Journal of Traditional Chinese Medicine ›› 2023, Vol. 43 ›› Issue (1): 27-33.DOI: 10.19852/j.cnki.jtcm.20221006.003
• Meta-analysises • Previous Articles Next Articles
Efficacy of acupuncture therapy for post-stroke fatigue: a systematic review and Meta-analysis
YOU Jianyu1, LI Haiyan2, XIE Dingyi3, CHEN Mingren2, CHEN Rixin3(
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- 1 School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang 330004, China
2 Acupuncture and Tuina School, Jiangxi University of Chinese Medicine, Nanchang 330004, China
3 Department of Acupuncture and Moxibustion, the Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang 330006, China
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Received:2021-11-22Accepted:2022-02-28Online:2023-02-15Published:2023-01-10 -
Contact:CHEN Rixin -
About author:CHEN Rixin, Department of Acupuncture and Moxibustion, the Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang 330006, China. chenrixin321@163.com, Telephone:+86-18779112700
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Supported by:National Key Basic Research and Development Program(2015CB554503);Collaborative Innovation Center for Moxibustion Therapy Research and Clinical Translation(5241400202);Jiangxi University of Chinese Medicine School-level Science and Technology Innovation Team Development Program(CXTD22010);Jiangxi University of Chinese Medicine Innovation Special Project(JZYC21B03)
Cite this article
YOU Jianyu, LI Haiyan, XIE Dingyi, CHEN Mingren, CHEN Rixin. Efficacy of acupuncture therapy for post-stroke fatigue: a systematic review and Meta-analysis[J]. Journal of Traditional Chinese Medicine, 2023, 43(1): 27-33.
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Figure 1 Study selection process
Figure 1 Study selection process
Table1 Characteristics of included studies
| Study | Participants | Interventions | Acupuncture session | Outcomes | ||
|---|---|---|---|---|---|---|
| Number (male/female) | Age (Mean±SD) | Interventions Group | Control Group | |||
| Yin HN et al 201620 | T: 16 /14 C: 17 /13 | T:61.16±8.2 C:62.23±8.0 | MA (GV20, EX-HN1) +C | Routine treatment (rehabilitation) | Once a day, five times per week for 4 weeks, 30 min | CE, FSS |
| Huang Z et al 201821 | T: 27 /8 C: 20 /15 | T:60.57±10.77 C:60.29±10.11 | MA (CV12, CV10, CV6, CV4, ST24, ST26) +C | Routine treatment (western medicine basic treatment + rehabilitation) | Once a day, six times per week for 2 weeks, 30 min | CE, FSS, FMA |
| Bei JH et al 201922 | T: 28 /22 C: 26 /23 | T: 58.46 ±7.48 C: 58.06 ±7.45 | MA (GV20, GV24, CV4, CV6, ST36, SP6, LR3) +C | Routine treatment (western medicine basic treatment + rehabilitation) | Once a day, five times per week for 4 weeks | FSS, FMA |
| Gao L 201923 | T: 18 /12 C: 21 /9 | T: 58.17±12.00 C: 58.80±11.99 | MA (GV4, GV14, GV16, GV20, EX-B2, LI15, LI11, LI4, TE5, LU5, ST36, SP6, BL40, GB39) +C | Routine treatment (western medicine basic treatment + rehabilitation) | Once a day for 8 weeks | CE, FSS |
Table1 Characteristics of included studies
| Study | Participants | Interventions | Acupuncture session | Outcomes | ||
|---|---|---|---|---|---|---|
| Number (male/female) | Age (Mean±SD) | Interventions Group | Control Group | |||
| Yin HN et al 201620 | T: 16 /14 C: 17 /13 | T:61.16±8.2 C:62.23±8.0 | MA (GV20, EX-HN1) +C | Routine treatment (rehabilitation) | Once a day, five times per week for 4 weeks, 30 min | CE, FSS |
| Huang Z et al 201821 | T: 27 /8 C: 20 /15 | T:60.57±10.77 C:60.29±10.11 | MA (CV12, CV10, CV6, CV4, ST24, ST26) +C | Routine treatment (western medicine basic treatment + rehabilitation) | Once a day, six times per week for 2 weeks, 30 min | CE, FSS, FMA |
| Bei JH et al 201922 | T: 28 /22 C: 26 /23 | T: 58.46 ±7.48 C: 58.06 ±7.45 | MA (GV20, GV24, CV4, CV6, ST36, SP6, LR3) +C | Routine treatment (western medicine basic treatment + rehabilitation) | Once a day, five times per week for 4 weeks | FSS, FMA |
| Gao L 201923 | T: 18 /12 C: 21 /9 | T: 58.17±12.00 C: 58.80±11.99 | MA (GV4, GV14, GV16, GV20, EX-B2, LI15, LI11, LI4, TE5, LU5, ST36, SP6, BL40, GB39) +C | Routine treatment (western medicine basic treatment + rehabilitation) | Once a day for 8 weeks | CE, FSS |
Figure 2 Risk of bias assessment
Figure 2 Risk of bias assessment
Figure 3 Meta-analysis results of the efficacy of acupuncture versus control group A: forest plot of acupuncture on the effective rate; B: forest plot of acupuncture on FSS; C: forest plot of acupuncture on FMA. FSS: Fatigue Severity Scale; FMA: Fugl-Meyer Assessment.
