Stroke, Heart Attack, Atherosclerosis and DVT

Paul L. Reller L.Ac. / Last Updated: August 03, 2017


Additional Information and information resources

NOTA: Important Considerations in Cardiovascular Care and the Need for Change

  1. A July 31, 2010 article in the New York Times outlines recent findings of the dangers of CT or CAT scans commonly used to evaluate the patients with strokes. This is an ongoing series in the New York Times that explores the dangers and harm from excess routine radiation in radiology tests in the U.S. that was initiated after the 2009 President's Council on Cancer found that radiology radiation was now a very significant cause of cancer in the U.S. Other methods of evaluation with advanced MRI pose no threat of harm or risk of cancer:
  2. A 2004 study by the UCLA Stroke Center, in Los Angeles, California, U.S.A. concluded that "MRI may be as accurate as CT for the detection of acute hemorrhage in patients presenting with acute focal stroke symptoms and is more accurate than CT for the detection of chronic intracerebral hemorrhage". Newer technology with MRI, such as diffusion-weighted MRI (DWI), and advancement in software technology that has drastically reduced the cost of advanced MRI, as well as allowed for patient movement during the testing, has also changed the evaluation. The accumulative radiation in patient history has become a cancer concern yet is still rarely evaluated as well. All of this information suggests that clearly MRI, with no adverse health effects or cancer risk, should be the standard of care. Unfortunately, the use of CT still has not been curtailed, and these recommendations were largely ignored. Several small studies have compared MRI to CT, but have conveniently been designed to largely ignore the question of risk or adverse effects:
  3. A 2013 ruling by U.S. Medicare finally ends the rule of thumb invented in the 1990s that stated that when a patient is considered to be "plateaued" or not progressing, as is frequently seen with stroke patients, that rehabilitative care can no longer be denied. A large percentage of patients with serious debility after a serious stroke were termed plateaued after just a few weeks and provided only minimal nursing care, not rehabilitation. This system was indeed cruel for patients that often could not even speak:
  4. A 2005 report from the American Stroke Association starts out noting that 40 percent of stroke patients are left with moderate functional impairments and another 30 percent with severe disability! Stroke has become the leading cause of disability in the United States, and insurance and government programs have strongly denied conservative care in rehab, including the integration of Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) with its many safe and inexpensive therapeutic protocols. These experts from the Veterans Affairs note that "a growing body of evidence indicates that patients do better with a well-organized multidisciplinary approach to post-acute rehabilitation after a stroke":

Cardiovascular care and prevention is perhaps the most important consideration today for the population, and an enormous amount of evidence is accumulating to support the array of therapies offered together in TCM clinical care, where short courses of acupuncture and physiotherapy are combined with more prolonged use of herbal and nutrient medicine, along with sound individualized advice in diet and lifestyle habits. Much evidence is accumulating to help guide the modern herbalist in the best course of therapy for the patient with cardiovascular risk. For example, use of a double boil water extract of Dang gui, Astragalus, Rhodiola and American Ginseng has been proven highly beneficial, as has the alcohol extract of European olive leaf, Gingko biloba, Gotu Kola and Siberian Ginseng. Red Rice Yeast extract and sytrinol and tocotrienols are also supported by much research to improve cholesterol and lipid metabolism. These are just samples from the growing menu of treatment protocols that are now evidence-based for cardiovascular care in CIM/TCM. Below are many more examples, but still just a fraction of the scientific study.

