Acupuncture for the Adjunctive Therapy of Post-stoke Fatigue: A Systematic Review and Meta-analysis

The aim of this research is to assess the effectiveness and safety of acupuncture combined with rehabilitation therapy for post-stroke fatigue. The methods used in this research are as follows: systematically retrieving China National Knowledge Infrastructure, Chinese Scientific Journal Database, Chinese Biological Medicine Database, Cochrane Library, Medline and Embase were electronically searched from inception to Dec 2020. The dataset included randomized controlled trials (RCTs) with Chinese and English only that compared acupuncture as an adjunct to rehabilitation in stroke patients with fatigue. The methodological quality of the included trials was assessed using the Cochrane risk of bias assessment tool. Statistical analyses were performed by RevMan V.5.4.A total of 6 RCTs were included in this study, including 426 cases (213 cases in the treatment group and 213 cases in the control group). The results of meta-analysis showed that compared with conventional treatment, acupuncture as an adjuvant therapy can significantly reduce the incidence of post-stroke fatigue [MD = -5.45, 95% CI = (-6.75, -4.14), Z= 8.19 (P < 0.001)]. In terms of energy, acupuncture also has an obvious effect [MD = 1.69, 95% CI = (0.27, 3.12), Z = 2.33 (P < 0.02)]. Our systematic review and meta-analysis suggests that acupuncture combined with conventional rehabilitation therapy is an effective therapy for patients suffering from post-stroke fatigue, which is suitable for clinical promotion and use. However, due to methodological weakness and limited number of RCTs, the results should be interpreted cautiously. Further clinical trials with large sample sizes and a rigorous design are needed.