Efficacy and safety of acupuncture or moxibustion combined with rehabilitation therapy for post-stroke shoulder-hand syndrome: a systematic review and meta-analysis of randomized controlled trials

IF 2.1 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2026-01-01 Epub Date: 2025-11-29 DOI:10.1016/j.jstrokecerebrovasdis.2025.108509

Xinle Wang , Lujia Xiao , Xingxing Lin , Feng Zhang , Kaixuan Zhang , Baoqiang Dong

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引用次数: 0

Abstract

Background

This study evaluated the efficacy and safety of acupuncture or moxibustion combined with rehabilitation therapy for post-stroke shoulder-hand syndrome (SHS).

Methods

PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Scientific Journals Database (VIP), and SinoMed were searched from inception to March 5, 2025 for randomized controlled trials (RCTs). Cochrane Risk of Bias 2.0 (RoB2) tool was used to assess study quality, RevMan 5.4 software was employed for meta-analysis, GRADE criteria were applied to evaluate evidence quality.

Results

46 RCTs involving 3730 participants were included. Compared to rehabilitation alone, acupuncture or moxibustion combined with rehabilitation significantly improved efficacy rate (RR = 1.24, 95 % CI: 1.20 to 1.28), motor function (FMA: MD = 8.35, 95 % CI: 6.96 to 9.74), reduced pain (VAS: MD = -1.43, 95 % CI:1.65 to -1.21), and reduced SHS severity (SHSS: MD = -1.60, 95 % CI:1.99 to -1.22). Combination therapy also significantly reduced biomarkers (SP, BK, ET-1), increased CGRP (SMD = 1.27, 95 % CI: 0.53 to 2.02), decreased swelling volume (MD = -5.88, 95 % CI:9.25 to -2.50), and improved activities of daily living (MBI: MD = 13.31, 95 % CI: 9.10 to 17.53). However, the GRADE indicated low or very low certainty for most outcomes. Only six studies explicitly documented adverse events (none severe), warranting cautious interpretation.

Conclusions

Acupuncture or moxibustion combined with rehabilitation improves outcomes for post-stroke SHS. Nevertheless, conclusions require further validation through multicenter, large-sample RCTs due to evidence limitations.

查看原文本刊更多论文

针灸联合康复治疗脑卒中后肩手综合征的疗效和安全性：随机对照试验的系统回顾和荟萃分析。

背景：本研究评价针灸联合康复治疗脑卒中后肩手综合征（SHS）的疗效和安全性。方法：检索PubMed、Embase、Web of Science、Cochrane Library、中国知网（CNKI）、万方网（Wanfang）、中国科学期刊数据库（VIP）和中国医学信息网（SinoMed）自建库至2025年3月5日的随机对照试验（RCTs）。采用Cochrane Risk of Bias 2.0 （RoB2）工具评价研究质量，RevMan 5.4软件进行meta分析，GRADE标准评价证据质量。结果：纳入46项随机对照试验，共3730名受试者。与单独康复治疗相比，针灸联合康复治疗显著提高了有效率（RR = 1.24,95% CI: 1.20 ~ 1.28）、运动功能（FMA: MD = 8.35,95% CI: 6.96 ~ 9.74）、疼痛减轻（VAS: MD = -1.43,95% CI: -1.65 ~ -1.21）、SHS严重程度减轻（SHSS: MD = -1.60,95% CI: -1.99 ~ -1.22）。联合治疗还显著降低了生物标志物（SP， BK, ET-1），增加了CGRP (SMD = 1.27,95% CI: 0.53至2.02)，减少了肿胀体积（MD = -5.88,95% CI: -9.25至-2.50），改善了日常生活活动（MBI: MD = 13.31,95% CI: 9.10至17.53）。然而，GRADE表明大多数结果的确定性较低或非常低。只有6项研究明确记录了不良事件（不严重），需要谨慎解释。结论：针灸结合康复治疗可改善脑卒中后SHS的预后。然而，由于证据有限，结论需要通过多中心、大样本随机对照试验进一步验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.