needling method for acute ischemic stroke: a meta-analysis of safety and efficacy.

OBJECTIVE

To evaluate the effectiveness and safety of the needling method for treating acute ischemic stroke.

DATA SOURCES

We retrieved relevant randomized controlled trials involving acupuncture for treatment of acute ischemic stroke. The China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and PubMed were searched from June 2006 to March 2016.

DATA SELECTION

We analyzed randomized and semi-randomized clinical controlled trials that compared acupuncture with various control treatments, such as conventional drugs or other acupuncture therapies, for treatment of acute ischemic stroke. The quality of articles was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1), and the study was carried out using Cochrane system assessment methods. RevMan 5.2 was used for the meta-analysis of the included studies.

OUTCOME MEASURES

The mortality rate, disability rate, activities of daily living (Barthel Index), and clinical efficacy were observed.

RESULTS

Twelve studies met the inclusion criteria for this review. The meta-analysis showed that between acupuncture and the control treatment, acupuncture reduced the disability rate [risk ratio () = 0.51, 95% confidence interval () = 0.27-0.98, = 2.03, < 0.05], elevated the activities of daily living (weighted mean difference = 12.23, 95% : 3.66-20.08, = 2.80, < 0.005), and had greater clinical efficacy ( = 1.61, 95% : 1.23-2.09, = 3.53, < 0.0004). However, there was no significant difference in mortality rate ( = 0.61, 95% : 0.15-2.45, = 0.70, > 0.05).

CONCLUSION

The needling method is effective and safe for acute ischemic stroke. However, there was selective bias in this study, and the likelihood of measurement bias is high. Thus, more high-quality randomized controlled trials are needed to provide reliable evidence of the efficacy and safety of acupuncture in the treatment of acute ischemic stroke.