Assessing the impact of moxibustion on colonic mucosal integrity and gut microbiota in a rat model of cerebral ischemic stroke: insights from the “brain-gut axis” theory

I can't see any use for this unless we are talking about extra sensation caused by the pain this produces.

Impossible for acupuncture to have effects except as a placebo. Energy meridians have never been proven to exist.

No mechanism of action is possible.

Moxibustion is a form of therapy that entails the burning of mugwort leaves. This is a small, spongy herb that is believed to enhance healing with acupuncture. As such, the leaves are burnt close to the skin's surface using a stick to apply heat.‌ The practice is derived from Chinese medicine.

 Assessing the impact of moxibustion on colonic mucosal integrity and gut microbiota in a rat model of cerebral ischemic stroke: insights from the “brain-gut axis” theory

Yi-Xia Ding^{1 ,2 ,3 †}Liang-Liang Chen^{2 ,3 ,4 †}Kui-Wu Li⁵Ling Zou⁵Lu-Min Liao⁵Xiao-Yu Han⁵Jie OuYang⁵Yue-Ping Wu⁵Wen-Dong Zhang^{1 ,2 ,3}Hao Ran Chu^{2 ,3 ,6 *}

• ¹Department of Encephalopathy (V), The Second Affiliated Hospital of Anhui University of Chinese Medicine (Anhui Acupuncture Hospital), Hefei, Anhui, China
• ²Institute of Clinical Acupuncture and Moxibustion, Anhui Academy of Chinese Medicine, Hefei, Anhui, China
• ³Anhui Clinical Medical Research Center of Acupuncture and Moxibustion, Hefei, Anhui, China
• ⁴Department of Spleen and Stomach Diseases, The Second Affiliated Hospital of Anhui University of Chinese Medicine (Anhui Acupuncture Hospital), Hefei, Anhui, China
• ⁵Graduate School of Anhui University of Chinese Medicine, Hefei, Anhui, China
• ⁶Outpatient Department, The Second Affiliated Hospital of Anhui University of Chinese Medicine (Anhui Acupuncture Hospital), Hefei, Anhui, China

Objective: The aim of this study is to assess the impact of moxibustion on the colonic mucosal barrier and gut microbiota in a rat model of cerebral ischemic stroke (CIS).

Method: The CIS rat model was established using the modified Zea Longa suture method. Successfully modeled rats were randomly allocated into a model group and a moxibustion group, with a sham surgery group serving as the control. The moxibustion group received suspended moxibustion at Dazhui (GV 14), Baihui (GV 20), Fengfu (GV 16), and bilateral Tianshu (ST 25) and Shangjuxu (ST 37) acupoints. Neurological function was assessed using the Longa score, and brain infarct size was assessed through 2,3,5-triphenyl tetrazolium chloride staining. Gut microbiota composition was analyzed using 16S rDNA amplification sequencing. Intestinal mucosal permeability was evaluated using the FITC-Dextran tracer method. The serum ET-1 levels and the expression of Occludin and ZO-1 proteins in colonic tissues were also measured.

Result: The model group exhibited significantly higher Longa scores, larger brain infarct size, and higher serum FITC-Dextran levels and ET-1 levels when compared with the sham surgery group (p < 0.01). The model group demonstrated decreased expression of Occludin and ZO-1 in colonic tissues (p < 0.01) and changes in gut microbiota structure. When compared to the model group, the moxibustion group demonstrated significantly lower Longa scores, smaller brain infarct size, and lower serum FITC-Dextran levels and ET-1 levels (p < 0.05). Furthermore, the moxibustion group demonstrated decreased inflammatory cell infiltration in colonic tissues, increased expression of Occludin and ZO-1 proteins in colonic tissues (p < 0.05), enhanced gut microbiota structure, and a decreased Simpson index (p < 0.05).

Conclusion: Moxibustion can improve the neurological dysfunction in CIS model rats. The mechanism may be associated with the improvement in gut microbiota dysbiosis, reduction in colonic mucosal permeability, and restoration of intestinal mucosal barrier damage.

