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Effect of Jianpi Shengxue Tablet on Iron Metabolism and Nutritional Status in Patients with Renal Anemia:A Prospective,randomized,Open,Parallel Controlled and Multicenter Clinical Study

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Current Medical Science 2024年第3期44卷 603-610页

作者： Juan YANG Meng-yuan LIANG Yu LI Hao ZHANG Wei LI Jing LV Li-ping DONG Jing-song JIN Cheng YANG Qing-hong ZHANG Li LONG Rong ZOU Yi GAO Dan SONG Chun-qin PAN Ying YAO Xiao-lin ZHAN Xiao-hui WANG Department of Nephrology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Department of Nephrology The First People’s Hospital of GuiyangGuiyang550000China Department of Nephrology The Third Xiangya HospitalCentral South UniversityChangsha410000China Department of Nephrology The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an710061China Department of Nephrology Wuhan No. 4 HospitalWuhan430033China Department of Nephrology Hubei Provincial Hospital of Traditional Chinese MedicineWuhan430060China Department of Nephrology Central Theater General Hospital of PLAWuhan430064China Department of Nephrology Taihe HospitalShiyan442000China Department of Nephrology Third People’s Hospital of Hubei ProvinceWuhan430033China Department of Nephrology Hubei Province Integrated Traditional Chinese and Western Medicine Hospital of Hubei provinceWuhan430024China Department of Nephrology Xi’an No.3 HospitalAffiliated Hospital of Northwest UniversityXi’an710000China Department of Nephrology Shenzhen Guangming District People’s HospitalShenzhen518000China Department of Nephrology Xiantao First People’s HospitalXiantao433000China Department of Nutrition Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Department of Nephrology Huangshi Central HospitalHuangshi435000China Department of Nephrology The Fifth Hospital of WuhanWuhan430050China

Objective This study aimed to analyze the clinical efficacy of the Jianpi Shengxue tablet for treating renal anemia.Methods A total of 200 patients with renal anemia from December 2020 to December 2022 were enrolled and randomly divided into two groups.Patients in the control group were treated with polysaccharide-iron complex,and those in the experimental group were administered Jianpi Shengxue tablet.After 8 weeks of continuous treatment,the therapeutic outcomes regarding anemia were compared between the two groups.Results After treatment,the red blood cell(RBC)count,hematocrit(HCT),reticulocyte percentage(RET),ferritin(SF),serum iron(SI),transferrin saturation(TSAT),and serum albumin(ALB)all increased(P<0.01),and the clinical symptom score and total iron binding capacity decreased(P<0.01)in the experimental group.Moreover,the improvements in RBC,HCT,RET,SF,SI,TAST,ALB,and clinical symptoms(fatigue,anorexia,dull skin complexion,numbness of hands and feet)in the experimental group were significantly greater than those in the control group(P<0.05).The total effective rate for treating renal anemia was significantly higher in the experimental group than in the control group(P<0.01).Conclusion The Jianpi Shengxue tablet demonstrates efficacy in treating renal anemia,leading to significant improvements in the laboratory examination results and clinical symptoms of patients with renal anemia.

关键词： Jianpi Shengxue tablet renal anemia randomized open parallel control multicenter clinical study

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Effect of Qingda granules in treating grade 1 hypertension patients with different levels of anxiety:A randomized controlled trial

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China Medical Abstracts(Internal Medicine) 2024年第1期41卷 14-14页

作者：彭煜暄 Graduate Sch Beijing CM UnivBeijing 100029

Objective To evaluate the effects of Qingda Granules (QDG) on office blood pressure (OBP) and the anxiety score in patients with grade 1 hypertension with different levels of anxiety.Methods A randomized,multicenter,double-blinded,non-inferiority clinical trial design was adopted.A total of 552 patients with grade 1hypertension were randomly assigned to the treatment group(276 cases) and the control group (276 cases).

