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Journal of Traditional Chinese Medicine >

2023 , Vol. 43 >Issue 1: 27 - 33

DOI: https://doi.org/10.19852/j.cnki.jtcm.20221006.003

Meta-analysises

Efficacy of acupuncture therapy for post-stroke fatigue: a systematic review and Meta-analysis

  • Jianyu YOU ,
  • Haiyan LI ,
  • Dingyi XIE ,
  • Mingren CHEN ,
  • Rixin CHEN
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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
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

Received date: 2021-11-22

  Accepted date: 2022-02-28

  Online published: 2023-01-10

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)

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Abstract

OBJECTIVE: To assess the effectiveness and safety of acupuncture for post‐stroke fatigue (PSF).
METHODS: Eight online databases were searched to collect relevant trials of acupuncture for PSF published before April 2021. Meta-analysis was performed by using RevMan 5.4 software. The Grading of Recommendations, Assessment, Development and Evaluation system was used to assess the certainty of evidence.
RESULTS: Four randomized controlled trials involving 289 PSF patients were identified and included in the systematic review. The results of the Meta-analysis revealed that acupuncture group was significantly better than routine treatment group in improving the effective rate [risk ratio (RR) = 1.15, 95%CI (1.01, 1.33), P = 0.04], reducing the FSS score [mean difference (MD) =?－4.71, 95% CI?(－6.22, －3.20), P < 0.000 01] and FMA score [MD?=?15.60, 95% CI?(11.96, 19.23), P < 0.000 01]. Side effects of acupuncture were mild and rarely reported. The certainty of evidence of the outcomes based on the four trials was assessed as low.
CONCLUSIONS: The existing evidence suggests acupuncture as an adjunct to routine treatment may benefit in managing fatigue in stroke patients. However, high-quality RCTs are needed to further confirm these findings.

Key words： acupuncture; stroke; fatigue; systematic review; Meta-analysis

Cite this article

Jianyu YOU , Haiyan LI , Dingyi XIE , Mingren CHEN , Rixin CHEN . 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 . DOI: 10.19852/j.cnki.jtcm.20221006.003