1 Introduction

Stroke is the second leading cause of death globally, with cerebral ischemic stroke (CIS) accounting for 62.4% of all stroke cases (1). CIS is characterized by a clinical syndrome resulting from inadequate blood supply to the vessels of the brain, leading to ischemia and hypoxia in the affected brain tissue, which causes neuronal damage and a series of brain function impairments (2).

The “brain-gut axis” has recently gained significant attention, with its role in CIS prevention and treatment gaining widespread recognition (3, 4). The gut microbiota, a crucial regulator of the brain-gut axis, influences the physiological and pathological states of both the gut and brain through neural, immune, and endocrine pathways (5). Patients post-stroke often experience gut microbiota dysbiosis, increased intestinal mucosal permeability, decreased expression of tight junction proteins, and damage to the mucosal barrier. These changes can lead to bacterial translocation and immune-inflammatory responses, further exacerbating neurological damage (3). Consequently, targeting the gut microbiota presents a promising therapeutic strategy for CIS (6–8).

Moxibustion therapy has demonstrated efficacy in enhancing neurological function and reducing complications in CIS; however, its underlying mechanisms remain elusive. Therefore, we propose the hypothesis that moxibustion intervention can improve CIS nerve function damage by regulating intestinal microbiota structure and improving intestinal barrier damage. The objective of this study is to investigate the impact of moxibustion on neurological function impairment and gut microbiota in a rat model of CIS, and to preliminarily assess its mechanistic pathways.

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Efficacy and Safety of a Novel Plum Blossom Needling with Mild Moxibustion Device for Upper Limb Pain Disorder and Motor Dysfunction in Patients with Stage 1 Post-Stroke Shoulder-Hand Syndrome: Study Protocol for a Multi-Center, Single-Blind, Randomized Sham-Controlled Trial

FYI.

Efficacy and Safety of a Novel Plum Blossom Needling with Mild Moxibustion Device for Upper Limb Pain Disorder and Motor Dysfunction in Patients with Stage 1 Post-Stroke Shoulder-Hand Syndrome: Study Protocol for a Multi-Center, Single-Blind, Randomized Sham-Controlled Trial

Authors Meng X , Sun J, Liu Q, Huang Y, Qiu X, Seto DJ, Li Y, Wang L, Li C, Gao S, Yu H, Zhao J, Zhao B

Received 4 November 2022

Accepted for publication 19 January 2023

Published 13 February 2023 Volume 2023:16 Pages 407—420

DOI https://doi.org/10.2147/JPR.S396195

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Houman Danesh

Download Article [PDF] 

Xiaonan Meng,^1,2,* Jie Sun,^3,* Qi Liu,^4,* Yueping Huang,⁵ Xianwen Qiu,⁶ David Jung Seto,^7,8 Ying Li,³ Liping Wang,² Chunying Li,² Sen Gao,⁹ Haikuo Yu,¹⁰ Jiping Zhao,¹ Baixiao Zhao<sup>1

1</sup>Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; ²Department of Acupuncture and Moxibustion, Beijing Huguosi TCM Hospital, Affiliated with Beijing University of Chinese Medicine, Beijing, People’s Republic of China; ³Department of Integrated Chinese and Western Medicine Rehabilitation, Beijing Xiaotangshan Hospital, Beijing, People’s Republic of China; ⁴Department of General Internal Medicine, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China; ⁵School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; ⁶Department of Acupuncture and Moxibustion, Beijing Shichahai Community Healthcare Center, Beijing, People’s Republic of China; ⁷Division of Integrative Medicine, Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; ⁸Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; ⁹Department of Rehabilitation, Beijing Huguosi TCM Hospital, affiliated with Beijing University of Chinese Medicine, Beijing, People’s Republic of China; ¹⁰Rehabilitation Department, Xuanwu Hospital Capital Medical University, Beijing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jiping Zhao; Baixiao Zhao, Email zjp7883@sina.com; baixiao100@vip.sina.com

Background: Post-stroke shoulder-hand syndrome (PS-SHS), a common neurological comorbidity after stroke episodes, poses a grave threat on patients’ functional recovery. Preliminary trials have demonstrated that the acupuncture and moxibustion treatment, including a dermal acupuncture tapping method known as plum blossom needling (PBN) can improve pain and motor dysfunctions in patients with PS-SHS. However, there are few reports describing simultaneous moxibustion treatment in combination with PBN. Hence, a novel plum blossom needle device with mild moxibustion (PBNMM) was developed to evaluate its potential efficacy and safety in patients with stage 1 PS-SHS.