关键词： hypertension patients randomized

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Clinical efficacy of comprehensive therapy based on traditional Chinese medicine patterns on patients with pneumoconiosis: a pilot double-blind, randomized, and placebo-controlled study

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Frontiers of Medicine 2022年第5期16卷 736-744页

作者： Jiansheng Li Hulei Zhao Yang Xie Jieya Li Qingwei Li Xuexin Chen Weiyu Zhang Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province&Education Ministry of China Henan University of Chinese MedicineZhengzhou 450046China Henan Key Laboratory of Chinese Medicine for Respiratory Disease Henan University of Chinese MedicineZhengzhou 450046China Department of Respiratory Diseases The First Affiliated Hospital of Henan University of Chinese MedicineZhengzhou 450000China Department of Pneumoconiosis Henan Hospital for Occupational DiseasesZhengzhou 450052China Department of Respiratory Diseases Jiaozuo Coal Industry Group Co.Ltd.Central HospitalJiaozuo 454000China Department of Pneumoconiosis Yima Coal Industry Group Co.Ltd.General HospitalYima 472300China

Effective therapy options for pneumoconiosis are lacking.Traditional Chinese medicine(TCM)presents a favorable prospect in the treatment of pneumoconiosis.A pilot study on TCM syndrome differentiation can evaluate the clinical efficacy and safety of TCM and lay a foundation for further clinical research.A double-blind,randomized,and placebo-controlled trial was conducted for 24 weeks,in which 96 patients with pneumoconiosis were randomly divided into the control and treatment groups.Symptomatic treatment was conducted for the two groups.The treatment group was treated with TCM syndrome differentiation,and the control group was treated with placebo.The primary outcomes were the six-minute walking distance(6MWD)and the St.George Respiratory Questionnaire(SGRQ)score.The secondary outcomes were the modified British Medical Research Council Dyspnea Scale(mMRC),Chronic Obstructive Pulmonary Disease Assessment Test(CAT),Hospital Anxiety and Depression Scale(HADS),and pulmonary function.Only 83 patients from the 96 patients with pneumoconiosis finished the study.For the primary outcome,compared with the control groups,the treatment group showed a significantly increased 6MWD(407.90 m vs.499.51 m;95%confidence interval(CI)47.25 to 135.97;P<0.001)and improved SGRQ total score(44.48 vs.25.67;95%CI 27.87 to 9.74;P<0.001).The treatment group also significantly improved compared with the control group on mMRC score(1.4 vs.0.74;95%CI 1.08 to 0.23;P=0.003),CAT score(18.40 vs.14.65;95%CI 7.07 to 0.43;P=0.027),and the total symptom score(7.90 vs.5.14;95%CI 4.40 to 1.12;P<0.001).No serious adverse events occurred.This study showed that TCM syndrome differentiation and treatment had a favorable impact on the exercise endurance and quality of life of patients with pneumoconiosis.

关键词： pneumoconiosis randomized controlled trials traditional Chinese medicine

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Envonalkib versus crizotinib for treatment-naive ALK-positive non-small cell lung cancer: a randomized, multicenter, open-label, phase III trial

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Signal Transduction and Targeted Therapy 2023年第9期8卷 4338-4345页

作者： Yunpeng Yang Jie Min Nong Yang Qitao Yu Ying Cheng Yanqiu Zhao Manxiang Li Hong Chen Shou’an Ren Jianying Zhou Wu Zhuang Xintian Qin Lejie Cao Yan Yu Jian Zhang Jianxing He Jifeng Feng Hao Yu Li Zhang Wenfeng Fang Department of Medical Oncology Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhou 510060China Department of Oncology The Second Affiliated Hospital of Air Force Medical UniversityXi’an 710038China Department of Medical Oncology Lung Cancer and Gastrointestinal UnitHunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of MedicineCentral South UniversityChangsha 410013China Department of Medical Oncology of Respiratory Affiliated Tumor Hospital of Guangxi Medical UniversityGuangxiNanning 530021China Department of Thoracic Medical Oncology Jilin Provincial Cancer HospitalChangchun 130012China Department of Medical Oncology The Affiliated Cancer Hospital of Zhengzhou UniversityZhengzhou 450003China Department of Respiratory First Affiliated Hospital of Xian Jiaotong UniversityXi’an 710061China Department of Respiratory and Critical Care Medicine The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400050China Department of Respiratory The First Hospital of Shanxi Medical UniversityTaiyuan 030001China Department of Respiratory Disease The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of Medical Oncology Fujian Cancer HospitalFuzhou 350014China The First Department of Oncology The First Affiliated Hospital of Guangdong Pharmaceutical UniversityGuangzhou 510699China Department of Respiratory and Critical Care Medicine Anhui Provincial HospitalHefei 230000China Department of Respiratory Medicine Affiliated Cancer Hospital of Harbin Medical UniversityHarbin 150000China Department of Respiratory Medicine The First Affiliated Hospital of Air Force Medical UniversityXi’an 710032China Department of Cardiothoracic Surgery The First Affiliated Hospital of Guangzhou Medical CollegeGuangzhou Research Institute of Respiratory Disease and China State Key Laboratory of Respiratory DiseaseGuangzhou 510120China Department

