Stroke Recovery (Post-Stroke)
Overview
Stroke recovery (post-stroke sequelae) refers to residual hemiplegia, deviated mouth and tongue, dysarthria, and hemianesthesia persisting more than six months after stroke. In TCM, the pathogenesis is root deficiency and branch excess: qi deficiency as the root, with blood stasis, phlegm turbidity, and wind pathogen obstructing the collaterals as the branch. Common patterns include qi deficiency with blood stasis, wind-phlegm obstructing the collaterals, and liver-kidney depletion. The disease is located in the brain and involves the heart, liver, spleen, and kidney. Treatment during rehabilitation aims to boost qi and invigorate blood, transform phlegm and unblock the collaterals, and nourish the liver and kidney, combined with acupuncture, tuina, and comprehensive rehabilitation to promote functional recovery.
Pattern differentiation (clinical patterns)
Qi Deficiency with Blood Stasis
Hemiplegia with flaccid limbs, hemianesthesia, deviated mouth and tongue, dysarthria, sallow complexion, shortness of breath and fatigue, spontaneous sweating, dark or ecchymotic tongue body with thin white coating, and a fine choppy pulse.
Boost qi and invigorate blood; transform stasis and unblock the collaterals.
Wind-Phlegm Obstructing the Collaterals
Hemiplegia, deviated mouth and tongue, stiff tongue with dysarthria, hemianesthesia, dizziness and vertigo, profuse sticky sputum, dark tongue body with white greasy coating, and a wiry slippery pulse.
Expel wind and resolve phlegm, unblock collaterals and open orifices.
Liver-Kidney Depletion
Hemiplegia with stiff and contracted affected limbs, soreness and weakness of the lower back and knees, dizziness and tinnitus, insomnia with profuse dreams, dry throat and mouth, red tongue with scanty coating, and a fine rapid pulse.
Tonify the liver and kidney, strengthen tendons and bones.
Connections
Daily care & prevention
Patients should adhere to rehabilitation training, including limb function exercises, speech therapy, and activities of daily living training. The diet should be light, avoiding greasy and sweet foods; appropriate consumption of Chinese yam, coix seed, and black sesame to strengthen the spleen and kidney is beneficial. Maintain emotional stability and avoid anger and worry. Keep warm and prevent external pathogen invasion. Regularly monitor blood pressure, blood glucose, and blood lipids. Family members should provide psychological support and prevent falls and other accidents.
When to seek medical care
If there is worsening of consciousness, severe headache, vomiting, unequal pupils, new-onset limb paralysis, or inability to speak, it may indicate recurrent stroke or deterioration; seek immediate medical attention. Patients with dysphagia should be guarded against aspiration. Sudden rise or drop in blood pressure, persistent high fever, or convulsions are also critical signs requiring emergency management.