References

1 De Groot MH, Phillips SJ, Eskes GA. Fatigue associated with stroke and other neurologic conditions: implications for stroke rehabilitation. Arch Phys Med Rehabil 2003; 84: 1714-20.
2 Cumming TB, Packer M, Kramer SF, English C. The prevalence of fatigue after stroke: a systematic review and Meta-analysis. Int J Stroke 2016; 11: 968-77.
3 Lerdal A, Bakken LN, Kouwenhoven SE, et al. Poststroke fatigue--a review. J Pain Symptom Manage 2009; 38: 928-49.
4 de Bruijn MA, Synhaeve NE, van Rijsbergen MW, et al. Quality of life after young ischemic stroke of mild severity is mainly influ-enced by psych-ological factors. J Stro-ke Cere-brovasc Dis 2015; 24: 2183-8.
5 Glader EL, Stegmayr B, Asplund K. Post-stroke fatigue: a 2-year follow-up study of stro-ke patients in Swe-den. Stroke 2002; 33: 1327-33.
6 Cumming TB, Yeo AB, Marquez J, et al. Investigating post-stro-ke fatigue: an indi-vi-dual participant data Meta-analysis. J Psy-chosom Res 2018; 113: 107-12.
7 Wu S, Mead G, Macleod M, Chalder T. Model of unde-rstanding fatigue after stroke. Stroke 2015; 46: 893-8.
8 Brioschi A, Gramigna S, Werth E, et al. Effect of modafinil on subjective fatigue in multiple sclerosis and stroke patients. Eur Neurol 2009; 62: 243-9.
9 Wu S, Ku-lubaev MA, Chun HY, et al. Inter-ventions for post-stroke fatigue. Co-chrane Data-base Syst Rev 2015: CD007030.
10 Karaiskos D, Tzave-llas E, Spengos K, Vassilopoulou S, Papar-rigopoulos T. Dulo-xetine versus citalopram and sertraline in the treatment of poststroke depression, anxiety, and fatigue. J Neuro-psy-chiatry Clin Neuro-sci 2012; 24: 349-53.
11 Choi-Kwon S, Choi J, Kwon SU, Kang DW, Kim JS. Fluo-xetine is not effective in the tr-eatment of post-stroke fatigue: a double-blind, placebo-contr-olled stu-dy. Cerebro-vasc Dis 2007; 23: 103-8.
12 Su Y, Yuki M, Otsuki M. Non-pharm-acological interventions for post-stroke fatigue: systematic review and network Meta-analysis. J Clin Med 2020; 9: 621.
13 You J, Li H, Xie D, Chen R, Chen M. Acu-puncture for chr-onic pain-related dep-ression: a systematic review and Meta-analysis. Pain Res Manag 2021; 2021: 6617075.
14 Yang A, Wu HM, Tang JL, Xu L, Yang M, Liu GJ. Acupuncture for stroke rehabilitation. Cochrane Database Syst Rev 2016: CD004131.
15 Xu M, Li D, Zhang S. Acupuncture for acute stroke. Cochrane Database Syst Rev 2018; 3: CD003317.
16 Chavez LM, Huang SS, MacDonald I, Lin JG, Lee YC, Chen YH. Mechanisms of acupuncture therapy in ischemic stroke rehabilitation: a literature review of basic studies. Int J Mol Sci 2017; 18: 2270.
17 Liu X, Yang FM, Dong LL, Hao CY. A clinical study on efficacy of Tiaoshen Yiqi acupuncture therapy in treating patients with post stroke fatigue. Zhong Guo Zhong Xi Yi Jie He Ji Jiu Za Zhi 2018; 25: 494-8.
18 Sterne JAC, Savovic J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898.
19 Balshem H, Helfand M, Schunemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol 2011; 64: 401-6.
20 Yin HN, Guo YH, Li Q. Clinical observation of acupuncture at Baihui (GV20) and Sishencong (EX-HN1) combined with rehabilitation training on patients of post stroke fatigue. Zhong Guo Zhong Yi Ji Zheng 2016; 2016: 1746-8.
21 Huang Z, Zhan LC, Chen HX, Pan RH. Abdominal acupuncture combined with rehabilitation training for post-stroke fatigue: a randomized controlled trial. Zhong Yi Yao Dao Bao 2018; 24: 71-3.
22 Bei JH, Chen PD, Ning Y, Wang L, Yang ZX. Clinical effect of "Tiaoren Tongdu" acupuncture combined with rehabilitation training in the treatment of fatigue after cerebral infarction. Xian Dai Zhong Xi Yi Jie He Za Zhi 2019; 28: 2443-6.
23 Gao L. Effect of tongdu tiaoshen acupuncture on homocysteine level in patients with post-stroke fatigue and its therapeutic effect Hefei: Anhui University of Chinese Medicine, 2019: 17-27.
24 Zhan LC, Pan RH, He MF, et al. Effect and inflammatory mechanism of abdominal acupuncture combined with rehabilitation training for patients with post-stroke fatigue. Zhong Xi Yi Jie He Xin Nao Xie Guan Bing Za Zhi 2017; 15: 1966-8.
25 Rudberg AS, Berge E, Laska AC, et al. Stroke survivors' priorities for research related to life after stroke. Top Stroke Rehabil 2021; 28: 153-8.
26 Pollock A, St George B, Fenton M, Firkins L. Top 10 research priorities relating to life after stroke- -consensus from stroke survivors, caregivers, and health professionals. Int J Stroke 2014; 9: 313-20.
27 Pollock A, St George B, Fenton M, Firkins L. Top ten research priorities relating to life after stroke. Lancet Neurol 2012; 11: 209.
28 Choi-Kwon S, Kim JS. Poststroke fatigue: an emerging, critical issue in stroke medicine. Int J Stroke 2011; 6: 328-36.
29 Su XT, Wang L, Ma SM, et al. Mechanisms of acupuncture in the regulation of oxidative stress in treating ischemic stroke. Oxid Med Cell Longev 2020; 2020: 7875396.
30 Cao BQ, Tan F, Zhan J, Lai PH. Mechanism underlying treatment of ischemic stroke using acupuncture: transmission and regulation. Neural Regen Res 2021; 16: 944-54.
31 Chang QY, Lin YW, Hsieh CL. Acupuncture and neuroregen-eration in ischemic stroke. Neural Regen Res 2018; 13: 573-83.
32 Yin ZH, Wang LJ, Cheng Y, et al. Acupuncture for chronic fatigue syndrome: an overview of systematic reviews. Chin J Integr Med 2021; 27: 940-6.
33 Zhang Q, Gong J, Dong H, Xu S, Wang W, Huang G. Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupunct Med 2019; 37: 211-22.
34 Jang A, Brown C, Lamoury G, et al. The effects of acupuncture on cancer-related fatigue: updated systematic review and Meta-analysis. Integr Cancer Ther 2020; 19: 1534735420949679.
35 Shui L, Yi RN, Wu YJ, et al. Effects of Mongolian warm acup-uncture on iNOS/NO and inflammatory cytokines in the hippo-campus of chronic fatigue rats. Front Integr Neurosci 2019; 13: 78.
36 Ma H, Liu X, Wu Y, Zhang N. The intervention effects of acupuncture on fatigue induced by exhaustive physical exercises: a metabolomics investigation. Evid Based Complement Alternat Med 2015; 2015: 508302.
37 Qing P, Zhao JF, Zhao CH, Hu J, Lin YL, He KJ. Effect of acupuncture on patients with cancer-related fatigue and serum levels of CRP, IL-6, TNF-alpha and sTNF-R1. Zhong Guo Zhen Jiu 2020; 40: 505-9.
38 Wang C, Xie WJ, Liu M, et al. Effect of manual acupuncture stimulation of "Baihui" (GV 20), etc. on serum IFN-gamma and IL-4 contents in rats with chronic fatigue syndrome. Zhen Ci Yan Jiu 2014; 39: 387-9.
39 Zhou Y, Zhou GY, Li SK, Jin JH. Clinical observation on the therapeutic effect of electroacupuncture combined with cupping on post-stroke fatigue. Zhen Ci Yan Jiu 2010; 35: 380-3.
40 Xu L, Xu XY, Hou XQ, Wang FG, Gao S, Zhang HT. Adjuvant therapy with Astragalus membranaceus for post-stroke fatigue: a systematic review. Metab Brain Dis 2020; 35: 83-93.
41 Guo YH, Chen HX, Xie RM. Effects of Qi-supplementing dominated Chinese materia medica combined with rehabilitation training on the quality of life of ischemic post-stroke fatigue patients of Qi deficiency syndrome. Zhong Guo Zhong Xi Yi Jie He Za Zhi 2012; 32: 160-3.
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