Objective Sentinel headache（SH） refers to new-onset headache or existing headache with altered characteristics that occurs within seven days before stroke in patients， and this study aims to investigate the incidence rate and clinical features of SH in stroke patients and its association with prognosis. Methods A total of 145 stroke patients who were admitted to Department of Neurology， The First Affiliated Hospital of Xi’an Jiaotong University， from August 2022 to April 2023 were enrolled based on inclusion/exclusion criteria， and general information was collected. According to the presence or absence of SH， they were divided into headache and control group. The features of SH were summarized， and follow-up was performed after 1 year to analyze the association between SH and prognosis. Results Among the 145 patients with stroke，30（20.7%） developed SH， with the subtypes of intracerebral hemorrhage（9 patients， 25.7%）， cerebral infarction （15 patients，18.9%）， transient ischemic attack（3 patients，14.3%）， and subarachnoid hemorrhage （3 patients， 30.0%）. Conclusion SH may occur in all stroke patients， with a prevalence rate of 20.7%. The manifestations of SH include migraine-like headache， tension-type headache， and cluster-like headache. The results of this study do not establish an association between SH and 1-year prognosis in stroke patients，and further studies are needed in the future.
Stroke ; Prognosis

Objective To investigate the prognosis of patients with brain abscess and related influencing factors. Methods A retrospective analysis was conducted for the patients with brain abscess who were consecutively admitted to Department of Neurology， Xijing Hospital of Air Force Medical University， from January 2010 to March 2022， and according to the Glasgow Outcome Scale（GOS） score at discharge， the patients were divided into good prognosis group （GOS score>3 points） and poor prognosis group（GOS score≤3 points）. The t-test， the Wilcoxon rank-sum test， the chi-square test， and the Logistic regression analysis were used to investigate the influencing factors for prognosis. Results Among the 173 patients with brain abscess，69（39.9%） had a poor prognosis， and 104 （60.1%） had a good prognosis. There were significant differences between the two groups in age， headache， seizure， coma events， focal neurological deficits， dexamethasone treatment， and cerebellar abscess （P<0.05）.The multivariate logistic regression analysis showed that age （OR=0.042，95%CI 1.001‒1.041，P=0.042）， seizure（OR=2.881，95%CI 1.172‒7.083，P=0.021）， and coma events （OR=2.694， 95%CI 1.195‒6.072， P=0.017） were significant predictive factors for poor prognosis. Conclusion Age， seizure， and coma events are major factors associated with poor prognosis. Age is an uncontrollable factor， and therefore， timely prevention and management of seizure and coma events can reduce the incidence rate of poor prognosis.
Prognosis

OBJECTIVE: To explore the dose-effect relationship between the number of acupuncture sessions and the efficacy for cervical vertigo (CV). METHODS: Literature regarding randomized controlled trials (RCTs) of acupuncture for CV was retrieved from CNKI, Wanfang, VIP, Web of Science, and PubMed databases from inception to June 28th, 2024. Studies were included if patients were treated solely with acupuncture and the core prescription included Baihui (GV20)-Fengchi (GB20)-neck-jiaji (EX-B2). Outcomes included the evaluation scale for cervical vertigo symptoms and function (ESCV) score and the mean blood flow velocity of vertebrobasilar arteries. The Cochrane risk of bias assessment tool 2.0 was used to evaluate study quality. Dose-effect Meta-regression analysis was performed using the robust-error Meta-regression (REMR) method in Stata 17.0 software. RESULTS: Nineteen RCTs were included with a total of 747 patients in the experimental groups. After 10 sessions of acupuncture, the ESCV score increased to 20.29 (95% CI: 16.77, 23.80), with a pre-post ESCV difference of 4.60 (95% CI: 2.59, 6.60) and an improvement rate of 0.36 (95% CI: 0.26, 0.46). After 20 sessions of acupuncture, the ESCV score increased to 21.55 (95% CI: 18.87, 24.22), with a difference of 5.42 (95% CI: 3.87, 6.97) and an improvement rate of 0.39 (95% CI: 0.31, 0.48). After 10 sessions of acupuncture, the improvement rates for left vertebral artery (LVA), right vertebral artery (RVA), and basilar artery (BA) mean blood flow velocities were 0.08 (95% CI: 0.05, 0.12), 0.09 (95% CI: 0.05, 0.12), and 0.11 (95% CI: 0.06, 0.15), respectively. After 14 sessions of acupuncture, the improvement rates reached their peaks: LVA [0.09 (95% CI: 0.06, 0.12)], RVA [0.10 (95% CI: 0.07, 0.13)], and BA [0.12 (95% CI: 0.07, 0.16)]. CONCLUSION A nonlinear dose-effect relationship existed between the number of acupuncture sessions and the efficacy for CV. Fourteen sessions were recommended as the optimal number of acupuncture treatments.
Humans ; Acupuncture Therapy ; Randomized Controlled Trials as Topic ; Vertigo/physiopathology* ; Treatment Outcome ; Acupuncture Points ; Regression Analysis ; Male ; Female