  1. In 2013, finally, a large cohort study of 44,561 men and women investigated the effects of a healthy diet on cardiovascular risk. This study, conducted by the University of Oxford, United Kingdom, and part of the large European Prospective Investigation into Cancer and Nutrition (EPIC), found that a predominantly vegetarian diet reduced cardiovascular risk of ischemic heart disease by 34 percent, with significantly lowered non-HDL cholesterol, BMI, and systolic blood pressure. Such evidence points to the importance of improving the overall health holistically to counter cardiovascular disease, not just medicating to blood cholesterol production and high blood pressure. If herbal medicine, acupuncture, lifestyle changes, and nutrient medicine are added to this holistic protocol, the reduction of cardiovascular risk, and incidence of stroke, heart attack, peripheral vascular disease, and cardiac death, could perhaps be cut in half:
  2. In 2002, the American Heart Association (AHA) journal Circulation released the findings concerning diet and sugar consumption and cardiovascular disease. While large studies do not find a demographic link between sugar consumption overall and ischemic heart disease, many studies have found increased risk for overall cardiovascular disease and stroke, and patients with a high-glycemic load, or frequent consumption of sugars that stimulate increased insulin release, had up to a doubled risk over 10 years, as well as lowered HDL and increased triglycerides, which are strong markers for cardiovascular disease. Intake of advanced glycation endproducts (AGEs), in the form of processed and fast food that combines sugars, fats and proteins, was also found to contribute to vascular complications, hardening of arteries, and impeded cellular functions, with variable clearance of AGEs consumed (10 percent of AGEs end up in the circulation, but only a third are excreted in 3 days in a health individual, and only 5 percent in a patient with diabetes or metabolic syndrome). High fructose corn syrup and other altered processed sugars were also shown to be contributing to cardiovascular risk, increasing triglyceride levels, stressing liver function, and increases esterification of fatty acids. The strong recommendation was to avoid chronic high intake of sugar, and especially AGEs and processed sugars such as high-fructose corn syrup:
  3. A large cohort study in 2013, by experts at the U.S. CDC, Rollins School of Public Health, in Atlanta, Georgia, U.S.A., and the Harvard School of Public Health, Boston, Massachusetts, U.S.A. found that sugar consumption continued to rise between 1988 and 2004, and is decreasing a little in recent years, to about 15 percent of the daily calories for the U.S. population. This translates as a doubled risk of cardiovascular disease for the Americans consuming between 10-25 percent of their daily calories from added sugars, especially sugary drinks. With increased sugar, and processed sugars, in these soft drinks and other foods, the caloric intake from even one soda per day is substantial, and could increase cardiovascular risk significantly:
  4. In 2012, the U.S. FDA issued warnings concerning the chronic use of statin drugs to lower cholesterol, with evidence of increased risk of onset of type 2 diabetes, the potential for muscle damage over time manifesting as a slowly progressing muscle weakness and pain, risk of memory loss due to CNS degenerative changes, and liver injury, as well as citing the fact that many medications prescribed concurrently with statins used the same catabolic pathways in the liver and resulted in slowly rising circulating dosages and accumulations in many patients, increasing these adverse health effects. Clearly, the unstated recommendation was to try to improve metabolism of lipid cholesterol with other therapies and try to reduce long term statin use:
  5. A 2014 study at the Veteran Affairs Western New York Healthcare System, in Buffalo, New York, concluded that adverse effects on muscle function noted with long term statin drug use was linked to lower hormone Vitamin D levels. What is not mentioned is that statin drugs inhibit the melavonic acid pathway the body uses to create cholecalciferol, the precursor to hormone Vitamin D:
  6. Cardioprotective effects of common Chinese herbs, Dang gui and Huang qi, or Astragalus were confirmed with research in 2006:
  7. In 2012, yet another long-term controlled human trial comparing the benefits of low-dose aspirin to Warfarin (coumadin) confirmed that the outcomes of the low-dose aspirin regimen were equal to Warfarin in preventing heart attack, and while statistically worse in preventing overall stroke events, about double the benefit for preventing a stroke with a major hemmorrhage, which is much more important:
  8. Further information on cardioprotective effects of common Chinese herbs, Dang gui and Huang qi, or Astragalus were confirmed with research in 2007, which showed an increase in glutathione metabolism:
  9. Cardioprotective effects of European Olive leaf tincture were identified in 2003, preventing high blood pressure and atherosclerosis, while also improving insulin metabolism and providing antioxidant clearing of arteries:
  10. Cardioprotective effects of the unique Chinese herb, Rhodiola rosea, or Hong Jin Tian, were reviewed in 2007:
  11. Cardioprotective effects of Omega-3 fatty acids, EPA and DHA, were reviewed in Europe in 1999, and have become standard therapy following a stroke or myocardial infarction (heart attack). Krill oil presents the high quality and most concentrated type of this supplement, with a natural preservative, unlike fish oils:
  12. Cardioprotective effects of chelation therapy with sodium EDTA, helping the body to clear heavy metal toxins, was proven in a large, multicenter, randomized and controlled trial sponsored by the U.S. National Institutes of Health, and published in the NIH News and the Journal of the American Medical Association in March of 2013. Such therapy is becoming more popular as a preventive medicine, and a combination of a number of chelating herbs, nutrient molecules, and chemicals such as EDTA is now available in oral form, supplying a relatively inexpensive and easy to use therapy:
  13. Scientific study in Spain in 2010 found that the quality of fats in the diet explained the low incidence of cardiovascular disease in the Spanish population, which consumes a high amount of natural fatty foods with high content of the essential fatty acids DHA, alpha-linolenic, and oleic acid:
  14. A growing group of medical doctors, researchers, and scientists from around the world are urging a new direction in cardiovascular treatment, with growing evidence that the focus on cholesterol is not producing cardiovascular health or significantly affecting disease, but instead creating ill health by decreasing healthy fats in the diet and prescribing statin drugs with many long-term side effects and widespread deficiencies in CoQ10, steroid hormone precursors, Vitamin D3 hormone, and other beneficial terpenoids:
  15. A 2015 review of scientific studies and FDA warnings concerning the now widespread prescription of testosterone replacement, by experts at the University of Washington School of Medicine, Endocrinology and Nutrition, found clearly that testosterone replacement therapy has been touted as potentially beneficial to decrease cardiovascular risk but instead has been found to actually increase cardiovascular risk:
  16. In 2014, the U.S. FDA issued black box warnings for testosterone replacement therapy cautioning that increased risk for cardiovascular disease, stroke as well as heart attack, is evident, despite years of contrary claims, and that testosterone replacement therapy should not be used to treat "Low T" except when actual hypogonadism is diagnosed:
  17. A 2015 study at the Sun Yat-sen University School of Medicine, in Guangzhou, China, found that a common Chinese herbal formula, here marketed under the name Saikokaryukotsuboreito by the Tsumura company, significantly improved the testosterone levels of laboratory animals, and improved sexual function, as well as steroidogenic acute regulatory protein (StAR) expression, with dose-dependent effects. This formula consists of Ginseng root (Ren shen), Cinnamon Bark (Rou gui), Poria sclerotum (Fu shen), Scutellaria root (Huang qin), Oyster shell and prepared bone (Mu li and Long gu), Pinellia (Ban xia), with ginger and jujube. The researchers noted that almost no studies have been published exploring the effects on low testosterone with use of Chinese Herbal Medicine (CHM). Of course, TCM clinical practice would recommend this as part of a holistic approach, combining short courses of acupuncture, use of bioidentical hormone pregnenelone formulation topically, adrenal extracts with support herbs and nutrients. Such therapy would have no adverse effects, with the only side effect better overall health :
  18. Herbal research in China has focused on the effects of herbal chemicals on the expression of many genes involved in the ischemic process of stroke, with herbal chemicals proven to reduce the genetic expression of genes that were altered in the hippocampus of laboratory animals with induced ischemic stroke. The effects of the herbal preparations were also found to be modulatory, upregulating genetic expression that were beneficial to brain tissue repair, while downregulating genetic expression that produced negative effects:
