The impact of the traditional Chinese medicine Tianshu Capsule on treatment of headache[H1]  after cerebral apoplexy and neurological function recovery
 
Hongmei Ding, Chao Ren, Deqin Geng
 
Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu, China
 
Abstract: Objective: This paper aims to analyze the impact of Tianshu Capsule on treatment of headache-associated symptom after cerebral apoplexy and neurological function recovery. Method: 56 patients suffered from cerebral apoplexy with headache-associated symptom were divided into two groups: treated group (administered with Tianshu Capsule) and untreated group (without Tianshu Capsule’s treatment). Headache- and SSS[H2]  scores were observed respectively at second, fourth and sixth week before and after treatment. Result: The traditional Chinese medicine Tianshu Capsule showed positive effects in treated patients associated with headache after cerebral apoplexy and neurological function recovery.
 
Keywords: headache after cerebral apoplexy; Tianshu Capsule; traditional Chinese medicine treatment
Citation: Ding H, et al. The impact of the traditional Chinese medicine Tianshu Capsule on treatment of headache after cerebral apoplexy and neurological function recovery. J Gen Neuro 2016; 1(1): ; http://dx.doi.org/
^*Correspondence to:
Received:                          Accepted:                     Online Published:
 
Introduction
Headache-associated symptom after cerebral apoplexy is a common complication experienced after cerebral apoplexy that has a direct negative effect on the quality of life and neurological function recovery of patients, in which, 60% to 70% of patients with cerebral apoplexy suffer from different degrees of headache symptom^[1,2]. Many patients  experienced obvious headache symptoms that affect their rehabilitation exercise and treatment, and the headache even continues for more than 6 months for several patients. The quality of these patients’ lives is affected negatively to a large degree. A set of control experiments was conducted in order to explore the impact of Tianshu Capsule on the treatment of headache symptom after cerebral apoplexy and auxiliary rehabilitation of neurological function of patients.
 
 
 
 
Materials and methods
Case selection
From March[H3]  to October 2012, 56 patients suffering from cerebral apoplexy with headache symptom were chosen as the subject for the study, whereby all the selections were conducted in accordance to the diagnosis standard of cerebral hemorrhage and infarction guidelines as published in the Fourth National Cerebrovascular Disease Conference held by The Chinese Neuroscience Society in 1995^[3]. All patients underwent head computed tomography (CT) scanning for one to three times. The patients’ inclusion criteria were as follows: (1) at least one limb’s muscle force was not below than level 3 and patients included in the study must be  70 years old and below; (2) all patients were in clear consciousness and there were no obvious drop in intelligence, no language barrier, no serious dysfunction of heart, lung, and kidney; and (3) there were no organic brain disease, and no previous personal and familial positive mental disorders. The cases were randomly divided into treatment group (26 cases administered with Tianshu Capsule, produced by Jiangsu Kanion Pharmaceutical) and control group (30 cases without Tianshu Capsule’s treatment). There were no significant differences between the two groups in terms of age, sex, degree of illness and depression, etc.
 
Methods
The treatment for all the cases was conducted in accordance to the conventional diagnosis and treatment of cerebral apoplexy. The treatment group was administered with 4 Tianshu Capsules by oral in three times a day. The Tianshu Capsule used lasted for a total of 6 weeks. The symptom of headache’s degree was scored before and after the treatment. The curative effect was evaluated by score-reduction rates with these indicators: >75% for recovery, ≥50% for significant positive effects, <25% for ineffectiveness. Chi-square (X2) method was adopted for determination of results. The rate differences between the two groups were analyzed. Neurological function deficit scale (SSS) for cerebral apoplexy patients published by The Chinese Neuroscience Society in 1995 (total score ranges of 0–45) was performed for the assessment and t-test was adopted for statistical test.
 
Results
Table 1 shows the headache test scores before and after the treatment for the two groups. In comparison to the score before the treatment, the post-treatment of headache test score in the treatment group was decreased significantly, which was way better than the control group. Table 2 shows the SSS score of the two groups before and after the treatment. The result showed that the headache symptoms in both groups were improved to varying degrees and the result of treatment group was much better than the control group (p < 0.05).
 