Materials and Methods: This multicenter, sham-controlled, randomized controlled trial (RCT) will recruit 102 eligible patients with stage 1 PS-SHS from three clinical centers, randomly allocated in a ratio of 1:1:1 to the PBNMM group, PBNMM with no moxa smoke (PBNMM-NMS) group and sham control group. Patients in each group will receive a 30-minute treatment once per day for 4 weeks, with 5 consecutive sessions per week, for a total of 20 sessions. The primary outcome measure will be defined as the decreased scores from baseline in the visual analog scale (VAS) assessment at week 4. Secondary outcome measures will include scores on the Fugl-Meyer Assessment of the Upper Extremity Scale (FMA-UE), the Modified Barthel Index (MBI), and the somatosensory evoked potential (SEP) records. All outcomes will be evaluated at baseline and weeks 4, 5, 6 and 10, and the intention-to-treat analysis will be applied.

Conclusion: This study aims to provide robust evidence for the efficacy and safety of the PBNMM for PS-SHS treatment, as well as the specific impact of moxibustion smoke itself in dealing with PS-SHS.

Clinical Trial Registration: Chinese Clinical Trial Registry No. ChiCTR2200062441. Registered on 7 August 2022.

Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients

As compared to non-professional training? Like what all stroke survivors have to do because there are no protocols to get you to 100% recovery from any so-called 'professional'?

Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients

Chao-jin-zi Li¹, Xiao-xia Du M.D. ¹, Kun Yang², Lu-ping Song¹, Peng-kun Li³, Qiang Wang¹, Rong Sun¹, Xiao-ling Lin⁴, Hong-yu Lu⁴, Tong Zhang^1
1 School of Rehabilitation Medicine, Capital Medical University, Beijing; Department of Neurological Rehabilitation, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing, China
² Department of Neurology, Xi'an Gaoxin Hospital, Xi'an, Shaanxi Province, China
³ School of Rehabilitation Medicine, Capital Medical University, Beijing; Room of Medical Records, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing, China
⁴ School of Rehabilitation Medicine, Capital Medical University, Beijing, China

Date of Acceptance	06-Feb-2016
Date of Web Publication	9-Dec-2016

Correspondence Address:
Xiao-xia Du
School of Rehabilitation Medicine, Capital Medical University, Beijing; Department of Neurological Rehabilitation, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing
China

Source of Support: This research was supported by the Special Fund of Basic Scientific Research Service Fee of Central Public Welfare Scientific Research Institute of China, No. 2014CZ-13., Conflict of Interest: None

DOI: 10.4103/1673-5374.194746

Abstract

Young stroke patients have a strong desire to return to the society, but few studies have been conducted on their rehabilitation training items, intensity, and prognosis. We analyzed clinical data of young and middle-aged/older stroke patients hospitalized in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China from February 2014 to May 2015. Results demonstrated that hemorrhagic stroke (59.6%) was the primary stroke type found in the young group, while ischemic stroke (60.0%) was the main type detected in the middle-aged/older group. Compared with older stroke patients, education level and incidence of hyperhomocysteinemia were higher in younger stroke patients, whereas, incidences of hypertension, diabetes, and heart disease were lower. The average length of hospital stay was longer in the young group than in the middle-aged/older group. The main risk factors observed in the young stroke patients were hypertension, drinking, smoking, hyperlipidemia, hyperhomocysteinemia, diabetes, previous history of stroke, and heart disease. The most accepted rehabilitation program consisted of physiotherapy, occupational therapy, speech therapy, acupuncture and moxibustion. Average rehabilitation training time was 2.5 hours/day. Barthel Index and modified Rankin Scale scores were increased at discharge. Six months after discharge, the degree of occupational and economic satisfaction declined, and there were no changes in family life satisfaction. The degrees of other life satisfaction (such as friendship) improved. The degree of disability and functional status improved significantly in young stroke patients after professional rehabilitation, but the number of patients who returned to society within 6 months after stroke was still small.

