Acupuncture for poststroke coma: A systematic review and meta-analysis

IF 3.5 3区 医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE Complementary therapies in medicine Pub Date : 2024-05-03 DOI:10.1016/j.ctim.2024.103046
Yulun Wu , Kun Zhao , Wanshun Wen, Keying Zhu, Fei’ao Lu, Yurou Kong, Xiangming Ye , Hui Wang
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Abstract

Background

Despite being widely applied in clinical practice, the wake-promoting effect of acupuncture in poststroke coma patients remains controversial.

Objective

This study aimed to evaluate the efficacy of acupuncture for the treatment of poststroke coma.

Methods

Randomized controlled trials (RCTs) of acupuncture for treating poststroke coma were identified in PubMed, Cochrane Library, EMBASE, CNKI, WanFang and VIP up to 25 November 2023. The main outcomes were Glasgow Coma Scale (GCS) score, National Institute of Health Stroke Scale (NIHSS) score, awakening ratio and clinically effective ratio. Stata 17 and Review Manager 5.4 software were used for mate analysis.

Results

A total of 34 RCTs involving 2757 patients were included. GCS (WMD = 1.78; 95% CI: 1.35 to 2.21) and NIHSS score (WMD = −2.84; 95% CI: −3.84 to −1.84) were significantly increased in acupuncture group compared with control group. Acupuncture combined with routine treatment may be better than routine treatment in improving the awakening ratio (RR= 1.65; 95% CI: 1.24 to 2.91) and the clinically effective ratio (RR= 1.20; 95% CI: 1.13 to 1.27). Some methodological flaws were identified in the included studies, including non-implementation of blinding, inappropriate disease assessment and heterogeneous interventions.

Conclusions

The existing evidence suggests that acupuncture combined with conventional treatment may be an effective treatment for poststroke coma patients. In the meantime, more high-quality RCTs are needed to demonstrate these findings due to methodological weaknesses like randomization, blinding, heterogeneous interventions and long-term follow-up.

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针灸治疗中风后昏迷:系统回顾和荟萃分析。
背景:尽管针灸被广泛应用于临床,但其对中风后昏迷患者的促醒作用仍存在争议:尽管针灸已被广泛应用于临床,但其对中风后昏迷患者的促醒作用仍存在争议:本研究旨在评估针灸治疗中风后昏迷的疗效:截至 2023 年 11 月 25 日,在 PubMed、Cochrane Library、EMBASE、CNKI、WanFang 和 VIP 中找到了针灸治疗中风后昏迷的随机对照试验(RCT)。主要结果为格拉斯哥昏迷量表(GCS)评分、美国国立卫生研究院卒中量表(NIHSS)评分、苏醒率和临床有效率。使用Stata 17和Review Manager 5.4软件进行配对分析:结果:共纳入 34 项 RCT,涉及 2,757 名患者。与对照组相比,针刺组的 GCS(WMD = 1.78;95% CI:1.35 至 2.21)和 NIHSS 评分(WMD = -2.84;95% CI:-3.84 至 -1.84)显著增加。针灸联合常规治疗在提高唤醒率(RR= 1.65;95% CI:1.24 至 2.91)和临床有效率(RR= 1.20;95% CI:1.13 至 1.27)方面可能优于常规治疗。在纳入的研究中发现了一些方法上的缺陷,包括未实施盲法、疾病评估不当和干预措施不一致等:结论:现有证据表明,针灸结合常规治疗可能是治疗中风后昏迷患者的有效方法。结论:现有证据表明,针灸联合常规治疗对中风后昏迷患者可能有效,但由于随机化、盲法、异质性干预和长期随访等方法学缺陷,需要更多高质量的研究性临床试验来证明这些发现。
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来源期刊
Complementary therapies in medicine
Complementary therapies in medicine 医学-全科医学与补充医学
CiteScore
8.60
自引率
2.80%
发文量
101
审稿时长
112 days
期刊介绍: Complementary Therapies in Medicine is an international, peer-reviewed journal that has considerable appeal to anyone who seeks objective and critical information on complementary therapies or who wishes to deepen their understanding of these approaches. It will be of particular interest to healthcare practitioners including family practitioners, complementary therapists, nurses, and physiotherapists; to academics including social scientists and CAM researchers; to healthcare managers; and to patients. Complementary Therapies in Medicine aims to publish valid, relevant and rigorous research and serious discussion articles with the main purpose of improving healthcare.
期刊最新文献
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