Anaplastic lymphoma kinase(ALK)rearrangements are present in about 5–6%of non-small cell lung cancer(NSCLC)cases and associated with increased risks of central nervous system(CNS)involvement.Envonalkib,a novel ALK inhibitor,demonstrated promising anti-tumor activity and safety in advanced ALK-positive NSCLC in the first-in-human phase I study.This phase III trial(ClinicalTrials.gov NCT04009317)investigated the efficacy and safety of first-line envonalkib in advanced ALK-positive NSCLC cases.Totally 264 participants were randomized 1:1 to receive envonalkib(n=131)or crizotinib(n=133).Median independent review committee(IRC)-assessed progression-free survival(PFS)times were 24.87(95%confidence interval[CI]:15.64–30.36)and 11.60(95%CI:8.28–13.73)months in the envonalkib and crizotinib groups,respectively(hazard ratio[HR]=0.47,95%CI:0.34–0.64,p<0.0001).IRC-assessed confirmed objective response rate(ORR)was higher(81.68%vs.70.68%,p=0.056)and duration of response was longer(median,25.79[95%CI,16.53–29.47]vs.11.14[95%CI,9.23–16.59]months,p=0.0003)in the envonalkib group compared with the crizotinib group.In participants with baseline brain target lesions,IRC-assessed CNS-ORR was improved with envonalkib compared with crizotinib(78.95%vs.23.81%).Overall survival(OS)data were immature,and median OS was not reached in either group(HR=0.84,95%CI:0.48–1.47,p=0.5741).The 12-month OS rates were 90.6%(95%CI,84.0%–94.5%)and 89.4%(95%CI,82.8%–93.6%)in the envonalkib and crizotinib groups,respectively.Grade≥3 treatment-related adverse events were observed in 55.73%and 42.86%of participants in the envonalkib and crizotinib groups,respectively.Envonalkib significantly improved PFS and delayed brain metastasis progression in advanced ALK-positive NSCLC.

关键词： crizotinib randomized cancer

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The Efficacy and Safety of Tolvaptan in Heart Failure Patients with Congestive Signs:A Systematic Review and Meta-Analysis of randomized Controlled Trials

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Cardiology Discovery 2023年第1期3卷 30-39页

作者： Mei Zeng Na Li Tongshuai Chen Yun Ti Chunmei Zhang Peili Bu The Key Laboratory of Cardiovascular Remodeling and Function Research Chinese Ministry of EducationChinese National Health Commission and Chinese Academy of Medical SciencesThe State and Shandong Province Joint Key Laboratory of Translational Cardiovascular MedicineDepartment of CardiologyQilu HospitalCheeloo College of MedicineShandong UniversityJinan 250012China