Figure 3 Meta-analysis results of the efficacy of acupuncture versus control group A: forest plot of acupuncture on the effective rate; B: forest plot of acupuncture on FSS; C: forest plot of acupuncture on FMA. FSS: Fatigue Severity Scale; FMA: Fugl-Meyer Assessment.
Table 2 GRADE quality grading evaluation.
| Quality assessment | No of patients | Quality | |||||||
|---|---|---|---|---|---|---|---|---|---|
| No of studies | Design | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Experimental group | Control group | |
| Clinical efficacy (Acupuncture+Routine treatment vs Routine treatment) | |||||||||
| 3 | Randomized | Serious a | No serious inconsistency | No serious indirectness | Serious b | None | 82/95 (86.3%) | 71/95 (74.7%) | ⊕⊕?? Low |
| FSS (Acupuncture+Routine treatment vs Routine treatment) | |||||||||
| 4 | Randomized | Serious a | No serious inconsistency | No serious inconsistency | Serious b | None | 145 | 144 | ⊕⊕?? Low |
| FMA (Acupuncture+Routine treatment vs Routine treatment) | |||||||||
| 2 | Randomized | Serious a | No serious inconsistency | No serious inconsistency | Serious b | None | 85 | 84 | ⊕⊕?? Low |
Table 2 GRADE quality grading evaluation.
| Quality assessment | No of patients | Quality | |||||||
|---|---|---|---|---|---|---|---|---|---|
| No of studies | Design | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Experimental group | Control group | |
| Clinical efficacy (Acupuncture+Routine treatment vs Routine treatment) | |||||||||
| 3 | Randomized | Serious a | No serious inconsistency | No serious indirectness | Serious b | None | 82/95 (86.3%) | 71/95 (74.7%) | ⊕⊕?? Low |
| FSS (Acupuncture+Routine treatment vs Routine treatment) | |||||||||
| 4 | Randomized | Serious a | No serious inconsistency | No serious inconsistency | Serious b | None | 145 | 144 | ⊕⊕?? Low |
| FMA (Acupuncture+Routine treatment vs Routine treatment) | |||||||||
| 2 | Randomized | Serious a | No serious inconsistency | No serious inconsistency | Serious b | None | 85 | 84 | ⊕⊕?? Low |
Table 3 Appendix 1 Search strategy in each database
| Database | Search strategy |
|---|---|
| PubMed | (Stroke [MeSH] OR Cerebrovascular Disorders [MeSH] OR Brain Ischemia [MeSH] OR Cerebral Hemorrhage [MeSh] OR Cerebral infarction [MeSH] OR Cerebrovascular Disorder [MeSH] OR Stroke [Ti/Ab] OR Cerebrovascular Disorders [Ti/Ab] OR Brain Ischemia [Ti/Ab] OR Cerebral Hemorrhage [Ti/Ab] OR Cerebral infarction [Ti/Ab] OR Cerebrovascular Disorder [Ti/Ab]) AND (Fatigue [MeSH] OR Fatigue [Ti/Ab] OR Tiredness [Ti/Ab] OR exhaustion [Ti/Ab] OR Fatigue after stroke [Ti/Ab] OR Post stroke fatigue [Ti/Ab]) AND (Acupuncture [MeSH] OR Acupuncture therapy [MeSH] OR Acupuncture [Ti/Ab] OR Electroacupuncture [Ti/Ab] OR Electro-acupuncture [Ti/Ab] OR Acupoint [Ti/Ab]) |
