginger juice 15ml. He stopped hiccuping within a few minutes after taking the fresh ginger juice. Formula Gan Jiang Fu Zi Tang was added together to the previous formula (Bu Yang Huan Wu Tang) to enhance Yang energy to warm the spleen.

The fifth and sixth days of treatment: continue both acupuncture and herbal medicine treatment as above. After the treatment, he could walk independently without the support of a crutch. He also could lift his left arm to his chest level.

He is still going through both herbal medicine and acupuncture treatments.

Summary:

1. One of the key points in this case is the timely treatment. Time is significantly important to both intracerebral heamorrhage and ischemic stroke,such as cerebral infarction. This patient received both Chinese herbal medicine and acupuncture treatment on the 7th days after stroke onset. Patient may acquire the best result if TCM treatment was applied within a few weeks after stroke onset. Both Chinese herbal medicine and acupuncture treatment should be applied, as long as the patients’ condition is stable, the sooner the better.

2. The reason why this patient suffered from stoke was that he did not take care of his hypertension, neither regular monitor nor regular treatments. This greatly increased the risk of stroke. He also has a family history of both hypertension and diabetics.

3. The combination of acupuncture and Chinese herbal medicine can incredibly improve the rehabilitation speed and result. However, detailed evaluation such as medical history and medication currently used shall be addressed before prescribing a formula in order to reducing the risk of the incompatible of patients’ conditions.

4. Patients with chronic diseases, it is recommended to maintain a healthy lifestyle. Stop smoking and healthy diet are also recommended.


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