Adverse reactions
All the patients in the treatment group underwent blood routine test, liver and kidney function examination and electrocardiogram (ecg) examination before and after the treatment, and the results showed no abnormal changes. 6 patients experienced nausea and three patients experienced dry mouth. There were no other adverse reactions, such as heart palpitations, tremor and dysuria.
 
 
Discussion
Headache-associated symptom after cerebral apoplexy is one of the most common problems occurs after treatment of cerebral apoplexy, with the highest incidence rate reported after cerebral hemorrhage events. The pathogenesis is unclear. Research suggested that the pathogenesis of headache may be as follows: (1) It is probably related to the balancing of norepinephrine and 5-hydroxytryptamine caused by the brain damage, because norepinephrine and 5-hydroxytryptamine neuron cell bodies are in the brain stem with the axon reaches the frontal cortex passing through the thalamus and basal ganglia. When lesions involve at the above parts of the brain, it can affect norepinephrine and 5-hydroxytryptamine neural pathways in the affected area. The norepinephrine and 5-hydroxytryptamine neuron dysfunction will occur and then it will cause headaches. (2) Paralysis after cerebral apoplexy will cause inability to move and live independently, leading to psychological disorders, such as depression and despair, which subsequently leads to headache symptom occurrence due to emotional tension.
In principle, early detection and treatment is advocated in the treatment of headache after cerebral apoplexy. The main components of Tianshu Capsule comprise of variety of Chinese traditional patent medicines. It has the function of promoting blood circulation that could remove blood stasis, dredging blood vessels and has an antagonism characteristic against inflammatory pain factor with fewer side effects, higher safety, and suitable for treatment of various headaches. The current research shows that the headache test score of the treatment group at the second-, fourth- and sixth week after treatment decreased significantly, with the scores at fourth and sixth week were significantly lower than the scores of the control group in the same periods. It indicated that Tianshu Capsule has positive effects in the treatment of headache symptom after cerebral apoplexy. There were no significant differences between the score of the second week and the score of the control group after the treatment. It was probably due to the traditional Chinese patent medicines that often took longer time to become effective. The neurological function deficit scale (SSS) scores of the two groups showed that both scores decreased after the treatment, however, score for the treatment group decreased much more than that of the other group (p ≤ 0.001). The result suggested that Tianshu Capsule is helpful in the neurological function recovery.
 
 
Conflict of interest
The authors declared no potential conflict of interest with respect to the research, authorship, and/or publication of this article.
 
 
References
1. Wang Y, Guo C, Chen X. Curative effect observation of the treatment of cerebral apoplexy by Xuefu-Zhuyu decoction, radix angelicae dahuricae and astragalus. Chinese Journal of Modern Medicine 2009; 22: 315.
2. Hu W, Xiao G, Ge S, Yang J, Xu G, et al. Analysis of lacunar infarction complicated by stroke-related risk factors for headache. Chinese Journal of Nervous and Mental Diseases 2008; 34(5): 262–265.
3. Chinese Medical Association. All kinds of main points of cerebrovascular disease diagnosis and neurological deficits scale standard. Chinese Journal of Neurology 1996; 29(6): 376–382.[H4] 
 
 
 
 
 
 
 
 
 
 
 
TABLES
Table 1 Comparison of headache scores before and after treatment between the two groups
 
 
 

Notes: the results of the comparison showed *p > 0.05, p < 0.01. ‘a’ showed significant difference in comparison to the score before the treatment in the same group, p < 0.001. ‘b’ showed significant difference in comparison to the control group of the same time, p < 0.001.
 
Table 2 Comparison of SSS scores of the two groups before and after treatment
 
 
 

Notes: comparison of the score before treatment in the same time within the same group, p ≤ 0.001; the score of the control group in the same time, p ≤ 0.001; the score before treatment within the same group, p ≤ 0.01.