To observe the effects of ZHU Lianʹs excitation-type acupuncture manipulation on limb function and serum oxidative stress indexes, and angiogenic factors in patients with ischemic stroke during the recovery period.

A total of 84 patients with ischemic stroke during the recovery period were randomly divided into a ZHU Lian acupuncture group (42 cases, 5 cases dropped out) and a conventional acupuncture group (42 cases, 8 cases dropped out). On the basis of routine treatment, the ZHU Lian acupuncture group received ZHU Lianʹs excitation-type acupuncture manipulation, while the conventional acupuncture group received conventional acupuncture treatment. Acupoints on the affected side were selected, including Fengchi (GB20), Jianyu (LI15), Quchi (LI11), Waiguan (TE5), Xinshe (Extra), Jianliao (TE14), Xinyi (Extra), Hegu (LI4), etc. Treatments were administered once daily for 3 weeks in both groups. The Fugl-Meyer assessment (FMA), Berg balance scale (BBS), modified Barthel index (MBI) scores and serum levels of superoxide dismutase (SOD), malondialdehyde (MDA), reduced glutathione (GSH), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), endothelin-1 (ET-1) were observed before and after treatment in both groups.

Compared with before treatment, the FMA, BBS, MBI scores and serum levels of SOD, GSH, VEGF, bFGF after treatment were increased in both groups (P<0.001, P<0.05, P<0.01), and serum levels of MDA and ET-1 were decreased (P<0.001); after treatment, the FMA, BBS, MBI scores and serum levels of SOD, GSH, VEGF, bFGF in the ZHU Lian acupuncture group were higher than those in the conventional acupuncture group (P<0.05, P<0.001), and serum levels of MDA and ET-1 in the ZHU Lian acupuncture group were lower than those in the conventional acupuncture group (P<0.001, P<0.01).

ZHU Lianʹs excitation-type acupuncture manipulation may exert neuroprotective effects in patients with ischemic stroke during the recovery period by modulating antioxidant capacity and angiogenesis, thereby improving limb function.

To observe the effects of Zhu Lian's type Ⅱ inhibition needling on neurological function and angiogenesis in rats with ischemic stroke (IS), so as to explore its potential mechanisms.

Wistar rats were divided into sham operation group, model group, acupuncture group, and acupuncture+angiogenin (Ang)-2 group, with 12 rats in each group. A suture method was used to establish the IS model. The acupuncture group received Zhu Lian's type Ⅱ inhibition needling at the "Guanyuan" (CV4), "Guilai" (ST29), "Zusanli" (ST36), "Sanyinjiao" (SP6), and "Fenglong" (ST40) acupoints for 30 min per session. Rats in the acupuncture+Ang-2 group were injected via the tail vein with Ang-2 recombinant protein (10 mg/kg) before Zhu Lian's type Ⅱ inhibition needling intervention. All treatments were administered once daily for 7 consecutive days. Neurological deficit scores were assessed in rats of each group. TTC staining was employed to determine the percentage of cerebral infarction volume. HE staining was used to observe the pathological changes in the ischemic penumbra cortex. Immunohistochemistry was used to evaluate microvascular density in the ischemic penumbra cortex. Western blot was conducted to detect the expression levels of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 2 (VEGFR-2), Ang-1, Ang-2, tyrosine kinase 2 (Tie-2), and phosphorylated Tie-2 (p-Tie-2) proteins in the ischemic penumbra cortex.

Compared with the sham operation group, the model group showed elevated neurological deficit scores, cerebral infarction volume percentage, microvascular density in the ischemic penumbra cortex, and protein levels of VEGF, VEGFR-2, Ang-1, and p-Tie-2/Tie-2 ratio. Conversely, Ang-2 protein level was decreased (P < 0.05). Compared with the model group and the acupuncture+Ang-2 group, rats in the acupuncture group had lower neurological deficit scores, cerebral infarction volume percentage, and Ang-2 protein level. While microvascular density in the ischemic penumbra cortex and the protein levels of VEGF, VEGFR-2, Ang-1, and the p-Tie-2/Tie-2 ratio were further increased (P < 0.05). In the model group, the number of neurons in the ischemic penumbra cortex of rats was decreased, the nuclei were shrank or disappeared, the cell bodies were vacuolated and degenerated, accompanied by a large number of inflammatory cell infiltrations. Compared with the model group, the injury of cortical neurons in the acupuncture group was alleviated. Compared with the acupuncture group, the injury of cortical neurons in the acupuncture+Ang-2 group was aggravated.

Zhu Lian's type Ⅱ inhibition needling can improve neurological function in IS rats, possibly by activating the Ang-1/Tie-2 pathway to promote angiogenesis.