Evidence-based Optimization of Acupuncture Timing Strategies for Ischemic Stroke
10.13422/j.cnki.syfjx.20260292
- VernacularTitle:缺血性卒中针刺干预时间策略的循证优化
- Author:
Gezhi ZHANG
1
;
An LI
1
;
Weixuan BAI
1
;
Xue CHEN
1
;
Fangqi LIU
2
;
Mengyu LIU
1
Author Information
1. Institute of Basic Research in Clinical Medicine，China Academy of Chinese Medical Sciences， Beijing 100700，China
2. School of Traditional Chinese and Western Medicine， Gansu University of Chinese Medicine，Lanzhou 730000，China
- Publication Type:Journal Article
- Keywords:
ischemic stroke;
acupuncture;
intervention timing;
needle retention time;
treatment interval
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2025;31(24):144-152
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the impacts of three types of acupuncture timing factors， including intervention initiation time， needle retention duration， and treatment intervals， on the treatment efficacy of ischemic stroke （IS） and provide evidence-based support for optimizing acupuncture timing strategies. MethodsA systematic search was conducted in both Chinese and English databases， including CNKI， Wanfang Data， VIP， CBM， PubMed， Web of Science， Cochrane Library， and Embase. The randomized controlled trials involving multiple acupuncture intervention time groups were included to reduce inter-study heterogeneity. A network meta-analysis model was constructed to compare the effects of different intervention initiation time， needle retention duration， and treatment intervals on primary IS outcomes， including total clinical response rate， neurological and limb function scores， quality of life score， and hemorheological parameters. Adverse events were also assessed. ResultsA total of 32 studies were included. The results showed that early acupuncture intervention （1-3 days and 4-7 days after onset） outperformed late intervention （>14 days） in terms of response rate， neurological function improvement， and quality of life （P<0.05， P<0.01）. Extending needle retention time to 40-60 min was associated with improved response rates and hemorheological parameters （P<0.01）. No significant differences were observed among different treatment intervals. The evidence of key outcomes showed high overall certainty， with low heterogeneity and inconsistency. Sensitivity analyses and publication bias assessments indicated the stability of the main results and a low risk of publication bias. No significant adverse reaction was reported. ConclusionDifferent timing factors significantly influence the efficacy of acupuncture treatment for IS. Early intervention and appropriately extended needle retention time result in better clinical outcomes， while treatment interval has no significant effect on efficacy. The inclusion of studies with multiple acupuncture timing groups helps control methodological heterogeneity and enhances the robustness of the analysis， providing evidence-based guidance for optimizing acupuncture timing strategies in IS management.
