Zhang Shuyan, Zhou Haichun
Heilongjiang University of Chinese Medicine, Harbin, China.
The Fourth Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China.
Front Neurol. 2025 May 30;16:1550611. doi: 10.3389/fneur.2025.1550611. eCollection 2025.
This systematic review aimed to evaluate the efficacy and safety of elongated needle therapy in improving motor and balance functions after stroke, to inform its clinical adoption in rehabilitation.
We searched PubMed, Web of Science, EMBASE, Medicine, CNKI, CBM, Wanfang, and VIP from inception to May 1, 2024, for randomized controlled trials (RCTs) assessing elongated needles for post-stroke limb movement and balance dysfunction. Primary outcomes were balance and motor ability; secondary outcomes included Activities of Daily Living (ADL) and adverse events. Meta-analysis used RevMan 5.4 and Stata 16.0. Heterogeneity was explored via subgroup/meta-regression/sensitivity analyses (if significant). Two reviewers independently assessed bias risk using Cochrane tools. Outcome quality was evaluated with GRADE.
This meta-analysis included 18 randomized controlled trials (RCTs), encompassing a total of 1,230 subjects. The results indicated that elongated needles, utilized either as a solo intervention or in conjunction with other modalities, markedly enhanced balance capabilities in stroke patients when compared to conventional acupuncture, rehabilitation training, oral Chinese medicine, and alternative therapies including electroacupuncture and acupoint sticking (MD = 6.34, < 0.001, = 85%, 95% CI = 4.80-7.89). Furthermore, elongated needles, whether applied alone or in combination with other therapies, significantly improved the motor function of limbs in patients (SMD = 1.21, < 0.00001, = 92%, 95% CI = 0.63-1.79). Additionally, elongated needles, when used alone or in conjunction with other treatments, demonstrated greater efficacy in enhancing patients' activities of daily living compared to conventional acupuncture alone, rehabilitation training, or their combined regimen (SMD = 1.13, < 0.00001, = 83%, 95% CI = 0.70-1.55). However, further clinical research is warranted to substantiate the advantages of elongated needles over other therapies, including electroacupuncture and acupoint sticking. In terms of safety, the overwhelming majority of the studies included in the analysis reported the absence of adverse reactions.
Evidence from current studies indicates that elongated needle may improve post-stroke patients' balance and motor function, and enhance their daily living skills. However, the number of rigorous scientific studies is limited, and there is considerable variability across studies, limiting the confidence in these findings. Therefore, the clinical effectiveness of this treatment still requires additional validation. It is imperative to conduct more high-quality, large-scale, multi-center RCTs that conform to international guidelines to establish the efficacy of this therapy's clinical applications.
https://www.crd.york.ac.uk/prospero/, identifier CRD42024542151.
本系统评价旨在评估芒针疗法在改善中风后运动和平衡功能方面的疗效和安全性，为其在康复中的临床应用提供依据。
我们检索了从数据库建库至2024年5月1日的PubMed、Web of Science、EMBASE、Medline、中国知网、中国生物医学文献数据库、万方数据库和维普数据库，以查找评估芒针治疗中风后肢体运动和平衡功能障碍的随机对照试验（RCT）。主要结局为平衡和运动能力；次要结局包括日常生活活动（ADL）和不良事件。采用RevMan 5.4和Stata 16.0进行荟萃分析。通过亚组分析/元回归分析/敏感性分析（如有显著性差异）探索异质性。两名评价者使用Cochrane工具独立评估偏倚风险。采用GRADE评估结局质量。
本荟萃分析纳入18项随机对照试验，共1230名受试者。结果表明，与传统针刺、康复训练、口服中药以及包括电针和穴位贴敷在内的替代疗法相比，芒针单独使用或与其他疗法联合使用时，能显著提高中风患者的平衡能力（MD = 6.34，P < 0.001，I² = 85%，95%CI = 4.80 - 7.89）。此外，芒针单独使用或与其他疗法联合使用时，能显著改善患者的肢体运动功能（SMD = 1.21，P < 0.00001，I² = 92%，95%CI = 0.63 - 1.79）。此外，与单独使用传统针刺、康复训练或其联合方案相比，芒针单独使用或与其他治疗联合使用时，在提高患者日常生活活动能力方面显示出更大的疗效（SMD = 1.13，P < 0.00001，I² = 83%，95%CI = 0.70 - 1.55）。然而，需要进一步的临床研究来证实芒针相对于其他疗法（包括电针和穴位贴敷）的优势。在安全性方面，纳入分析的绝大多数研究报告未出现不良反应。
目前研究的证据表明，芒针可能改善中风后患者的平衡和运动功能，并提高其日常生活技能。然而，严格的科学研究数量有限，且各研究之间存在相当大的差异，限制了对这些结果的信心。因此，这种治疗方法的临床有效性仍需进一步验证。必须开展更多符合国际指南的高质量、大规模、多中心RCT，以确定该疗法临床应用的疗效。