  19. Research at King's College London, UK, as far back as 1996, found that the family of coumarins, abundant in Chinese herbs, and less so in some foods, exert significant benefits in cardiovascular care, citing coumarins in Artemesia scopolaria (Yin chen hao), Angelica pubescens (Du huo), and Imperata cylindrica (Bai mao gen) that relax smooth muscle to treat hypertension, reduce excess cholesterol and triglycerides, inhibit platelet aggregation (thrombus), and inhibit lipid peroxidation (atherosclerotic plaque):
  20. Studies in 2010 at Beijing University found that a common Chinese herbal formula used to reduce inflammation, Huang lian Jie Du Tang, could remarkably inhibit cellular calcium overload after an ischemic stroke to decrease injury to brain neurons:
  21. Randomized controlled study in 2015 in China found that the classic acupuncture technique used in hospitals in China during acute cerebral infarction, strong stimulation of the DU26 point, does produce significant reaction in the immune system and down-regulate Protein Kinase C in the middle artery of study animals. These goals are also the emphasis on improved acute stroke therapy in hospitals with medications in recent years. In this study, electroacupuncture to the point, with leads attached to DU26 and probably ST36, at 15 Hz, 1mA for 20 minutes significantly enhanced these effects that may save the stroke victim from much brain damage. Integration even in the hospital setting would be relatively easy, and could be used with standard pharmaceutical care for these patients, improving the outcomes. Why this is not considered is the question, because there is no adverse effects to this treatment, and it is very easy to perform, even by the doctors or nurses in the hospital:
  22. A 2015 meta-review of all published scientific studies combining, or integrating, acupuncture with standard medical care for patients experiencing angina, a precursor to a heart attack, showed that the integration of short courses of acupuncture therapy significantly improved a number of measurable outcomes, including reduction of symptoms, reduced dependency on nitroglycerin, improved CRP levels, improved malondialdehyde levels of cell toxicity, improved lipid peroxide levels, SOD and nitric oxide levels of oxidant stress, and improved endothelin levels. All of these markers of cardiovascular risk have been shown to be most significant in true assessment in the last decade:
  23. A 2007 meta-review of all published studies with randomized controlled human clinical trials (RCTs) of acupuncture in the treatment of stroke recovery and rehabilitation, by the University of Arizona, in Tucson, Arizona, found that these RCTs generally had designs that tended to "obscure and reduce the reported affect size", but that with consideration of 3 design flaws, and adjusting for them, the 5 small RCTs that are used to purport that no evidence of benefit exists in standard medicine in fact shows significant benefits. Such RCTs are not provided for any other type of manual physiotherapies in stroke rehabilitation, yet none of the standard therapies are discounted the way that acupuncture is. Stroke rehabilitation is difficult, and requires individualized and comprehensive protocol, and unfortunately, most of the patients with severe stroke are not provided with the care they need to fully recover:
  24. A 2014 follow-up to the reports that study design in randomized controlled human clinical trials (RCTs) of acupuncture in stroke rehabilitation, by experts at Guangzhou University of Chinese Medicine, and the Sun Yat-sen University, in Guangzhou, China, found that 15 RCTs could be found of high quality, and that the overall quality of reporting was general to good, but that some key information in all these studies was insufficient or inadequate according to modern CONSORT and STRICTA guidelines set up to stop the practice of using study design to achieve preconceived goals. These experts note that results from clinical studies in the past evaluating standardized acupuncture in stroke rehabilitation have produced contradictory results. Of course, the full TCM protocol integrated into standard care of stroke patients does not use acupuncture only, and certainly does not use a standardized set of points with no stimulation, but instead integrates acupuncture, electroacupuncture, herbal and nutrient medicine, and most importantly Tui Na physiotherapy to help these patients recover:
