Complementary Therapy with Traditional Chinese Medicine for Neonatal Hypoxic Ischemic Encephalopathy

Hypoxic ischemic encephalopathy (HIE) is one of the most significant causes of mor - bidity, mortality, and lifelong disability in newborns. The diagnosis of neonatal HIE is based on the dysfunction of neurogenic signs and classification according to the Sarnat staging system, which evaluates conscious level, neuromuscular control, complex reflexes, autonomic function, seizures, electroencephalogram readings, and duration of neurologic sign. There is no standard treatment for neonatal HIE, but it is widely accepted that hypothermia therapy is a safe and effective method for treating neonates with HIE. Traditional Chinese medicine (TCM) has recently been used to treat cases of neonatal HIE, especially herbal medicine prescriptions. Acupuncture is a common method used in TCM and is another promising therapy for neonatal HIE due to its dem onstrated effective treatment of the disease in animal models. While there is a lack of direct evidence in clinical practice, we have observed acupuncture to be useful in adult HIE and in animal studies; therefore, we believe a clinical trial designed to evaluate the effectiveness of acupuncture in neonatal HIE treatment is worthwhile. Taken together, TCM is a promising technique that can be integrated into the conventional therapies for neonatal accumulation in cells, nNOS and ROS increase, which causes lipid peroxidation and induce cell apoptosis. Furthermore, excess Ca 2+ will reduce Bcl- 2 expression and increase Bax expression, also leading cells to undergo apoptosis. In addition, CO might play an important role in preventing immune cell recruitment, decrease the inflammatory response, inhibit cell apoptosis, and promote vasodilation. (3) In the days to months following the initial HIE onset: BDNF and GDNF might be involved in many signaling cascades responsible for brain tissue repair and remodeling.