OBJECTIVE: To compare the clinical efficacy of electroacupuncture (EA) at neuro-arterial stimulation points with topical western medication in treating post-stroke shoulder-hand syndrome (SHS). METHODS: A total of 72 patients with post-stroke SHS were randomly assigned to an observation group (n=36, 2 cases dropped out) and a control group (n=36, 3 cases dropped out). Both groups received standard neurological treatment, comprehensive rehabilitation, and physical therapy. The observation group received EA at neuro-arterial stimulation points, including the ipsilateral stellate ganglion point, vagus nerve trunk and auricular branch (left side), and stimulation points of the radial and ulnar arteries, radial nerve, ulnar nerve, and median nerve, once daily for 4 weeks. The control group was treated with topical diclofenac diethylamine emulgel, and mucopolysaccharide polysulfate cream was added for patients with pronounced early-stage edema, twice a day for 4 weeks. The VAS pain score and hand edema volume were recorded before treatment, at 2 and 4 weeks during treatment, and 2 weeks after treatment completion (follow-up). Musculoskeletal ultrasound was used to measure the thickness of the dorsal hand and middle finger skin on the affected side before and after 4 weeks of treatment. RESULTS: Compared before treatment, the VAS pain scores and edema volume of the affected hand in both groups were decreased at week 2, week 4, and follow-up (P<0.05). At week 4, both groups showed lower VAS pain scores and edema volume than those at week 2 (P<0.05); during follow-up, both VAS pain scores and edema volume were further reduced compared to those at week 4 (P<0.05). At week 2, week 4, and follow-up, the VAS scores and edema volume of the affected hand in the observation group were lower than those in the control group (P<0.05). Compared before treatment, the dorsal hand skin thickness and middle finger skin thickness on the affected side were decreased in both groups after 4 weeks of treatment (P<0.05). Compared with the control group, the observation group showed thinner dorsal hand and middle finger skin thickness after 4 weeks of treatment (P<0.05). CONCLUSION EA at neuro-arterial stimulation points effectively alleviates pain and edema in patients with post-stroke SHS, and demonstrates superior efficacy compared to topical western medication.
Humans ; Male ; Female ; Middle Aged ; Electroacupuncture ; Aged ; Stroke/complications* ; Acupuncture Points ; Adult ; Reflex Sympathetic Dystrophy/physiopathology* ; Treatment Outcome ; Hand

OBJECTIVE: To observe the clinical effect of Fu's subcutaneous needling based on anatomy train theory for nonspecific low back pain (NLBP). METHODS: A total of 120 patients with NLBP were randomized into an anatomy train Fu's subcutaneous needling group (40 cases, 3 cases dropped out), a conventional acupuncture group (40 cases, 2 cases dropped out) and a conventional Fu's subcutaneous needling group (40 cases, 2 cases dropped out). Acupuncture was applied at ashi points and bilateral Shenshu (BL23) and Dachangshu (BL25) in the conventional acupuncture group, once every other day, 3 times a week. Fu's subcutaneous needling was applied at lumbodorsal myofascial trigger points (MTrPs) in the Fu's subcutaneous needling group, once every 3 days, twice a week. On the basis of the treatment in the Fu's subcutaneous needling group, Fu's subcutaneous needling was applied at MTrPs along the posterior superficial line and lateral line in the anatomy train Fu's subcutaneous needling group, once every 3 days, twice a week. All groups were treated for 2 weeks. Before and after treatment, the scores of numeric rating scale (NRS) and Oswestry disability index (ODI) were observed, the distance of Schober test was measured and the endurance of trunk extensors was assessed in the 3 groups. RESULTS: After treatment, in the 3 groups, the NRS and ODI scores were decreased compared with those before treatment (P<0.05), the Schober test distance was increased compared with that before treatment (P<0.05), the static and dynamic muscle endurance was increased compared with that before treatment (P<0.05). After treatment, in the anatomy train Fu's subcutaneous needling group, the NRS and ODI scores were lower than those in the conventional acupuncture group and the conventional Fu's subcutaneous needling group (P<0.05), the Schober test distance was longer than that in the conventional acupuncture group and the conventional Fu's subcutaneous needling group (P<0.05), the static and dynamic muscle endurance was superior to that in the conventional acupuncture group and the conventional Fu's subcutaneous needling group (P<0.05). CONCLUSION Fu's subcutaneous needling based on anatomy train theory can effectively relieve the pain symptom, enhance quality of life, improve lumbar motion and lumbar muscle function in patients with NLBP.
Humans ; Low Back Pain/physiopathology* ; Female ; Male ; Adult ; Acupuncture Therapy/methods* ; Middle Aged ; Acupuncture Points ; Young Adult ; Treatment Outcome ; Aged

OBJECTIVE: To observe the clinical effect of Jin's three-needle therapy combined with game therapy on children with autism spectrum disorder (ASD). METHODS: Sixty children with ASD were randomly divided into an observation group and a control group, with 30 cases in each. The children in the observation group received Jin's three-needle therapy combined with game therapy. The acupoints used in Jin's three-needle therapy included Zhisanzhen, Niesanzhen, Sishenzhen and Naosanzhen, and matches acupoints with syndromes. The acupoints included Shenting (GV24), Naohu (GV17) and bilateral Benshen (GB13), Naokong (GB19), Xinshu (BL15), Zusanli (ST36), etc. The needles were retained for 1 h for scalp acupuncture and not retained for body acupuncture. Game therapy included social interaction, music and dance, language stimulation, etc. The children in the control group were treated with the same game therapy in the observation group. Treatments were administered once daily, five times a week, with a three-month course considered as one treatment cycle, and a total of two cycles were provided. The scores of childhood autism rating scale (CARS), autism behavior scale (ABC) and 0-6-year-old Children's neuropsychological development assessment scale (children's psychological scale) were compared between the two groups before treatment and after 3 and 6 months of treatment. RESULTS: After 3 and 6 months of treatment, the CARS and ABC scores of both groups were lower than those before treatment (P<0.01). After 6 months of treatment, the CARS and ABC scores of the observation group were lower than those of the control group (P<0.05). After 3 and 6 months of treatment, the scores of gross motor, fine motor, adaptive ability, language, and social behaviors in both groups were higher than those before treatment (P<0.01). After 3 months of treatment, the observation group showed a greater improvement in gross motor, fine motor, adaptive ability, and social behaviors compared to the control group (P<0.05). After 6 months of treatment, the observation group showed a greater improvement in gross motor, fine motor, adaptive ability, language, and social behaviors compared to the control group (P<0.01, P<0.05). CONCLUSION Jin's three-needle therapy combined with game therapy is an effective method for the treatment of ASD, which shows more obvious advantages than simple game therapy in promoting the improvement of children's ability and reducing related behavior.
Humans ; Autism Spectrum Disorder/psychology* ; Male ; Acupuncture Therapy/instrumentation* ; Female ; Child ; Child, Preschool ; Acupuncture Points ; Treatment Outcome ; Play Therapy ; Combined Modality Therapy