  25. A 2015 meta-review of the effectiveness of integrating acupuncture stimulation with physiotherapy in the treatment of acute or subacute stroke, by experts at the Tianjin University of Traditional Chinese Medicine, in China, and the Federal University do Rio Grande do Sul, in Porto Alegra, Brazil, found that while 17 published randomized controlled human clinical trials of quality were found, with 14 of these RCTs showing proof of effectiveness, that still only 5 were of high quality, due to the problems of study design in trials of manual therapies. Still, such evidence provides us with incentive to try such integrative care, especially since it is of low cost and without any adverse effects. The combination of acupuncture stimulation and physiotherapy (Tui na) can be provided in the same session from a Licensed Acupuncturist with such training:
  26. A 2014 randomized controlled human clinical trial of trigger point myofascial needling, sometimes called "dry needling", in the treatment of post-stroke spasticity, by experts at the University of Rey Juan Carlos School of Medicine, and the University Camila Jose Cela, in Madrid, Spain, showed that a single session of myofascial trigger point needling, or "deep dry needling" (DDN) decreased spasticity and improved pressure and pain sensitivity in these patients:
  27. A 2015 randomized controlled study in China found that electroacupuncture stimulation at points on the Pericardium (PC) meridian upregulated circulating levels of neuron growth factor (NGF) in laboratory animals with induced cerebral ischemic stroke, explaining the effect on recovery. Stimulation of points on another meridian randomly assigned as a control stimulated much less circulating NGF. The PC meridian stimualtion also downregulated serum Nogo-A, a myelin associated neurite outgrowth inhibitor and antigen for monoclonal antibody IN-1. Such study clearly identifies the modulatory benefits of acupuncture in stroke recovery. The points used were PC2, PC3, PC6 and PC7, with 20 Hz stimulation:
  28. A randomized controlled 2012 study at the Hunan University of Chinese Medicine, in Changsha, China, showed that electroacupuncture stimulation at PC3 and PC6, as well as LI4 and LI11, with 20 Hz frequency at 2-4 V, up-regulated the expression of VEGF (vascular endothelial growth factor) in blood circulation, in the cerebrum and increased the number of VEGF-positive microvessels in laboratory animals with induced cerebral ischemic stroke. Such study demonstrates how acupuncture can accelerated recovery by stimulating increased angiogenesis. The PC meridian stimulation was much superior in effect to the LI meridian stimulation and sham controls:
  29. A 2009 randomized controlled study at the China Academy of Chinese Medical Sciences, in Beijing, China, found that electroacupuncture stimulation at ST36 and LI11 effectively downregulated serum cortisol , hypothalamic cortcotropin release factor mRNA and pituitary ACTH (adrenocorticotropic hormone) mRNA expression in laboratory animals with induced cerebral ischemic stroke. Such effects could decrease the ischemic reperfusion injury if performed in the weeks following the stroke. A 2/30 Hz alternating stimulation was used:
  30. Studies in 2010 presented by the American College of Cardiology showed that the array of medications commonly prescribed to reduce risk for patients with metabolic syndrome are not only ineffective, but actually increased cardiovascular risk for most patients:
  31. Randomized controlled studies have shown significant benefit in correcting the mechanisms of atherosclerotic plaque formation with Chinese herbal formulas. This study, published in the Oxford Journal in 2009 discusses the physiology of atherosclerotic plaque formation and explains how specific Chinese herbs, including Coptis chinensis with berberine, reverse this pathology:
  32. A study in 2010 of a specific Chinese herbal formula used in cardiovascular medicine found that this array of phytochemicals exerted significant effects modulating the inflammatory cytokine TNF-alpha that promotes the inflammation central to the formation of atherosclerotic plaque. This study at Dongguk University in South Korea details the study and findings. The herbal formula HMC05, comprised of Pinelliae ternate Ten. Ex Breitenb. (Ban xia), Atractylodes macrocephala Koidz. (Bai zhu), Gastrodia elata Blume (Tian ma), Citrus unshiu Marcow. (Zhi ke), Poria cocos Wolf (Fu ling), Crataegus pinnatifida Bunge var. typica C. K. Schneider (Shan zha), Siegesbeckia pubescens Makio. (Xi xian cao), and Coptidis japonica Makino (Huang lian), is comprised of herbs commonly used in TCM.
