Acupuncture is effective for treating intracerebral hemorrhage. An intracerebral hemorrhage is a type of stroke wherein a hematoma is formed within the brain. Researchers from the hospital affiliated with the Nanjing University of Traditional Chinese Medicine conducted a clinical trial comparing usual care to the combined therapy of usual care plus electroacupuncture. The results indicate that the integrated protocol using acupuncture increases nerve efficiency and mental clarity while lowering serum-AQP4. Research indicates early stages of cytotoxic edema may be ameliorated by AQP4 inhibition.
Observational indicators used in the study included the modified Barthel index (MBI), a mini-mental-state examination (MMSE), and the levels of serum-AQP4. After treatment, MBI in the integrated group improved markedly from 28.75 ±5.08 to 69.84 ±4.66. MMSE increased from 26.62 ±6.48 to 46.03 ±4.73. As for serum-AQP4 levels, the integrated group presented a more significant decline from 0.359 ±0.011 to 0.037 ±0.011. The change was smaller in the control group, decreasing to 0.173 ±0.0201.
A total of 72 cases were recruited to partake in the study. They were randomized into a combined therapy group and a routine group, with 36 patients in each group. In the integrated group, four cases dropped out. The remaining group consisted of 24 male patients and 8 female patients. The ages ranged from 39–70 years. The mean age was 57 ±10 years. Course of condition was 1–4 days. The average course of condition was one day. In the control group, 24 patients were male and 10 were female. The ages ranged from 45–70 years. The mean age was 60 ±8 years. The course of condition was the same as in the electroacupuncture integrated group.
Patients’ computed tomography (CT) scans and magnetic resonance imaging (MRI) confirmed ICH. All patients were first-time onset, and the course of condition was within two weeks. Volume of hemorrhage was less than 9 ml. Expectant treatment for ICH was performed. According to the National Institute of Health stroke scale (NIHSS), patients' scores were below 15 points.
The control group received standard two-week routine care, including hemostasis, blood pressure management, hemostasis and intracranial pressure reduction, oxygen inhalation, bed rest, and water-electrolyte balance restoration. In addition to the same standard two-week routine care, the integrated treatment group was given electroacupuncture at the following points:
- GV26 (Shuigou)
- PC6 (Neiguan)
- SP6 (Sanyinjiao)
- HT1 (Jiquan)
- BL40 (Weizhong)
- LU5 (Chize)
Patients took a supine position, and 0.30 × 40 mm needles were sterilized and applied. For Shuigou, needles were obliquely inserted to a depth of 10–15 mm. For Neiguan and Weizhong, needles were perpendicularly inserted to a depth of 25–30 mm. For Chize, needles were perpendicularly inserted to a depth of 10–15 mm. For Sanyinjiao, needles were inserted to a depth of 25–30 mm, forming a 45 degree angle towards the inner shinbone. For Jiquan, patients extended the upper limbs to expose the armpits. Needles were perpendicularly inserted to a depth of 25–35 mm. Local arteries were avoided. A numbing sensation or local distending sensation were some of the sensations documented as the arrival of deqi at the acupoints.
For Sanyinjiao and Weizhong, a reinforcing manipulation method was used. For Jiquan and Chize, a twisting and attenuating method was used. The remaining points all received mild reinforcing and attenuating manipulation.
Upon obtaining a deqi sensation, an electroacupuncture device was connected to the needle ends. Neiguan was linked to the negative electrodes and Sanyinjiao was linked to the positive electrodes. A disperse-dense wave was applied at 2 Hz/100 Hz. The intensity was adjusted based on patients’ tolerance level. Needle retention time was 30 minutes. The procedure was conducted on a daily basis for six consecutive days, followed by a one day interval before the next week of treatment. Treatment was administered for two weeks in total. The integrated treatment approaching, adding acupuncture to the therapeutic regimen, produced greater patient outcomes.
Reference:
Ni Siming, Lu Hequn, Xu Shuying, Peng Yongju. Effect of electroacupuncture on efficacy and serum AQP4 content in patients with acute cerebral hemorrhage. Department of Acupuncture and Rehabilitation, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, R246.2. 2023-07-20.