| Embase | (Stroke/exp OR Cerebrovascular Disorders/exp OR Brain Ischemia/exp OR Cerebral Hemorrhage/exp OR Cerebral infarction/exp OR Cerebrovascular Disorder/exp OR Stroke:ti,ab OR Cerebrovascular Disorders:ti,ab OR Brain Ischemia:ti,ab OR Cerebral Hemorrhage:ti,ab OR Cerebral infarction:ti,ab OR Cerebrovascular Disorder:ti,ab) AND (Fatigue/exp OR Fatigue:ti,ab OR Tiredness:ti,ab OR Exhaustion:ti,ab OR Fatigue after stroke:ti,ab OR Post stroke fatigue:ti,ab) AND (Acupuncture/exp OR Acupuncture therapy/exp OR Acupuncture:ti,ab OR Electroacupuncture:ti,ab OR Electro-acupuncture:ti,ab OR Acupoint:ti,ab) |
| The Cochrane Library | 1. Stroke:ti,ab OR Cerebrovascular Disorders:ti,ab OR Brain Ischemia:ti,ab OR Cerebral Hemorrhage:ti,ab OR Cerebral infarction:ti,ab OR Cerebrovascular Disorder:ti,ab 2. MeSH descriptor: [Stroke] explode all trees 3. MeSH descriptor: [Cerebrovascular Disorders] explode all trees 4. MeSH descriptor: [Brain Ischemia] explode all trees 5. MeSH descriptor: [Cerebral Hemorrhage] explode all trees 6. MeSH descriptor: [Cerebral infarction] explode all trees 7. MeSH descriptor: [Cerebrovascular Disorder] explode all trees 8. #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 9. MeSH descriptor: [Fatigue] explode all trees 10. Fatigue:ti,ab OR Tiredness:ti,ab OR Exhaustion:ti,ab OR Fatigue after stroke:ti,ab OR Post stroke fatigue:ti,ab 11. #9 OR #10 12. MeSH descriptor: [Acupuncture] explode all trees 13. MeSH descriptor: [Acupuncture therapy] explode all trees 14. Acupuncture:ti,ab OR Electroacupuncture:ti,ab OR Electro-acupuncture:ti,ab OR Acupoint:ti,ab 15. #12 OR #13 OR #14 16. #8 AND #11 AND #15 |
| Web of science | 1. TS=( Stroke OR Cerebrovascular Disorders OR Brain Ischemia OR Cerebral Hemorrhage OR Cerebral infarction OR Cerebrovascular Disorder) 2. TI=(Stroke OR Cerebrovascular Disorders OR Brain Ischemia OR Cerebral Hemorrhage OR Cerebral infarction OR Cerebrovascular Disorder) 3. #1 OR #2 4. TS=(Fatigue) 5. TI=( Fatigue OR Tiredness OR Exhaustion OR Fatigue after stroke OR Post stroke fatigue) 6. #4 OR #5 7. TS =( Acupuncture OR Acupuncture therapy) 8. TI=( Acupuncture OR Electroacupuncture OR Electro-acupuncture OR Acupoint) 9. #7 OR #8 10. #3 AND #6AND #9 |
| CNKI | (SU%'中风'+'脑卒中'+'脑梗塞'+'脑出血'+'脑梗死') and (SU%'疲劳'+'疲乏') and (SU%'针刺'+'针灸'+'电针'+'针') |
| WanfangData | 主题= (中风 OR脑卒中 OR 脑梗塞 OR 脑出血OR 脑梗死) AND主题= (疲劳OR 疲乏) AND 主题= (针刺 OR 针灸 OR 电针 OR 针) |
| VIP | U=(中风 OR 脑卒中OR 脑梗塞OR 脑梗死 OR 脑出血) AND U=(疲劳 OR 疲乏) AND U=(针刺 OR 针灸 OR 电针 OR 针) |
| SinoMed | (中风[标题] OR 脑卒中[标题] OR 脑梗塞[标题]) OR 脑梗死[标题] OR 脑出血[标题]) AND (疲劳[标题]) OR 疲乏[标题]) AND (针刺[标题] OR 针灸[标题] OR 电针[标题] OR 针[标题]) |
Table 3 Appendix 1 Search strategy in each database
| Database | Search strategy |
|---|---|
| PubMed | (Stroke [MeSH] OR Cerebrovascular Disorders [MeSH] OR Brain Ischemia [MeSH] OR Cerebral Hemorrhage [MeSh] OR Cerebral infarction [MeSH] OR Cerebrovascular Disorder [MeSH] OR Stroke [Ti/Ab] OR Cerebrovascular Disorders [Ti/Ab] OR Brain Ischemia [Ti/Ab] OR Cerebral Hemorrhage [Ti/Ab] OR Cerebral infarction [Ti/Ab] OR Cerebrovascular Disorder [Ti/Ab]) AND (Fatigue [MeSH] OR Fatigue [Ti/Ab] OR Tiredness [Ti/Ab] OR exhaustion [Ti/Ab] OR Fatigue after stroke [Ti/Ab] OR Post stroke fatigue [Ti/Ab]) AND (Acupuncture [MeSH] OR Acupuncture therapy [MeSH] OR Acupuncture [Ti/Ab] OR Electroacupuncture [Ti/Ab] OR Electro-acupuncture [Ti/Ab] OR Acupoint [Ti/Ab]) |