  33. Studies in 2009 in Turkey found that the Chinese herb Bai ji li (Tribulus terrestris) was effective both in lowering high lipids as well as reducing atherosclerotic plaque and protecting the endothelial lining of blood vessels:
  34. Studies in 2009 in Turkey also found that St. John's Wort, or Hypericum, alcoahol extract, was effective in lowering high lipids and improving the lipid balance and profile, while also exerting significant beneficial antioxidant effect:
  35. An overview of recent scientific studies of Red Rice Yeast extract by UCLA found that it was surprisingly effective in lowering high cholesterol and triglycerides, without side effects, and with a balancing or modulating action:
  36. A 2009 placebo-controlled human clinical trial of nattokinase plus Red Yeast Rice extract in Taiwan showed that 6 months of this regimen produced dramatic improvements in all lipid levels for patients with hyperlipidemia:
  37. A 2010 study at Guangzhou University of Chinese Medicine in China found that 2 of the most common herbs in cardiovascular formulas, Dang gui and Hong hua, exerted significant antithrombotic effects in animal studies, but did not show an additive effect to the common pharmaceutical clopidorgrel:
  38. A 2001 study at the Loma Linda University School of Medicine in Loma Linda, California, found that aged garlic extract is able to clear oxidized LDL (low-density lipoprotein), a major component of atherosclerotic plaque:
  39. A 2010 study at Henan College in China found that an herbal extract from wild rhubarb root (Da huang), aglycone, when combined with thrombolytic therapy following a stroke, exerted significant protective effects on brain microvascular membranes, reducing the risk of intercranial hemmorrhage recurrence (ICHR) and mortality, when taken after a cerebral ischemic stroke:
  40. A 2002 study at the Beijing College of TCM showed that a common Chinese herb prescribed to promote blood circulation and inhibit blood stasis worked by inhibiting thrombus formation and platelet aggregation in arteries. The herb Paeonia lactiflora (Chi shao) prolonged the prothrombin time (PTT) and exerted significant antithrombin effects, showing how traditional Chinese herbs are scientifically proven in medical efficacy:
  41. A 2012 study at the University of Milan explored the potential of acupuncture to provide a safe and reliable first-line therapy for paroxysmal atrial fibrillation, or with persistent atrial fibrillation after receiving electric cardioversion to stop the arrhythmia, instead of using the surgical cardiac ablation or anti-arrhythmic, or other drugs to try to control the misfiring. This study showed that acupuncture was as effective as the standard anti-arrhythmic drug amiodarone, with none of the adverse effects and drug contraindications:
  42. A 2011 study at the University of Milan studied the efficacy of a simple acupuncture treatment to prevent recurrence of atrial fibrillation after electronic cardioversion (a safe and simple procedure) and found that during a 12 month period the simple acupuncture treatment with 10 sessions (limited to 3 points and no needle technique stimulation) achieved the same results as the standard anti-arrhythmic drug amiodarone, with 65 percent of patients receiving this simplified acupuncture therapy having no recurrence of atrial fibrillation. When the acupuncture is performed with more skill in a broader context, with herbal and nutrient medicine added to the treatement protocol, the results would probably be improved:
  43. A 2015 study at the China Academy of Chinese Medical Sciences, in Beijing, China, found that a simple treatment with acupuncture on the left wrist at P6 for a patient diagnosed with a ventral defect in the heart valve that was surgically corrected at age 11, but still with a measurable arrhythmia in EKG, found that the acupuncture stimulation did indeed regulate the heart rate variability after the treatment. Such studies show the potential for this small aspect of the actual holistic clinical protocol in TCM:
  44. A 2012 study at Guangzhou University of Chinese Medicine, in China, found that acupuncture significantly improved post-stroke brain function over controls in patients immediately after suffering a cerebral infarction. The measurements utilized serial diffusion tensor imaging, functional MRI scans, and fluid-attenuated inversion recovery testing, as well as the U.S. National Institute of Health Stroke Scale and Barthel index evaluation of signs and symptoms. Here, 20 patients with rupture of the artery in the basal ganglia in an area greater than 1 cm, a common type of debilitating stroke, were evaluated, half receiving a course of acupuncture, and half not receiving acupuncture. Numerous studies in the U.S. and Europe have been conducted, with surprisingly positive results and patient appreciation, but this simple treatment protocol has not been implemented in hospitals, and most hospitals in the United States either have refused to allow acupuncture in standard care, or limited acupuncture to the treatment of pain, with controlled and simplified techniques and point selections allowed:
