Liu Yuxiang, Zhou Jing, Zheng Jiawen, Chen Jing
The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Rehabilitation, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Front Neurol. 2025 May 22;16:1589874. doi: 10.3389/fneur.2025.1589874. eCollection 2025.
Hand dysfunction is one of the main causes of disability in stroke. This systematic review and meta-analysis aimed to evaluate the efficacy of different types of acupuncture therapy in improving hand dysfunction among post-stroke patients.
A comprehensive search was conducted across eight databases (PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure [CNKI], Chongqing VIP Chinese Scientific Journals Database [VIP], China Biology Medicine [CBM], and Wan Fang) to identify randomized controlled trials (RCTs). Forty-two RCTs involving 2,766 participants were included. Primary outcomes were the Brunnstrom Recovery Stage (BRS), Fugl-Meyer Assessment (FMA), and Lindmark scores; secondary outcomes included the Modified Ashworth Scale (MAS), Range of Motion (ROM), Manual Muscle Testing (MMT), and Modified Barthel Index (MBI).
Meta-analyses demonstrated significant improvements in hand function across multiple outcomes: BRS (mean difference [MD] = 0.56, 95% confidence interval [CI]: 0.43-0.69), FMA (MD = 1.24, 95% CI: 0.96-1.53), MAS (MD = -0.48, 95% CI: -0.59 to -0.38), ROM (MD = 0.95, 95% CI: 0.64-1.26), and MBI (MD = 6.70, 95% CI: 4.85-8.55). Subgroup analyses revealed that electroacupuncture (EA) outperformed traditional acupuncture (TA) in improving BRS ( = 0.008). Heterogeneity was partially attributed to acupuncture modalities, with EA exhibiting lower variability compared to traditional methods.
This meta-analysis supports the use of acupuncture, particularly EA, for enhancing hand function in post-stroke patients. EA demonstrates superior efficacy and consistency, suggesting its prioritization in clinical practice.
手部功能障碍是中风致残的主要原因之一。本系统评价和荟萃分析旨在评估不同类型针刺疗法对改善中风后患者手部功能障碍的疗效。
对八个数据库（PubMed、Cochrane图书馆、Embase、Web of Science、中国知网[CNKI]、重庆维普中文科技期刊数据库[VIP]、中国生物医学数据库[CBM]和万方）进行全面检索，以识别随机对照试验（RCT）。纳入了42项涉及2766名参与者的RCT。主要结局指标为Brunnstrom恢复阶段（BRS）、Fugl-Meyer评估（FMA）和Lindmark评分；次要结局指标包括改良Ashworth量表（MAS）、关节活动度（ROM）、徒手肌力测试（MMT）和改良Barthel指数（MBI）。
荟萃分析表明，多种结局指标的手部功能均有显著改善：BRS（平均差[MD]=0.56，95%置信区间[CI]：0.43 - 0.69）、FMA（MD = 1.24，95% CI：0.96 - 1.53）、MAS（MD = -0.48，95% CI：-0.59至-0.38）、ROM（MD = 0.95，95% CI：0.64 - 1.26）和MBI（MD = 6.70，95% CI：4.85 - 8.55）。亚组分析显示，在改善BRS方面，电针（EA）优于传统针刺（TA）（P = 0.008）。异质性部分归因于针刺方式，与传统方法相比，EA的变异性较低。
本荟萃分析支持使用针刺疗法，尤其是电针，来增强中风后患者的手部功能。电针显示出卓越的疗效和一致性，表明其在临床实践中应优先使用。
