Articles

Stroke

Related Health Condition

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Introduction

Cerebral apoplexy is manifested through the following symptoms: sudden coma, loss of consciousness, semi paralysis, hemianesthesia, speech difficulty or aphasia, or hemiplegia and crooked mouth and tongue in the absence coma. After apoplexy attacks, symptoms such as hemiplegia, aphasia, dementia, epileptic attacks, etc. are termed as apoplectic sequelae and attributed to the category of Pian Ku, Wei Zhen (flaccidity syndrome), Phlegm-syndrome, and blood-stasis-syndrome in traditional Chinese medicine.

Etiology/Pathogenesis

Apoplexy attacks are closely related to pathogenic wind, fire, phlegm, qi and blood, and particularly to liver-wind. Weak constitution due to old age, insufficiency of qi and blood, qi disorder, blood yin and yang and additional excessive grief, anger, improper diet, and lack of proper care during abrupt changes of weather and overwork can cause deficiency in both the liver-yin and kidney-yin, sudden hyperactivity of the liver-yang, yang transformation and wind stirring up, and derangement of qi and blood. Consequently, the qi and blood invade the brain or leave the blood vessels to injure the cerebral marrow. As a result, tongue stiffness, slurred speech, hemiplegia, unconsciousness, etc. can appear.

Primary Treatments with Chinese Medicinal Herbs

Bu Yang Huan Wu

It is reported that 45 cases of apoplectic sequelae were treated with a modified Bu Yang Huan Wu decoction. The formula constituted of the following single herbs: Huang Qi (Astragalus Root), Chi Shao (Peony Red), Tao Ren (Persica), Hong Hua (Carthamus), Dang Gui (Chinese Angelica Root), Di Long (Earthworm), and Chuan Xiong (Cnidium). The formula was modified according to each individual's symptoms. These ingredients were decocted in water, and taken one dose a day, divided into 3 parts for oral administration. One month of treatment constituted one therapeutic course. The results show that 6 cases were mainly resolved, 24 cases showed remarkable improvement, 11 cases improved, and the last 4 cases showed no effectiveness. The total effectiveness rate was 91.1%. (1)

Other Treatments with Chinese Medicinal Herbs

Deng Zhan Hua (Herba Erigerontis) Su

In another report, 32 cases of apoplectic sequelae were treated with a Deng Zhan Hua (Herba Erigerontis) Su tablet. The formula was processed with the effective components of Deng Zan Xi Xin. This was taken as 120 g 3 times a day. At the same time, Bu Yang Huan Wu Tang was also used. 14 days comprised one course of treatment. The results showed that 5 cases had remarkable improvement, 23 cases had improved, and 4 cases had no effectiveness. The total effectiveness rate is 87.5%. (2)

Piantan Kangfu powder

In treatment of 300 cases of apoplectic sequelae with Piantan Kangfu powder, the formula consisted of Yin Xing Ye (Folium Ginko), Luo Shi Teng (Chinese Starjasmine), Huang Qi (Astragalus Root), Dang Gui (Chinese Angelica Root), Sang Zhi (Mulberry Twig), Shui Zhi (Hirudo), Da Huang (Rhubarb), Ma Qian Zi (prepared Nut-vomitive Poisonnut Seed), Chuan Shan Jia (Anteater Scales), Bai Hua She She Cao (Oldenlandia), and Qing Pi (Blue Citrus). The total effectiveness rate was 94%. (3)

Dang Gui Si Ni

36 cases of apoplectic sequelae were treated with a modified Dang Gui Si Ni decoction. The formula consisted of Dang Gui (Chinese Angelica Root), Bai Shao (White Peony Root), Ma Huang (Ma-Huang), Chuan Xiong (Cnidium), Gui Zhi (Cinnamon Twig), Xi Xin (Wild Ginger), Fu Pian (sliced prepared Aconite), Gan Cao (Licorice), and Da Zao (Ziziphus). The formula was modified according to the individuals' symptoms. The formula was decocted in water, and taken orally once a day. The results showed that 14 cases were resolved, 18 had improved, and 4 had no effectiveness. The effectiveness rate was 89%. (4)

Yu Feng

49 cases of apoplectic sequelae were treated with a Yu Feng decoction. The formula consisted of Huang Qi (Astragalus Root), Dan Shen (Salvia), Dang Gui (Chinese Angelica Root), Niu Xi (Achyranthes), Chuan Xiong (Chuan Xiong), Tao Ren (Persica), Chi Shao (Peony Red), Mu Dan Pi (Moutan), Hong Hua (Carthamus), Xue Jie (Draconis), Di Long (Earthworm), Ji Xue Teng (Milettia), and Ze Lan (Lycopus). These herbs were decocted in water, and taken orally one dose a day divided into 6-8 administrations. 15 days constituted one course of treatment. The results showed that 18 cases were resolved, 23 had remarkable improvement, 6 had some improvement, and 2 had no effectiveness. (5)

Sheng's Stroke Formula

Chen Yong Sheng treated 36 cases of apoplectic sequelae on the basis of syndrome differentiation. For the type of qi-stagnation and blood stasis, the herbs used include Huang Qi (Astragalus Root), Chi Shao (Peony Red), Tao Ren (Persica), Dang Gui (Chinese Angelica Root), Chuan Xiong (Cnidium), Hong Hua (Carthamus), Di Long (Earthworm), and Tu Bie Chong (Ground Beetle). For wind-phlegm blocking meridians, the herbs used were Qin Jiu (Gentiana), Chuan Xiong (Cnidium), Fu Ling (Poria), Bai Zhu (White Atractylodes), Dang Gui (Chinese Angelica Root), Bai Shao (White Peony), and Sheng Di (dried Rehmannia). For food retention in the interior, the herbs administered were Da Huang (Rhubarb), Ze Xie (Alisma), Bo He (Mentha), Huang Qin (Scutellaria), Zhi Shi (Immature Bitter Orange), Fu Ling (Poria), Bai Zhu (Atractylode), Shi Chang Pu (Grassleaved Sweetflag Rhizome), Huang Lian (Coptis), and Sheng Jiang (Ginger) juice. For deficiency of the liver-yin and kidney-yin, the herbs used were Shou Di Huang (prepared Rehmannia), Ji Xue Teng (Milettia), Ba Ji Tian (Morinda), Shan Yu Rou (Cornus), Mai Dong (Ophiopogon Root), Rou Cong Rong (Cistanche), Shi Chang Pu (Grassleaved Sweetflag Rhizome), Dang Gui (Chinese Angelica Root), Shi Hu (Dendrobium), Rou Gui (Cinnamon Bark), Yuan Zhi (Polygala Root), and Fu Zi (Aconite). The mentioned ingredient groups were separately decocted in water, and administered once a day. After 2-6 months of treatment, 14 cases were resolved, 13 showed significant improvement, 5 had some improvement, and 4 showed no noticeable changes. The total effectiveness rate was 88.8%. (6)

Other Treatments

In a study, 62 cases of apoplectic sequelae were treated with magnetic field radiation of acupoints (treatment group) and electroacupuncture therapy (control group). The results revealed that the total effectiveness rates of the treatment and the control groups were 93.55% and 70.9% respectively. The therapeutic effect of former group was significantly superior to that of the latter (P < 0.05). (7)

References

  1. Dong Jia Fen. Treating 45 cases of apoplectic sequelae with modified Bu Yang Huan Wu Tang. Sichuan Journal of TCM. 1998;16(12):27.
  2. Zhang Pin Ya. Clinical analysis of treating 32 cases of apoplectic sequelae with Deng Zhan Hua (Herba Erigerontis) Su Tablet. Journal of Chinese Patented Medicine. 1998;20(1):26-27.
  3. Dang Yu Wen, et al. Treating 300 cases of apoplectic sequelae with Pian Tan Kang Fu Powder. Northwestern Journal of Pharmacy. 2000;15(3):131.
  4. Zhen Jun Shan, et al. Treating 36 cases of apoplectic sequelae with modified Dang Gui Si Ni Tang. National Journal of Medicine Forum. 1999;14(2):11.
  5. He Guang Xiang, et al. Treating 49 cases of apoplectic sequelae with Yu Feng Tang. Journal of Applied Internal Medicine in TCM. 1998;12(1):34.
  6. Chen Yong Sheng. Therapeutic observation on treating 36 cases of apoplectic sequelae with differential analysis. Jilin Journal of TCM. 1996;(2):10.
  7. Lian Han Jian, et al. Clinical observation on treating apoplectic sequelae with magnetic field radiation of acupoints. Shanghai Journal of Acupuncture. 2000;19(1):18-19.