  45. A 2011 study at Shanghai Research Center for Acupuncture, Shanghai, China, found that electroacupuncture effectively protects the brain from ischemic injury after a stroke. This study on laboratory animals used electroacupuncture at the points DU26 and DU20, points between the nose and lip (philtrum) and the apex of the skull, with a low intensity 5-20 Hz signal, increased blood flow by greater than 100 percent during the treatment, promoted the recovery of blood flow after middle cerebral artery occlusion, and remarkably reduced the death rate, neurological deficit and area of infarction. Animals that received too low of electrical stimulation, or a frequency over 40 Hz did not show benefits of increased blood circulation in the affected areas. Such study could guide effective treatment immediately following a cerebral hemorrhage, without any risk of harm:
  46. A 2008 study at Shanghai Medical College, Fudan University, Shanghai, China, found that electroacupuncture could upregulate the delta-opioid receptors and protein expressions following an ischemic stroke to reduce the adverse effects of infarction and neurological deficits, in study animals. Delta-opioid receptors utilize enkaphlins to reduce the calcium ion channels and increase the potassium ion conductance in neurons and glial support cells, protecting the cells from injury. This opioid receptor has been found to be protective against hypoxic stress (sudden loss of oxygen to the cells):
  47. A 2007 study at China Medical University in Taichung, Taiwan, found that 12 treatments at the acupuncture point DU20 produced significantly improved dopamine levels in the cerebral cortex in laboratory animals with induced stroke, in both animals with chronic deficits from stroke, and animals with acute injury from ischemic stroke, and reduced brain atrophy. This controlled study measured improvement in right-left hemisphere dopamine level comparisons with brain biopsy and tissue exams:
  48. A 2015 meta-review of randomized controlled human clinical trials of integration of acupuncture with physiotherapy in acute and subacute stroke rehabilitation found 17 published studies, with 5 meeting the highest quality standards, and 14 showing significant benefits over physiotherapy alone. This review from the Federal University of Rio Grande do Sol, in Porto Alegre, Brazil and the Tianjin University of Traditional Chinese Medicine, in Tianjin, China, recommends that larger studies be designed to achieve consensus in standard medicine for this approach:
  49. A 2013 study at the Nantong University Key Laboratory of Neuroregeneration, in Nantong, China found that the Chinese herb Achyranthes bidentata (Niu xi) could improve the post-stroke recovery of sensory and motor functions, as well as cognitive function:
  50. A 2012 randomized controlled human clinical trial of the Chinese herb Astragalus (Huang qi), at the China Medical University Hospital, in Taichung, Taiwan, to enhance post-stroke recovery with hemorrhagic stroke found that measurement of outcome measures using the standard Glasgow outcome scale showed that use of the herbal extract was associated with a 3-fold rate of recovery compared to placebo:
  51. A 2015 study at the Federal University of Sao Paolo, in Brazil, showed that the supplement N-acetylcysteine was effective in improving recovery of a hemmorrhagic stroke or heart attack in laboratory animals by reducing tissue damage and edema, and lowering concentrations of toxic metabolites:
  52. A 2010 study at the LR Institute of Pharmacy, Solan, India, found that the alcohol herbal extract of Artemesia absinthia significantly benefited patients following a non-hemorrhagic stroke:
  53. A 2010 study at the Institute of Medical Education and Research, Chandigarth, India, found that an alcohol extract of the herb Bacopa monieri exerted sigificant benefits for patients following a non-hemorrhagic stroke:
  54. A 2015 multicenter review of all randomized controlled human clinical trials (RCTs) of the Chinese herbal formula for post-stroke recovery in hemorrhagic stroke, Wen Dan Tang (Zhur ru, Zhi shi, Ban xia, Chen pi, Fu ling, Gan cao, Sheng jiang, Da zao), by experts at Guilin Medical University adn The Chinese University of Hong Kong Prince of Wales Hospital, in China, concluded that this simple classic formula showed significant benefits for improved neurological function and quality of life for post-stroke patients in 22 RCTs. This simple and benign formula was designed by Sun Si Miao and published in the Thousand Ducat Formulas (Qian Jin Yao Fang) in the Tang Dynasty in the 7th century AD for patients recovering from a severe illness with debility: