Integrating Traditional Chinese and Western Medicine to Prevent and Treat Cerebral Stroke

Stroke is the name of traditional Chinese medicine, and it is called stroke or cerebrovascular accident in western medicine. This is a cerebrovascular disease characterized by acute onset and rapid onset of localized or diffuse brain function damage. It is characterized by high morbidity, high disability and high mortality. The moment of the attack, a person loses all dignity: the mouth is crooked, the eyes are slanted, the limbs are numb, and even paralyzed… The “Iron Lady” Margaret Thatcher, Stalin, Roosevelt, and Churchill all died because of it. This is a stroke. “Death or disability” is the most terrifying feature of stroke. After the onset, about 75% of survivors have varying degrees of disability, of which 40% are severely disabled, which brings great pain and trouble to patients and their families. According to Huang Yanmei, the nurse in charge of the Xianhu Campus of the First Affiliated Hospital of Guangxi University of Chinese Medicine, traditional Chinese medicine believes that stroke is caused by weak righteousness, liver and kidney yin deficiency, qi stagnation and blood stasis, phlegm blocking the collaterals, etc. The main manifestations are hemiplegia, Wrong mouth and tongue, difficulty speaking, numbness of limbs, cyanosis, nausea and vomiting, coma, etc.

Stroke Treatment

1. Antiplatelet therapy: Commonly used drugs include aspirin and clopidogrel. Patients with ischemic stroke who have not received thrombolytic therapy should take preventive drug treatment as soon as possible within 48 hours, and should be given 150~325 mg daily. Antithrombotic drug treatment can be selected after 2 weeks. Generally, antiplatelet treatment cannot be performed within 24 hours of thrombolytic treatment to avoid increasing the risk of cerebral hemorrhage.

2. Anticoagulant therapy Commonly used drugs include heparin, low molecular weight heparin and warfarin. High-risk patients with stroke complicated by hypercoagulable state, pulmonary embolism, and deep vein thrombosis can be prevented with anticoagulant therapy.

3. Intravenous thrombolytic treatment Suitable conditions: ischemic stroke; age 18-80 years old; onset to thrombolysis <4.5 hours. Commonly used thrombolytic drugs include urokinase, recombinant tissue plasminogen activator, etc.

4. Arterial thrombolysis treatment: Suitable conditions: the time from onset to thrombolysis is <6 hours. For patients with vertebral-basilar artery thrombosis, the thrombolysis time window can be appropriately extended to 24 hours. For patients with stroke caused by severe occlusion of the middle cerebral artery, etc., it is necessary to carefully evaluate whether intra-arterial thrombolytic therapy can be selected. Commonly used drugs are roughly the same as intravenous thrombolytic drugs, and thrombolytic therapy needs to be performed under DSA monitoring.

5. Treatment with traditional Chinese medicine. Traditional Chinese medicine believes that this disease is caused by the deficiency of the five internal organs and excessive yin and yang, which leads to the disorder of qi and blood, carrying phlegm across the meridians, or affecting the brain vessels and straining the divine vessels. The treatment is based on the principles of clearing away heat and purging fire, calming the liver and extinguishing wind, resolving phlegm and blood stasis, and dredging the meridians. Commonly used drugs include Salvia miltiorrhiza, Ligusticum chuanxiong, Panax notoginseng and Pueraria lobata, etc., which can improve stroke symptoms by promoting blood circulation and removing blood stasis.

The overall treatment principle is to stay in bed quietly, reduce intracranial pressure, appropriately adjust blood pressure, actively prevent recurrence, strengthen nursing, and reduce mortality and disability rates.

Tertiary prevention of stroke

Primary prevention refers to intervention that targets high-risk factors for stroke, with the main purpose of reducing the incidence of stroke. The method is to conduct regular physical examinations to detect potential risk factors early. At the same time, it is necessary to change unhealthy eating habits and insist on physical exercise. It has been proven that smoking bans, salt restriction, eating more fresh fruits and vegetables, regular physical exercise, controlling excess weight, and avoiding excessive drinking can reduce the risk of stroke. Additionally, pharmacological treatment of diabetes, hypertension, and hyperlipidemia is needed to reduce the incidence of cardiovascular disease and stroke.

Secondary prevention refers to the early treatment and rehabilitation of patients after a stroke occurs to prevent the condition from worsening and prevent disability and dysfunction. Five commonly used antihypertensive drugs can be used for secondary prevention of stroke.

Tertiary prevention refers to actively carrying out functional rehabilitation exercises for the disability caused by stroke, and at the same time preventing the recurrence of stroke. The main contents include rehabilitation, medical treatment, training guidance, psychological counseling, knowledge popularization, etc., in order to restore the patients’ damaged functions as soon as possible and enhance their ability to participate in social life.

health guidance

1. Living environment The living environment should be quiet and clean, and avoid noise, strong light and other adverse stimuli. Keep the stool smooth and develop the habit of regular bowel movements. Carry out active activity training in bed as early as possible, including turning over, moving on the bed, sitting up on the side of the bed, bridge exercises, etc. If the patient cannot do active activities, passive activity training of each joint should be carried out as soon as possible. Provide basic care to meet patients’ daily needs.

2. Dietary guidance: For patients who are comatose or have difficulty swallowing, fasting or nasal feeding should be given according to the specific condition to supplement sufficient water and nutritious liquids, such as rice soup, mixed milk, etc. Avoid fat, sweet, thick, and damp-stimulating foods. A diet of fire.

3. Emotional care: Medical staff and patients’ family members should communicate more with patients and provide timely psychological counseling. To help patients eliminate fear, anxiety, pessimism and other emotions, release and catharsis methods can be used to allow patients to release their anxiety and pain. Encourage patients to communicate with each other about their treatment experiences, improve their cognition and enhance their confidence in treatment. Relatives and friends should visit more often, stay with the patient more, and provide more emotional support. Set reasonable expectations for patients to avoid depression due to excessive expectations and unmet expectations.