Wang Yining, Yu Hongtao, Chen Yuyu, Hu Yuxin, Zhou Haichun, Zhao Jian
Graduate School Department, Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, People's Republic of China.
Science and Education Department, The Fourth Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, People's Republic of China.
Int J Gen Med. 2025 Sep 11;18:5379-5393. doi: 10.2147/IJGM.S535590. eCollection 2025.
Ischemic stroke (IS) is a leading cause of long-term disability worldwide, creating an urgent need for effective adjunctive therapies to complement conventional treatments. Acupuncture has emerged as a widely investigated intervention for post-stroke recovery. This review provides a critical evaluation of the proposed biological mechanisms underlying acupuncture's effects in IS. We synthesize evidence from preclinical and clinical studies on its potential to promote the dynamic repair of the neurovascular unit (NVU), modulate intercellular communication, improve cerebral hemodynamics, enhance angiogenesis, and support neurorestoration. While a significant body of preclinical evidence suggests multifaceted benefits, we highlight a critical translational gap and the methodological limitations that currently temper clinical certainty. Key challenges include the heterogeneity of treatment protocols, the complexity of sham controls, and a frequent lack of objective biomarkers. Consequently, we conclude by outlining a clear agenda for future research, emphasizing the need for protocol standardization, rigorous large-scale randomized controlled trials (RCTs), and the integration of biomarkers to bridge the gap between proposed mechanisms and validated clinical outcomes. This critical perspective aims to guide future research toward definitively establishing acupuncture's role in the stroke care continuum.
缺血性中风（IS）是全球长期残疾的主要原因，迫切需要有效的辅助疗法来补充传统治疗。针灸已成为一种广泛研究的中风后康复干预措施。本综述对针灸在缺血性中风中作用的潜在生物学机制进行了批判性评估。我们综合了临床前和临床研究的证据，证明其在促进神经血管单元（NVU）动态修复、调节细胞间通讯、改善脑血流动力学、增强血管生成和支持神经修复方面的潜力。虽然大量临床前证据表明针灸有诸多益处，但我们强调了一个关键的转化差距以及目前影响临床确定性的方法学局限性。关键挑战包括治疗方案的异质性、假对照的复杂性以及经常缺乏客观生物标志物。因此，我们通过概述未来研究的明确议程来得出结论，强调需要方案标准化、严格的大规模随机对照试验（RCT）以及整合生物标志物，以弥合所提出的机制与已验证的临床结果之间的差距。这一批判性观点旨在指导未来研究明确确立针灸在中风护理连续过程中的作用。