OBJECTIVE: To observe the efficacy and safety of Tiaowei Jiannao acupuncture (acupuncture for regulating defensive qi and nourishing brain) for post-ischemic stroke insomnia (PISI). METHODS: A total of 96 patients with PISI were randomized into an acupuncture group (32 cases, 1 case was excluded), a medication group (32 cases, 1 case dropped out, 1 case was excluded) and a sham-acupuncture group (32 cases, 1 case dropped out, 1 case was excluded). In the acupuncture group, Tiaowei Jiannao acupuncture was applied at bilateral Shenmai (BL62), Zhaohai (KI6), Hegu (LI4), Taichong (LR3), and Baihui (GV20), Sishencong (EX-HN1), Yintang (GV24⁺), Shenting (GV24), once a day, 1-day interval was taken after 6-day treatment, for 3 weeks totally. In the medication group, eszopiclone tablet was given orally, 1-3 mg a time, once a day for 3 weeks. In the sham-acupuncture group, non-invasive sham acupuncture was applied, the acupoint selection, frequency and course of treatment were the same as the acupuncture group. Before treatment, after 2,3 weeks of treatment, the scores of Pittsburgh sleep quality index (PSQI), self-rating sleep scale (SRSS), National Institutes of Health Stroke scale (NIHSS), Hamilton depression scale-17 (HAMD-17) were observed; before and after treatment, the sleep parameters were recorded using polysomnography (PSG); and the efficacy and safety were evaluated after treatment in the 3 groups. RESULTS: After 2,3 weeks of treatment, the scores of PSQI, HAMD-17 and SRSS in the acupuncture group and the medication group, as well as the SRSS scores in the sham-acupuncture group were decreased compared with those before treatment (P<0.05); after 2 weeks of treatment, the NIHSS score in the acupuncture group was decreased compared with that before treatment (P<0.05); after 3 weeks of treatment, the NIHSS scores in the acupuncture group, the medication group and the sham-acupuncture group were decreased compared with those before treatment (P<0.05). After 3 weeks of treatment, the scores of PSQI, SRSS, HAMD-17 and NIHSS in the acupuncture group and the medication group, as well as the NIHSS score in the sham-acupuncture group were decreased compared with those after 2 weeks of treatment (P<0.05). After 2,3 weeks of treatment, the scores of PSQI, SRSS and HAMD-17 in the acupuncture group and the medication group were lower than those in the sham-acupuncture group (P<0.05), the NIHSS scores in the acupuncture group were lower than those in the medication group and the sham-acupuncture group (P<0.05); after 3 weeks of treatment, HAMD-17 score in the acupuncture group was lower than that in the medication group (P<0.05), the NIHSS score in the medication group was lower than that in the sham-acupuncture group (P<0.05). Compared before treatment, after treatment, the total sleep time was prolonged (P<0.05), the wake after sleep onset, sleep latency, and non-rapid eye movement (NREM) sleep latency were shortened (P<0.05), the sleep efficiency was improved (P<0.05), the number of awakenings was reduced (P<0.05), the percentage of rapid eye movement (REM%) and the percentage of NREM stage 1 (N1%) were decreased (P<0.05), the percentage of NREM stage 2 (N2%) and the percentage of NREM stage 3 (N3%) were increased (P<0.05) in the acupuncture group and the medication group; the sleep latency was shortened in the sham-acupuncture group (P<0.05). After treatment, the PSG indexes in the acupuncture group and the medication group were superior to those in the sham-acupuncture group (P<0.05); in the acupuncture group, the number of awakenings was less than that in the medication group (P<0.05), the REM% and N1% were lower than those in the medication group (P<0.05), the N2% and N3% were higher than those in the medication group (P<0.05). The total effective rate were 93.5% (29/31) and 90.0% (27/30) in the acupuncture group and the medication group respectively, which were higher than 10.0% (3/30) in the sham-acupuncture group (P<0.05). There was no serious adverse events in any of the 3 groups. CONCLUSION Tiaowei Jiannao acupuncture improves the insomnia symptoms in patients with ischemic stroke, improves the quality of sleep, increases the deep sleep, promotes the recovery of neurological function, and relieves the depression. It is effective and safe for the treatment of PISI.
Humans ; Acupuncture Therapy ; Male ; Sleep Initiation and Maintenance Disorders/physiopathology* ; Female ; Middle Aged ; Aged ; Acupuncture Points ; Treatment Outcome ; Adult ; Ischemic Stroke/complications* ; Stroke/complications* ; Sleep

OBJECTIVE: To observe the clinical efficacy of wrist-ankle acupuncture in the treatment of functional frequent premature ventricular contractions (PVCs). METHODS: A total of 64 patients with functional frequent PVCs were randomly divided into an observation group and a control group, 32 cases in each group. The observation group was treated with wrist-ankle acupuncture at bilateral upper 1 and upper 2 on the wrist. The control group received sham acupuncture at the same points as the observation group. Both groups were treated once every day from Monday to Friday, with the needles retained for 60 min each time, for a total of 4 weeks. The TCM syndrome score, the 24-hour PVC count, and MOS 36-item short form health survey (SF-36) score were compared between the two groups before and after treatment, and the clinical efficacy was evaluated after treatment. RESULTS: After treatment, the TCM syndrome scores and the 24-hour PVC counts in both groups were reduced compared with those before treatment (P<0.01), and the above indexes in the observation group were lower than those in the control group (P<0.01). After treatment，scores of all SF-36 items in the observation group were increased compared with those before treatment (P<0.01); in the control group, the scores of general health (GH), social function (SF) and role-emotional (RE) were increased compared with those before treatment (P<0.05). After treatment, scores of all SF-36 items in the observation group were higher than those in the control group (P<0.01). The total effective rate in the observation group was 90.6% (29/32), which was higher than 46.9% (15/32) in the control group (P<0.01). CONCLUSION Wrist-ankle acupuncture has a significant clinical efficacy in the treatment of functional frequent PVCs. It can effectively improve symptoms such as chest tightness and palpitations, reduce 24-hour PVC count, and improve patients' quality of life.
Humans ; Acupuncture Therapy ; Male ; Female ; Middle Aged ; Adult ; Ventricular Premature Complexes/physiopathology* ; Ankle/physiopathology* ; Wrist/physiopathology* ; Acupuncture Points ; Treatment Outcome ; Aged ; Young Adult

