Home > Health Topics > Stroke
 Definition | Causes | Symptoms | Diagnosis | Treatment | Prevention | References
   
Stroke : Treatment
   
Western Medicine
Chinese Medicine

Medications:

People who have suffered from a transient ischemic attack (TIA's), which is a warning of a possible major stroke, may be given anti-coagulant medications such as warfarin and aspirin to prevent clot formation. They will also be given anti-hypertensive medication to control their blood pressure if it is raised, and/or they may be given cholesterol-lowering medication and put on a low cholesterol, low fat diet to reduce their blood cholesterol level if it is elevated. If you have high blood sugar levels from diabetes these too, will need to be controlled either with glucose lowering medications or with insulin injections. If you smoke, you will be advised to stop immediately, and if you are overweight, you should be put on a calorie-controlled diet and given a moderate exercise program.


People who have recovered from a major stroke are usually put on aspirin to help prevent a second stroke.


Surgical Procedures:

If tests reveal blockages in the carotid arteries, these can be surgically removed by doing an operation called a carotid endarterectomy.


If it is suspected your symptoms are being caused by a hemorrhage and this is confirmed by a CT or MRI brain scan, you may be given emergency neurosurgery during which the surgeon locates the source of the hemorrhage and closes the bleeding site. However, this is only beneficial in some forms of hemorrhage (where the bleeding is quite slow and damage small). Often the brain damage has been done and the hemorrhage has already stopped from brain swelling by the time the hemorrhage causes clear enough symptoms to be diagnosed.


Other Interventions:
Once a stroke has occurred, treatment centers on preventing further damage and on helping the other parts of the brain take over the functions of the damaged section. Medications to dissolve clots and to protect neurons (brain and nerve cells) are being evaluated now, but it is not yet clear how useful they are.


Getting someone with a stroke to the hospital as quickly as possible does help him or her survive and recover from a stroke. A stroke should be considered a medical emergency. Rehabilitation-physiotherapy, occupational therapy, speech therapy should be started as soon as possible. People who receive good rehabilitation after a stroke can make an effective recovery, sometimes regaining almost all the function lost during the stroke.




 

Generally, for the acute phases of stroke affecting the meridians or organs, herbal decoctions or remedies are mainly be used for treatment. The use of acupuncture and moxibustion may also be used as additional therapy. During the recovery phase, stroke sequelae symptoms will be principally treated with acupuncture,(click here to see moxibustion techniques) and accompanied by some Chinese medicine. It is always best to seek the advice of a qualified Chinese medicine practitioner before undergoing such treatment, so they can form a correct diagnosis and monitor an individual's response to therapy. The following are some examples of prescriptions and acupuncture points that can be useful for treating stroke.

Strokes Involving the Meridians

Therapeutic aim: Expel wind evils, eliminate phlegm, enrich the blood and remove obstruction in the meridian channels.

Prescriptions for strokes involving the meridians

Acupuncture and Moxibustion:
Mainly acupuncture or moxibustion is applied along the Arm-Yangming and Leg-Yangming meridians. Acupuncture with purgation techniques are used.

Acupoints for hemiplegia(paralysis on one side of the body):
Jian Yu, Qu Chi, Shou San Li, Wai Guan, He Gu, Huan Tiao, Zu San Li, Yang Ling Quan, Feng Long, Jie Xi, Kun Lun, Tai Chong.

Additional acupoints for facial distortion such as a crooked mouth:
Di Cang, Jia Che, Qian Zheng, Feng Chi

Additional acupoints for dizziness and blurred vision:
Bai Hui, Feng Chi, Feng Fu, He Gu

Additional acupoints for difficulty with speech:
Lian Quan, Ya Men, Jin Jin, Yu Ye, Tong Li

Additional acupoints for contracted fingers:
Ba Xie, Hou Xi, San Jian, Da Ling.

Additional acupoints for numbness foot toes:
Tai Chong, Tai Xi, San Yin Jiao, Ba Feng

Additional acupoints for tinnitus (ringing of the ears) and irritable sleeping:
Shen Yu, Guan Yuan, Tai Xi, San Yin Jiao

Strokes Involving the Viscera (Organs)
   
1. Stroke of Bi-syndrome
Therapeutic aim: Restore consciousness, eliminate phlegm, suppress the hyperactive liver and dispel the wind evils.