Objective:The aim of this study was to investigate the efficacy and safety of tolvaptan,as well as the impact of its treatment dose and duration in heart failure patients with congestive signs.Methods:The PubMed,Embase,Cochrane Library,and ClinicalTrials.gov databases were searched to collect data from all randomized controlled trials(RCT)examining the efficacy and safety of tolvaptan in heart failure patients with congestive signs compared with placebo or blank control until March 4,2021.Urine volume,change in body weight,improvement in dyspnea,and reduction of edema were evaluated as efficacy indicators.All-cause mortality,worsening heart failure,and adverse events were considered safety indicators.The quality of eligible publications was assessed using the Cochrane risk of bias for RCTs.Results:Ten RCTs with 5,980 patients were included in this analysis.Compared with control,tolvaptan significantly reduced weight in the short term(day 1,7 RCTs,weighted mean difference(WMD):-1.09,95%confidence interval(CI):-1.27 to-0.91;day 2,2 RCTs,WMD:-1.67,95%CI:-3.00 to-0.33;day 7,4 RCTs,WMD:-0.95,95%CI:-1.25 to-0.66),increased urine volume(WMD:1,825.72,95%CI:1,438.38-2,213.07),and relieved dyspnea(risk ratio(RR):1.12,95%CI:1.05-1.19)without increasing the mortality rate(RR:0.96,95%CI:0.87-1.06).Furthermore,the weight loss and increase in urine volume were not dose-dependent effects,and prolonged medication did not lead to sustained weight loss.In addition,there seemed to be more adverse events(RR:1.17,95%CI:1.03-1.32)after treatment with tolvaptan.Further analysis revealed that patients treated with tolvaptan were more likely to report thirst(RR:6.09,95%CI:3.37-11.00)and dry mouth(RR:6.36,95%CI:4.09-9.90),as well as develop hypernatremia(RR:12.76,95%CI:3.52-46.32).Conclusions:The meta-analysis shows that tolvaptan can improve congestion with no increase in mortality rate,but should be used to guard against adverse events.Deserve to be mentioned,the number of RCTs included was limited,suggesting that the observed results sh

关键词： Heart failure Tolvaptan Congestion Meta-analysis randomized controlled trials

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Effects of acupuncture in treating insomnia due to spleen-stomach disharmony syndrome and its influence on intestinal microbiome: Study protocol for a randomized controlled trial

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Journal of Integrative Medicine 2019年第3期17卷 161-166页

作者： Ya-ru Huangfu Wei Peng Bao-jun Guo Zhi-fu Shen Li Li Shi-wei Liu Hui Zheng You-ping Hu Acupuncture and Tuina School Chengdu University of Traditional Chinese Medicine

Background: Insomnia is a common complaint that is closely related to gastrointestinal symptoms, which is consistent with the traditional Chinese medicine classical theory of ‘‘stomach disharmony leading to restless sleep." Acupuncture is an effective complementary and alternative medicine therapy to improve gastrointestinal function and restore the normal sleep-wake cycle. However, studies on the effectiveness of acupuncture for insomnia due to spleen-stomach disharmony syndrome are limited to case reports and few randomized controlled trials; deeper research on its mechanism is still lacking. This randomized controlled trial aims to assess the treatment efficacy of ‘‘harmonizing stomach to tranquilize mind"acupuncture for insomnia and its influence on the intestinal microbiome.Methods/design: This is a randomized, single-blind, parallel-group study. Sixty eligible patients with insomnia due to spleen-stomach disharmony syndrome will be randomly divided into two groups(1:1 allocation ratio). The intervention group will use ‘‘harmonizing stomach to tranquilize mind"acupuncture, and the control group will receive sham acupuncture. Participants will receive 5 acupuncture treatment sessions per week for 4 consecutive weeks. The Pittsburgh Sleep Quality Index will be used to evaluate the clinical efficacy of acupuncture treatment by making assessments at baseline, the end of treatment and the end of the follow-up. High-throughput 16 S ribosomal ribonucleic acid gene sequencing will be performed to detect changes in the intestinal microbial composition before and after treatment.Discussion: The results of this trial are expected to confirm that ‘‘harmonizing stomach to tranquilize mind" acupuncture can effectively relieve insomnia and alter the intestinal microbiome.

关键词： Insomnia Gastrointestinal symptoms Acupuncture Intestinal microbiome randomized controlled trial Study protocol

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Evaluation on Effectiveness and Safety of Chinese Herbs inTreatment of Sub-health: A Systematic Review andMeta-Analysis of randomized Controlled Trials

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Chinese Journal of Integrative Medicine 2019年第6期25卷 471-480页

作者： ZHAO Jun LIAO Xing ZHAO Hui LI Zhi-geng WANG Nan-yue WANG Li-min China Academy of Chinese Medical Science Beijing (100700) China Beijing University of Chinese Medicine Beijing (100029) China Institute of Basic Research in Clinical Medicine China Academy of Chinese Medical Science Beijing (100700) China Institute of Basic Theory for Chinese Medicine China Academy of Chinese Medical Sciences Beijing (100700) China Experimental Research Center China Academy of Chinese Medical Sciences Beijing (100700) China