Keywords: nerve regeneration; young stroke patients; risk factors; recovery of neurological function; prognosis; Life Satisfaction Questionnaire; Barthel Index; modified Rank Scale; neural regeneration

How to cite this article: Li Cj, Du Xx, Yang K, Song Lp, Li Pk, Wang Q, Sun R, Lin Xl, Lu Hy, Zhang T. Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients. Neural Regen Res 2016;11:1766-72

How to cite this URL: Li Cj, Du Xx, Yang K, Song Lp, Li Pk, Wang Q, Sun R, Lin Xl, Lu Hy, Zhang T. Effects of professional rehabilitation training on the recovery of neurological function in young stroke patients. Neural Regen Res [serial online] 2016 [cited 2016 Dec 13];11:1766-72. Available from: http://www.nrronline.org/text.asp?2016/11/11/1766/194746

Introduction

Stroke with high incidence and high disability seriously threatens human life and health. Stroke onset in young patients between 18 and 44 years, is inclusive. Morbidity has been reported between 7 and 15 cases per 100,000 individuals (Griffiths and Sturm, 2011). Morbidity accounts for 5–15% of all strokes (Bi and Beijing Neurologist Club, 2003). In recent years, the incidence of stroke is rising. The etiology and risk factors for young stroke patients differ from those for middle-aged and older stroke patients, and are complicated in young patients with ischemic stroke (Béjot et al., 2013; Sultan and Elkind, 2013). Numerous studies have shown that the onset of stroke in young people is associated with hypertension, family history of stroke, smoking and hyperhomocysteinemia in developing countries (Hill et al., 1991; Lee et al., 2002; Feigin et al., 2003; Benninger et al., 2009; De Silva et al., 2009; Onwuchekwa et al., 2009; Griffiths and Sturm, 2011; Park et al., 2014). Moreover, the proportion of stroke without any clear cause increases year by year, and different risk factors are reported in different studies (Hill et al., 1991; Lee et al., 2002; Feigin et al., 2003; Benninger et al., 2009; De Silva et al., 2009; Onwuchekwa et al., 2009; Griffiths and Sturm, 2011; Park et al., 2014).

Professional rehabilitation relieves dysfunction in stroke patients, and promotes and maintains the recovery of cognition, language, movement, psychology, and social function. The demand to return to society and work is high in young stroke patients, but there are few studies that focus on rehabilitation training items, intensity, or prognosis for young stroke patients. Indeed, a multicenter study demonstrated a current lack of unified evaluation criteria for the effect of rehabilitation therapy in stroke patients (Engbers et al., 2005; Kuptniratsaikul et al., 2009). No studies regarding the rehabilitation, strength, or prognosis for young stroke patients have been performed in China.

We sought to analyze the clinical data of stroke patients hospitalized over the course of one year in the Department of Neurological Rehabilitation, China Rehabilitation Research Center, Capital Medical University, China. We compared general data and risk factors between young stroke patients and middle-aged/older stroke patients. We first analyzed rehabilitation and strength in young stroke patients by comparing the degree of disability and functional status between the time of admission and the time of discharge. We also collected information regarding the degree of disability, functional changes, life satisfaction, and return to society 6 months after discharge in young stroke patients. This was done to help patients have better access to rehabilitation services and to improve their quality of life.

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Moxibustion for stroke rehabilitation

I can't see any use for this unless we are talking about extra sensation caused by the pain this produces.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011294/abstract;jsessionid=3D70EFD25291A47E66E1B73978E7FFC1.f04t03?

Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows:
To evaluate the evidence for or against the effectiveness of moxibustion as an adjunctive or as sole therapy for reducing death and disability after stroke.

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