| Embase | (Stroke/exp OR Cerebrovascular Disorders/exp OR Brain Ischemia/exp OR Cerebral Hemorrhage/exp OR Cerebral infarction/exp OR Cerebrovascular Disorder/exp OR Stroke:ti,ab OR Cerebrovascular Disorders:ti,ab OR Brain Ischemia:ti,ab OR Cerebral Hemorrhage:ti,ab OR Cerebral infarction:ti,ab OR Cerebrovascular Disorder:ti,ab) AND (Fatigue/exp OR Fatigue:ti,ab OR Tiredness:ti,ab OR Exhaustion:ti,ab OR Fatigue after stroke:ti,ab OR Post stroke fatigue:ti,ab) AND (Acupuncture/exp OR Acupuncture therapy/exp OR Acupuncture:ti,ab OR Electroacupuncture:ti,ab OR Electro-acupuncture:ti,ab OR Acupoint:ti,ab) |
| The Cochrane Library | 1. Stroke:ti,ab OR Cerebrovascular Disorders:ti,ab OR Brain Ischemia:ti,ab OR Cerebral Hemorrhage:ti,ab OR Cerebral infarction:ti,ab OR Cerebrovascular Disorder:ti,ab 2. MeSH descriptor: [Stroke] explode all trees 3. MeSH descriptor: [Cerebrovascular Disorders] explode all trees 4. MeSH descriptor: [Brain Ischemia] explode all trees 5. MeSH descriptor: [Cerebral Hemorrhage] explode all trees 6. MeSH descriptor: [Cerebral infarction] explode all trees 7. MeSH descriptor: [Cerebrovascular Disorder] explode all trees 8. #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 9. MeSH descriptor: [Fatigue] explode all trees 10. Fatigue:ti,ab OR Tiredness:ti,ab OR Exhaustion:ti,ab OR Fatigue after stroke:ti,ab OR Post stroke fatigue:ti,ab 11. #9 OR #10 12. MeSH descriptor: [Acupuncture] explode all trees 13. MeSH descriptor: [Acupuncture therapy] explode all trees 14. Acupuncture:ti,ab OR Electroacupuncture:ti,ab OR Electro-acupuncture:ti,ab OR Acupoint:ti,ab 15. #12 OR #13 OR #14 16. #8 AND #11 AND #15 |
| Web of science | 1. TS=( Stroke OR Cerebrovascular Disorders OR Brain Ischemia OR Cerebral Hemorrhage OR Cerebral infarction OR Cerebrovascular Disorder) 2. TI=(Stroke OR Cerebrovascular Disorders OR Brain Ischemia OR Cerebral Hemorrhage OR Cerebral infarction OR Cerebrovascular Disorder) 3. #1 OR #2 4. TS=(Fatigue) 5. TI=( Fatigue OR Tiredness OR Exhaustion OR Fatigue after stroke OR Post stroke fatigue) 6. #4 OR #5 7. TS =( Acupuncture OR Acupuncture therapy) 8. TI=( Acupuncture OR Electroacupuncture OR Electro-acupuncture OR Acupoint) 9. #7 OR #8 10. #3 AND #6AND #9 |
| CNKI | (SU%'中风'+'脑卒中'+'脑梗塞'+'脑出血'+'脑梗死') and (SU%'疲劳'+'疲乏') and (SU%'针刺'+'针灸'+'电针'+'针') |
| WanfangData | 主题= (中风 OR脑卒中 OR 脑梗塞 OR 脑出血OR 脑梗死) AND主题= (疲劳OR 疲乏) AND 主题= (针刺 OR 针灸 OR 电针 OR 针) |
| VIP | U=(中风 OR 脑卒中OR 脑梗塞OR 脑梗死 OR 脑出血) AND U=(疲劳 OR 疲乏) AND U=(针刺 OR 针灸 OR 电针 OR 针) |
| SinoMed | (中风[标题] OR 脑卒中[标题] OR 脑梗塞[标题]) OR 脑梗死[标题] OR 脑出血[标题]) AND (疲劳[标题]) OR 疲乏[标题]) AND (针刺[标题] OR 针灸[标题] OR 电针[标题] OR 针[标题]) |
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