Objective: To evaluate the effectiveness and safety of Chinese herbs in the treatment of sub-health systematical y. Methods: Nine databases were systematicaly and extensively searched to col ect randomized control ed trials(RCTs) about Chinese herbs in the treatment of sub-health. The outcomes included overal effective rate, main symptoms, quality of life, etc. Literature screening, data extraction and quality assessment were conducted according to Cochrane Handbook 5.1. Meta-analysis was conducted to the included literature with Review Manager Software.Results: Seventy-two studies involving 9,296 patients with sub-health were included with 4,908 patients in experimental groups and 4,387 patients in control groups. The overal quality of included clinical research was not high. In the aspect of improving overall effective rate, relieving main symptoms, Pittsburgh sleep quality index(PSQI) score, Athens Insomnia Scale(AIS) score, Fatigue Scale-14(FS-14), Cornel Medical Index(CMI) score and discontinuation rate, the effects of experimental groups were better than that of control groups. According to available research reports, adverse reactions in Chinese herb groups were mainly mild gastrointestinal symptoms, which did not affect the treatment.Conclusion: Chinese herbs have a curative effect in the treatment of sub-health. However, there are no clear criteria for diagnosis and curative effectiveness judgment global y, which would affect the accuracy of curative effect evaluation.

关键词： sub-health randomized controlled trials Chinese medicine systematic review

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Blood-Letting Therapy for Hypertension: A Systematic Review and Meta-Analysis of randomized Controlled Trials

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Chinese Journal of Integrative Medicine 2019年第2期25卷 139-146页

作者： XIONG Xing-jiang WANG Peng-qian LI Sheng-jie Department of Cardiology Guang'anmen HospitalChina Academy of Chinese Medical Sciences Institute of Chinese Materia Medica China Academy of Chinese Medical Sciences Department of Molecular Biology Peking Union Medical College HospitalChinese Academy of Medical Sciences

Objective:To evaluate the efficacy and safety of blood-letting therapy(BLT)in treatment of hypertension.Methods:A comprehensive electronic and manual bibliographic searches were performed in Cochrane Central Register of Controlled Trials,Excerpt Medica Database(EMBASE),PubMed,China National Knowledge Infrastructure,Chinese Scientific Journal Database,Chinese Biomedical Literature Database,and Wanfang Database to identify randomized controlled trials(RCTs)in which hypertensive patients were treated with BLT or BLT plus antihypertensive drugs(BPAD)against placebo,no treatment or antihypertensive drugs.The Cochrane Risk Assessment Tool was used to assess the methodological quality of trials.The Review Manager 5.3 software was used for meta-analysis.Results:A total of 7 RCTs with 637 hypertensive patients from 1989 to 2017 were identified.Compared with antihypertensive drugs,blood pressure was significantly reduced by BLT(RR=1.21,95%CI:1.01 to 1.44,P=0.03;heterogeneity:P=0.06,I^2=60%)and BPAD(RR=1.25,95%CI,1.02 to 1.53,P=0.03;heterogeneity:P=0.01,I^2=71%).Moreover,a significant improvement in Chinese medicine syndrome by BLT(RR=1.32;95%CI:1.14 to 1.53,P=0.0002;heterogeneity:P=0.53,I^2=0%)and BPAD(RR=1.47;95%CI:1.06 to 2.04,P=0.02;heterogeneity:P=0.13,I^2=56%)was identified.The reported adverse effects were well tolerated.Conclusions:Although some positive findings were identified,no definite conclusions regarding the efficacy and safety of BLT as complementary and alternative approach for treatment of hypertension could be drew due to the generally poor methodological design,significant heterogeneity,and insufficient clinical data.Further rigorously designed trials are warranted to confirm the results.