(a). Treatment for yang Bi-syndrome of strokes
Therapeutic principle: clear liver-yang excess by eliminating wind-evils, extinguish the fire (or expel the evil heat influence), expel phlegm and restore consciousness.

Prescriptions for yang Bi-syndrome of strokes

Acupuncture and moxibustion:
Mainly the acupuncturist can apply acupressure, acupuncture or moxibustion to the twelve Well-points. (On each of the twelve meridians, there is one special point known as the well point, which makes up the twelve well points.) When using acupuncture it is best to prick with a three-edged needle to cause bleeding.

For unconscious persons:
Shi Xuan, Ren Zhong, twelve Well-point, He Gu, Lao Gong, Feng Long, Tai Chong, Xing Jian.

Additional acupoints for facial clenching:
Jia Che, xia Guan, He Gu

Additional acupoints for abundant expectoration:
Tian Tu, Feng Long, Yin Ling Quan, San Yin Jiao


(b). Treatment for yin Bi-syndrome of stroke
Therapeutic principle: restore consciousness by warming up the body, remove phlegm and arrest wind-evils.

Prescriptions for yin Bi-syndrome of strokes


Acupuncture and moxibustion:
It is best to use a filiform needle with mild reinforcing and attenuating acupuncture techniques.Use the same acupoints as for the yang Bi-syndrome of stroke, plus Zu San Li and San Yin Jiao.

2. Collapse Syndrome of Stroke
Therapeutic principle: Restore vital energy (qi) from collapsing and replenish the depleted yang.

Prescriptions for Collapse Syndrome of Stroke


Acupuncture and moxibustion:
Acupuncture is applied to the large collaterals of the Ren meridian, also known as the "Conception Vessel Meridian". A big moxa roll should be used with moxibustion along these collaterals.

Acupoints: Guan Yuan (monkshood moxibustion), Shen Que (Salt interposed moxibustion).

Stroke Sequelae
   
1. Hemiplegia
Therapeutic principle: Benefit qi by activating blood circulation and promote the flow of qi and blood in the meridians.

Prescriptions for Stroke Sequelae

Acupuncture and moxibustion:
The same acupoints along the Yangming meridians that used for Stroke Involving the Meridians are suggested for hemiplegia (paralysis on one side of the body).

Additional acupoints for individuals with qi deficiency: Dan Zhong, Zu San Li.

Additional acupoints for individuals with yang hyperactivity: Fen Chi, He Gu and Tai Chong.

Additional acupoints for individuals with yin deficiency: San Yin Jiao, Zhao Hai and Tai Xi.

2. Difficulty with speech
Therapeutic principle: Eliminate phlegm for resuscitation.

Prescription: Jieyu Decoction (See the treatment of Stroke Involving the Meridians)

Acupuncture and moxibustion: Use Lian Quan (triple puncture technique), Tong Li and Feng Long acupoints.

3. Facial Distortion such as Crooked Mouth
Therapeutic principle: Break up the evil wind and make the crooked mouth return normal.

Prescription: Qianzheng Powder (See the treatment of Stroke Involving the Meridians)

Acupuncture and moxibustion: Use Di Cang, Xia Guan, Jia Che, Feng Chi and He Gu acupoints.

4. Other Therapies
Scalp acupuncture: Select the part of the scalp that is opposite of the paralyzed part of the body. Use the acupuncture zones that correspond to the type of stroke injury i.e motion zone, zone for motion sensation of feet, and speech zone for the patients unable to speak.

Hydro-acupuncture therapy: Danshen injection, Chinese angelica (dang gui) injection, Safflower (hong hua) injection, Cerebrolysin injection, Citicoline (cytidine diphoshate Choline) injection and other injections of traditional Chinese medicines or Western medicines can be injected into the acupoints of Shou San Li and Zu San Li on the paralyzed part of the body.

Massage therapy: Relevant parts of the body are selected to have massage therapy in accordance with clinical symptoms.