Abstract
Aim: Stroke is the third prevalent cause of disability worldwide. This study aimed to evaluate the role of Dorema ammoniacum and acupuncture in the management of patients with stroke.Methods: In this randomized controlled clinical trial, patients with a recent ischemic stroke (within the first month of stroke) were investigated. The patients were divided into three groups. The first group was managed by acupuncture, while the second group received 1 g of Dorema ammoniacum (two 500 mg capsules per day) from ammoniacum gum. The two intervention groups also received standard treatment with routine medical therapy and physiotherapy. The final group was the control, which only received conventional treatment and physiotherapy. The patients were evaluated immediately before the interventions, and one month after the interventions, using the Modified Rankin Scale (mRS) and Modified National Institutes of Health Stroke Scale (mNIHSS).Results: There was a significant difference in the mean score of mNIHSS at the beginning and end of the study in all of the three studied groups (P<0.001). There were significant pre-treatment/post-treatment differences between the groups (P<0.001). After controlling for the effect of mNIHSS score at the beginning of the study and the follow-up visit, a significant difference was observed between the three groups regarding the mean mNIHSS score post-intervention (P<0.001). The results of the post-hoc test indicated a significant difference between the acupuncture and control groups, Dorema ammoniacum and control groups (P<0.001), acupuncture, and Dorema ammoniacum groups (P<0.001); the extent of reduction was greater in the acupuncture group. The mean mNIHSS scores of the acupuncture and Dorema ammoniacum groups were 1.82 and 1.04 lower than the control group's mean score, respectively. There was a significant difference in the mean mRS score at the beginning and end of the study in all three groups (P<0.001). However, the extent of reduction was greater in the acupuncture group.Conclusion: Acupuncture and Dorema ammoniacum may be beneficial if started within the first month of stroke incidence. However, acupuncture can cause a greater reduction in the mNIHSS score of stroke patients. Trial registration: Iranian Registry of Clinical Trials (IRCT20170227032797N2).Registered 5 March 2018 - Retrospectively registered, https://www.irct.ir/trial/25469
A randomized controlled clinical trial to compare the safety and efficacy of edaravone in acute ischemic stroke