Department of Korean Internal Medicine, Dongguk University Ilsan Hospital, Goyang, South Korea.
BMC Complement Altern Med. 2010 Jul 30;10:41. doi: 10.1186/1472-6882-10-41.
Contralateral acupuncture (CAT) involves inserting needles in the meridian on the side opposite the disease location and is often used in post-stroke rehabilitation. The aim of this systematic review is to summarize and critically evaluate the evidence for and against the effectiveness of CAT for post-stroke rehabilitation as compared to ipsilateral acupuncture (IAT).
Seventeen databases were searched from their inceptions through June 2010. Prospective clinical trials were included if CAT was tested as the sole treatment or as an adjunct to other treatments for post-stroke rehabilitation and compared to IAT.
Eight randomized clinical trials (RCTs) met our inclusion criteria. Four of them reported favorable effects of CAT compared to IAT for at least one outcome. A meta-analysis showed superior effects of CAT compared to IAT on recovery rate (n = 361; risk ratio (RR), 1.12; 95% confidence intervals (CIs), 1.04 to 1.22, P = 0.005). Subgroup analysis also showed favorable effects of using CAT on patients with cerebral infarction (n = 261; RR, 1.15; 95% CIs, 1.04 to 1.27, P = 0.006). Further analysis including patients with cerebral infarction and intracranial hemorrhage, however, failed to show these advantages (n = 100; RR, 1.11; 95% CIs, 0.85 to 1.46, P = 0.43).
The results of our systematic review and meta-analysis suggest that there is limited evidence for CAT being superior to IAT in the treatment of cerebral infarction. The total number of RCTs included in our analysis was low, however, and the RCTs included had a high risk of bias. Future RCTs appear to be warranted.
对侧针刺（CAT）是指在疾病部位对侧的经络上针刺，常用于中风后康复。本系统评价的目的是总结和批判性评估 CAT 与同侧针刺（IAT）相比在中风后康复中的有效性的证据。
从各数据库建立至 2010 年 6 月，检索了 17 个数据库。如果 CAT 被测试为中风后康复的唯一治疗方法或作为其他治疗方法的辅助治疗，并与 IAT 进行比较，则纳入前瞻性临床试验。
有 8 项随机临床试验（RCT）符合我们的纳入标准。其中 4 项报告 CAT 与 IAT 相比，至少在一个结局上有更好的效果。Meta 分析显示 CAT 与 IAT 相比，在恢复率上有更好的效果（n = 361；风险比（RR）为 1.12；95%置信区间（CI）为 1.04 至 1.22，P = 0.005）。亚组分析也显示，在脑梗死患者中使用 CAT 有更好的效果（n = 261；RR，1.15；95%CI，1.04 至 1.27，P = 0.006）。然而，包括脑梗死和颅内出血患者的进一步分析未能显示这些优势（n = 100；RR，1.11；95%CI，0.85 至 1.46，P = 0.43）。
我们的系统评价和 Meta 分析的结果表明，CAT 在治疗脑梗死方面优于 IAT 的证据有限。然而，我们分析中纳入的 RCT 总数较少，且纳入的 RCT 存在高偏倚风险。未来似乎需要进行 RCT。
