Fire Acupuncture versus conventional acupuncture to treat spasticity after stroke: A systematic review and meta-analysis

doi:10.1371/journal.pone.0249313

	Fire Acupuncture versus conventional acupuncture to treat spasticity after stroke: A systematic review and meta-analysis
	Qiu, Xuan 4,5; Gao, Yicheng 4,5; Zhang, Zhaoxu 1; Cheng, Sijia 5; Zhang, Shuangmei 2,3
刊名	PLOS ONE
	2021-04-09
卷号	16
ISSN号	1932-6203
DOI	10.1371/journal.pone.0249313
通讯作者	Qiu, Xuan(qiuxuan20202020@163.com)
英文摘要	Background Post-stroke spasm is currently a complex clinical problem that remains to be resolved. Due to its excellent efficacy and few side effects, clinicians have used fire acupuncture to treat post-stroke spasticity in China. Objectives The purpose of this study was to evaluate the clinical efficacy of fire acupuncture compared with conventional acupuncture to treat post-stroke spasms and provide a detailed summary of the commonly used acupoints. Methods Eight databases (MEDLINE/PubMed, Web of Science, the Cochrane database, EMBASE, CBM, CNKI, WanFang, and VIP) were searched for randomized controlled trials (RCTs) published from database inception through August 30, 2020. RCTs that compared fire acupuncture with conventional acupuncture as a treatment intervention for patients with spasticity after stroke were included. Revman 5.3 software was used to calculate risk ratios (RR) and standard mean differences (SMD) with 95% confidence intervals (CI). Methodological evaluation or critical appraisal of the included articles was assessed using RoB-2. Results Sixteen studies with a total of 1,118 patients were included. Although according to the standards of the Rob 2.0 tool, most studies are considered to have some problems. Comprehensive analysis of the results revealed a consistent trend indicating several advantages of using fire needles compared to conventional acupuncture in treating post-stroke spasms, including the effective rate, recovery rate, and improvement of multiple scales represented by MAS. Concerning secondary outcomes, using the scales of FMA, BI, or NDS in this random model meta-analysis, fire acupuncture exhibited better performance compared to acupuncture [SMD = 2.27, 95%CI [1.40,3.13 (random-effects model) ], [SMD = 1.46,95% CI [1.03,1.90 (random-effects model)], and [SMD = 0.90, 95%CI [0.44,1.35 (random-effects model)], respectively, with moderately high heterogeneity. When the effective rate was used as an outcome in the subgroup analysis, fire needles performed better than conventional acupuncture with respect to damage to the upper or lower limbs, and the thickness and depth of acupuncture. When the modified Ashworth scale (MAS) was used as the outcome, and the damage occurred in the lower extremity, the acupuncture depth exceeded 15mm, or the duration of stroke was longer than six months, the fire needles did not perform better than conventional acupuncture, [SMD = 0.01, 95%CI [-0.47,0.48 (fix-effects model)], [SMD = 0.21 [-0.51,0.93(random-effects model)], and [SMD = 0.76, 95%CI [-0.08,1.60 (random-effects model)], respectively. The acupoints identified with the highest frequencies in this study were Yang-meridian, including LI11-Quchi (nine times), LI4-Hegu (seven times), and ST36-Zusanli (five times). Moreover, no serious adverse effects were reported in any of the studies included in this analysis. Conclusions Despite several limitations, this was the first meta-analysis to focus on the treatment of post-stroke spasticity using fire needle acupuncture compared with conventional acupuncture. Our results confirmed that fire needles could provide a better clinical effect than conventional acupuncture, which will help standardize fire needle treatment strategies for post-stroke spasms.
资助项目	Zhuweifeng Guangdong Provincial Famous Chinese Medicine Studio Construction Project[2018(5)] ; 2020 Major Project of Science and Technology Project of Guangdong Province Traditional Chinese Medicine Bureau Grant[20203015] ; Science and technology development plan of Shandong Province[2017G006021]
WOS关键词	UPPER-LIMB SPASTICITY ; CEREBRAL-ISCHEMIA ; SHOULDER PAIN ; BLOOD-FLOW ; REHABILITATION ; EFFICACY ; THERAPY ; INJURY ; SAFETY ; RATS
WOS研究方向	Science & Technology - Other Topics
语种	英语
出版者	PUBLIC LIBRARY SCIENCE
WOS记录号	WOS:000639361000031
资助机构	Zhuweifeng Guangdong Provincial Famous Chinese Medicine Studio Construction Project ; 2020 Major Project of Science and Technology Project of Guangdong Province Traditional Chinese Medicine Bureau Grant ; Science and technology development plan of Shandong Province
内容类型	期刊论文
源URL	[http://ir.hfcas.ac.cn:8080/handle/334002/122447]
专题	中国科学院合肥物质科学研究院
通讯作者	Qiu, Xuan
作者单位	1.Peking Univ Peoples Hosp, Dept Neurol, Beijing, Peoples R China 2.Univ Chinese Acad Sci, Dept Rehabil, Canc Hosp, Zhejiang Canc Hosp, Hangzhou, Peoples R China 3.Chinese Acad Sci, Inst Canc & Basic Med IBMC, Hangzhou, Peoples R China 4.Guangzhou Univ Chinese Med, Clin Med Coll Acupuncture Moxibust & Rehabil, Guangzhou, Peoples R China 5.Guangzhou Univ Tradit Chinese Med, Guangzhou, Peoples R China
推荐引用方式 GB/T 7714	Qiu, Xuan,Gao, Yicheng,Zhang, Zhaoxu,et al. Fire Acupuncture versus conventional acupuncture to treat spasticity after stroke: A systematic review and meta-analysis[J]. PLOS ONE,2021,16.
APA	Qiu, Xuan,Gao, Yicheng,Zhang, Zhaoxu,Cheng, Sijia,&Zhang, Shuangmei.(2021).Fire Acupuncture versus conventional acupuncture to treat spasticity after stroke: A systematic review and meta-analysis.PLOS ONE,16.
MLA	Qiu, Xuan,et al."Fire Acupuncture versus conventional acupuncture to treat spasticity after stroke: A systematic review and meta-analysis".PLOS ONE 16(2021).