关键词： blood-letting therapy phlebotomy blood pressure Chinese medicine complementary and alternative medicine systematic review meta-analysis randomized controlled trials

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Burnout in the emergency department: randomized controlled trial of an attention-based training program

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Journal of Integrative Medicine 2019年第3期17卷 173-180页

作者： Pádraic J.Dunne Julie Lynch Lucia Prihodova Caoimhe O'Leary Atiyeh Ghoreyshi Sharee A.Basdeo Donal J.Cox Rachel Breen Ali Sheikhi áine Carroll Cathal Walsh Geraldine McMahon Barry White Trinity Translational Medicine Institute Trinity College Research Department Royal College of Physicians of Ireland Department of Innovation Fitbit Inc. Health Research Institute Main BuildingUniversity of Limerick Health Service Executive Dr Steevens' Hospital Department of Emergency Medicine St.James' s Hospital National Centre for Hereditary Coagulation Disorders St.James' s Hospital

Background: Burnout(encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, potentially impacting on quality of care and attrition from the specialty.Objective: The aim of this study was to apply an attention-based training(ABT) program to reduce burnout among emergency multidisciplinary team(MDT) members from a large urban hospital.Design, setting, participants and interventions: Emergency MDT members were randomized to either a notreatment control or an intervention group. Intervention group participants engaged in a four session(4 h/session) ABT program over 7 weeks with a practice target of 20 min twice-daily. Practice adherence was measured using a smart phone application together with a wearable Charge 2 device.Main outcome measures: The primary outcome was a change in burnout, comprising emotional exhaustion, depersonalization and personal achievement. The secondary outcomes were changes in other psychological and biometric parameters.Results: The ABT program resulted in a significant reduction(P < 0.05; T1 [one week before intervention]vs T3 [follow-up at two months after intervention]) in burnout, specifically, emotional exhaustion, with an effect size(probability of superiority) of 59%. Similar reductions were observed for stress(P < 0.05) and anxiety(P < 0.05). Furthermore, ABT group participants demonstrated significant improvements in heart rate variability, resting heart rate, sleep as well as an increase in pro-inflammatory cytokine expression.Conclusion: This study describes a positive impact of ABT on emergency department staff burnout compared to a no-treatment control group.

关键词： Burnout Emotional exhaustion Meditation Healthcare professional Sleep Stress Cytokines Cortisol randomized controlled trial

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Fire-needle acupuncture for upper limb spastic paralysis after stroke:Study protocol for a randomized controlled trial

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Journal of Integrative Medicine 2019年第3期17卷 167-172页

作者： Xin-yu Yue Zhuo-qi Feng Xi-yi Yu Jia-min Hu Xiao-Jing He Shi Shu School of Traditional Chinese Medicine Naval Medical University Beijing He's SanTong Acupuncture and Fire-needle Moxibustion Clinic Basic Medical School Shanghai University of Traditional Chinese Medicine

Background: Fire-needle acupuncture, an important kind of acupuncture therapy, has been clinically used to treat upper limb spastic paralysis(ULSP) after stroke. Clinical experience has indicated that fire-needle acupuncture treatment takes less time, requires fewer visits, and has more rapid results and fewer side effects compared to chemical medicine alternatives. This study will evaluate the effects of fire-needle acupuncture for ULSP in the context of standardized clinical research and provide high-quality data to inform clinical procedures and future study design.Methods/Design: A randomized controlled trial will be carried out to evaluate the effects of fire-needle acupuncture therapy in patients with ULSP from stroke. ULSP patients(n = 120) will be recruited at Changhai Hospital in Shanghai, China. Patients will be randomly divided into three groups, including fire-needle acupuncture group(FAG), filiform-needle acupuncture group(FFAG) and rehabilitation treatment group(RTG). During the 3-week treatment, the FAG will be treated every two days, while FFAG and RTG will be treated 5 d in a row and then rest for 2 d. The Simplified Fugl-Meyer Motor Function Scale and Modified Ashworth Scale will be used as the primary outcome measures. Statistical analysis will be conducted by an independent statistician.Discussion: Through this study, the utility of fire-needle acupuncture in treating ULSP after stroke will be tested, and some specific claims of fire-needle acupuncture therapy will be evaluated, such as relieving spasm and muscular tension, improving activities of daily living, rapidity of response and less frequency of treatment compared with other treatments.

关键词： Fire-needle acupuncture Upper limb spastic paralysis Stroke randomized controlled trial Study protocol

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