Acupuncture treatment for central post-stroke pain:a systematic review and meta-analysis
10.1007/s11726-024-1453-1
- VernacularTitle:针刺治疗中风后中枢性疼痛的系统评价与Meta分析
- Author:
Xinni CHENG
;
Xin ZHANG
;
Jun JI
;
Fuqing ZHANG
- Keywords:
Acupuncture Therapy;
Stroke;
Poststroke Syndrome;
Central Pain;
Meta-analysis;
Systematic Review
- From:
Journal of Acupuncture and Tuina Science
2024;22(4):341-352
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of acupuncture in the treatment of central post-stroke pain(CPSP). Methods:Randomized controlled trials of acupuncture treatment for CPSP in PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform(Wanfang),Chongqing VIP Database(VIP),and China Biology Medicine Disc(CBM)were retrieved by computer.The retrieval time was from each database's inception to July 2023.Meta-analysis was performed using RevMan 5.3 software;GRADEprofiler 3.6.1 software was used to evaluate the quality of evidence.Dichotomous variables were analyzed by the risk ratio(RR).Continuous data were analyzed by mean difference(MD)with a confidence interval(CI)of 95%. Results:A total of 14 studies were included,comprising a total of 1 045 patients.The findings of the meta-analysis showed that compared with Western medication in treating CPSP,the acupuncture treatment had a higher clinical effective rate[RR=1.09,95%CI(1.01,1.19),Z=2.08,P<0.05],a lower visual analog scale(VAS)score[MD=-0.75,95%CI(-1.18,-0.32),Z=3.41,P<0.001],a lower pain rating index(PRI)score[MD=-1.72,95%CI(-2.76,-0.68),Z=3.24,P<0.05],a higher plasma β-endorphin(β-EP)level[MD=5.81,95%CI(3.00,8.62),Z=4.05,P<0.001],and a lower adverse reaction rate[RR=0.05,95%CI(0.01,0.18),Z=4.35,P<0.001].There was no statistical difference in the present pain intensity(PPI)score between the two treatments[MD=-0.26,95%CI(-0.54,0.02),Z=1.79,P>0.05].Compared with Western medication in treating CPSP,acupuncture plus Western medication had a higher clinical effective rate[RR=1.18,95%CI(1.05,1.34),Z=2.75,P<0.05],a lower VAS score[MD=-1.04,95%CI(-1.26,-0.82),Z=9.25,P<0.001],and a lower Pittsburgh sleep quality index(PSQI)score[MD=-2.67,95%CI(-4.80,-0.54),Z=2.46,P<0.05].The results of the evidence quality grade evaluation showed that there was no moderate-or high-quality evidence for acupuncture or acupuncture plus Western medication compared with Western medication in the treatment of CPSP. Conclusion:Acupuncture has certain therapeutic advantages over Western medication in the treatment of CPSP.It can effectively relieve pain and improve sleep,with fewer adverse reactions and better safety.However,high-quality randomized controlled trials are still needed for further study and verification.
