Advances and Prospects in Non-Pharmacological Treatment of Acute Ischemic Stroke: From Mechanisms and Strategies to Evidence

doi:10.3969/j.issn.1673-5765.2026.07.002

Abstract

Abstract: Acute ischemic stroke (AIS) is a leading cause of disability and death worldwide. Although vascular recanalization therapies, including intravenous thrombolysis and endovascular thrombectomy, can significantly improve the outcomes in eligible patients, the constraints of strict time windows and the phenomenon of futile recanalization have driven the search for adjunctive brain cytoprotection therapies independent of vascular recanalization therapies. Over the past decades, the consecutive negative results from clinical trials involving over a thousand brain cytoprotection drugs have partially shifted the research focus toward non-pharmacological treatments. This paper systematically summarizes the research progress of non-pharmacological treatments in brain cytoprotection for AIS, including Trendelenburg position, remote ischemic preconditioning, hyperbaric oxygen/normobaric hyperoxic oxygen, physical stimulation therapies, acupuncture, and hypothermia. It elaborates on the molecular physiological mechanisms, clinical intervention strategies, and the strength of existing evidence for each therapy, analyzes the current challenges in this field, and outlines future development strategies, with the aim of providing references for promoting the innovation and clinical translation of non-pharmacological treatments for AIS.

Key words: Acute ischemic stroke; Non-pharmacological treatment; Mechanism; Evidence

摘要： 急性缺血性卒中是全球人群致残和致死的主要原因之一。尽管血管再通治疗（静脉溶栓、机械取栓）可显著改善部分患者预后，但严格的时间窗限制和无效再通现象促使研究者探索血管再通治疗以外的辅助性脑细胞保护策略。过去数十年，逾千种脑细胞保护药物的临床试验接连呈现阴性结果，这促使研究焦点一定程度上转向了非药物治疗。本文系统梳理头低脚高位、远隔缺血适应、高压氧与常压高浓度氧、物理刺激疗法、针灸及低温治疗等非药物治疗在急性缺血性卒中脑细胞保护中的研究进展，重点阐述各疗法的分子生理机制、临床干预策略及现有证据强度，分析当前该领域面临的挑战并展望未来发展策略，以期为推动急性缺血性卒中非药物治疗的创新与临床转化提供参考。

关键词: 急性缺血性卒中; 非药物治疗; 机制; 证据

CLC Number:

WANG Tingting, CHEN Huisheng. Advances and Prospects in Non-Pharmacological Treatment of Acute Ischemic Stroke: From Mechanisms and Strategies to Evidence[J]. Chinese Journal of Stroke, 2026, 21(7): 797-803.

王婷婷, 陈会生. 急性缺血性卒中非药物治疗的进展与展望：从机制、策略到证据[J]. 中国卒中杂志, 2026, 21(7): 797-803.

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URL: https://www.chinastroke.org.cn/EN/10.3969/j.issn.1673-5765.2026.07.002

https://www.chinastroke.org.cn/EN/Y2026/V21/I7/797

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