A case of Meige syndrome treated by acupuncture was reported. The main symptoms of this patient were involuntary and persistent twitching of muscles around the eyes, lips and jaws. The syndrome belongs to hyperactivity of liver yang. The treatment is dispelling wind and dredging collaterals, soothing liver and relieving spasm. Acupuncture treatment was given at bilateral Dadun (LR1), Sanjian (LI3), Shaoshang (LU11), Zulinqi (GB41), Yuyao (EX-HN4), Sibai (ST2), Jiachengjiang (Extra), Fengchi (GB20), Yifeng (TE17), once every other day. After 10 times of treatment, the twitching frequency of facial muscles decreased significantly, and basically did not twitch without emotional fluctuations; the acupuncture treatment was changed to once a week, and the consolidation treatment was 4 times. After 1 month of follow-up, there was no twitching of facial muscles.
Humans ; Acupuncture Points ; Acupuncture Therapy ; Meige Syndrome/physiopathology* ; Treatment Outcome

OBJECTIVE: To compare the clinical efficacy between thermo-electroacupuncture at yaosanzhen and oral celecoxib in the treatment of chronic lumbar muscle strain with cold dampness. METHODS: A total of 80 patients with chronic lumbar muscle strain of cold dampness were randomly divided into an observation group (40 cases, 1 case dropped out) and a control group (40 cases, 2 cases were excluded). The observation group was treated with thermo-electroacupuncture at yaosanzhen (bilateral Shenshu [BL23], Dachangshu [BL25], Weizhong [BL40]), disperse-dense wave was selected, with a pulse cycle of 0.08 s, current intensity of 1-3 mA, with needles heated to approximately 45 ℃, the duration was 25 min per session, once a day. The control group was given oral celecoxib capsules, once daily, 200 mg each time. Six sessions as one course, with a 1-day interval between courses, 2 courses were required in both groups. The TCM syndrome score, visual analogue scale (VAS) score, Oswestry disability index (ODI) score, and Japanese Orthopedic Association (JOA) score before and after treatment in both groups were compared. The serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), thromboxane B2 (TXB2) and C-reactive protein (CRP) were detected using ELISA method before and after treatment in both groups. The clinical efficacy was evaluated in both groups after treatment. RESULTS: After treatment, the TCM syndrome scores, VAS scores, ODI scores and serum levels of TNF-α, IL-6, TXB2, CRP in both groups were reduced compared with those before treatment (P<0.01), while the JOA scores were increased (P<0.01)；the TCM syndrome score, VAS score, ODI score and serum levels of TNF-α, IL-6, TXB2, CRP in the observation group were lower than those in the control group (P<0.01, P<0.05), and the JOA score was higher than that in the control group (P<0.01). The total effective rate of the observation group was 92.3% (36/39), which was superior to 78.9% (30/38) in the control group (P<0.05). CONCLUSION Thermo-electroacupuncture at yaosanzhen can alleviate pain symptom in patients with chronic lumbar muscle strain of cold dampness, regulate lumbar function, reduce the levels of inflammatory factors, and the therapeutic effect is superior to oral celecoxib.
Humans ; Male ; Female ; Middle Aged ; Adult ; Electroacupuncture ; Acupuncture Points ; Sprains and Strains/genetics* ; Cold Temperature ; Tumor Necrosis Factor-alpha/blood* ; Interleukin-6/blood* ; Aged ; Treatment Outcome ; Young Adult ; C-Reactive Protein/metabolism* ; Chronic Disease/therapy* ; Lumbosacral Region/physiopathology*