Effectiveness of Scalp Acupuncture for Ischemic Stroke: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 WANGJin-Hai ¹ , ZHANGXing-Hua ² ,  DUXiao-Zheng ³ , ZHAOMin ¹ , BAOYing-Cun ¹ , SHANGJun-Fang ¹ , JIANGHua ¹ , YUANBo ² , TIANLiang ² , ZHUBo-Wen ²

1. Department of Traditional Chinese Medicine, Second Hospital of Lanzhou University, Lanzhou 730000, China;
2. School of Acupuncture and Massage, Gansu College of Traditional Chinese Medicine, Lanzhou 73000, China;
3. School of Medical Technology, Gansu College of Traditional Chinese Medicine, Lanzhou 730000, China;

Corresponding author：

DUXiao-Zheng, Email: lz-duxiaozheng@163.com

Keywords：

Ischemic stroke; Scalp acupuncture; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20150193

Video：

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Objective To systematically review the effectiveness of scalp acupuncture for treating ischemic stroke. Method We searched databases including PubMed, EMbase, MEDLINE, The Cochrane Library, CBM, CNKI, VIP and WanFang Data from inception to December 30th 2014 for randomized controlled trials (RCTs) on scalp acupuncture in the treatment of ischemic stroke. Two reviewers independently screened literature, extracted data, and assessed risk bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 27 studies involving 2 741 patients were included. The results of meta-analysis showed that:a) As for the improvement of nervous functional deficiency, the scalp acupuncture plus drug group was superior to the drug alone group (MD=-5.33, 95%CI -6.71 to -3.96, P<0.000 01), and the scalp acupuncture plus conventional therapy group was superior to the conventional therapy alone group (MD=-2.11, 95%CI -3.31 to -0.91, P=0.0006). b) As for the effective rate, the scalp acupuncture group was superior to the body acupuncture group (OR=0.28, 95%CI 0.15 to 0.53, P<0.000 01), the scalp acupuncture plus drug group was superior to the drug alone group (OR=0.20, 95%CI 0.14 to 0.29, P<0.000 01), and the scalp acupuncture plus conventional therapy group was superior to the conventional therapy alone group (OR=0.12, 95% CI 0.02 to 0.56, P=0.008). However, there was no significant difference between the scalp acupuncture group and the drug alone group (OR=0.16, 95%CI 0.03 to 0.97, P=0.05). Conclusion Scalp acupuncture appears to be an effective adjuvant therapy method for ischemic stroke, and can significantly improve the nervous functional deficiency when combined with other treatment. However, the strength of evidence is low due to high risk of bias of the included studies. More rigorous studies are needed to verify the above conclusion.

Citation： WANGJin-Hai, ZHANGXing-Hua, DUXiao-Zheng, ZHAOMin, BAOYing-Cun, SHANGJun-Fang, JIANGHua, YUANBo, TIANLiang, ZHUBo-Wen. Effectiveness of Scalp Acupuncture for Ischemic Stroke: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(10): 1161-1167. doi: 10.7507/1672-2531.20150193 Copy

1.	张子明. 中风临床与康复. 北京:华夏出版社, 2007.
2.	徐红君, 傅立新. 国内外缺血性卒中卫生经济学评价研究. 中国现代神经疾病杂志, 2009, 9(5):430-433.
3.	李忠. 缺血性脑血管疾病. 北京:北京科学技术出版社, 2002.
4.	Pan S, Zhan X, Su X, et al. Proteomic analysis of serum proteins in acute ischemic stroke patients treated with acupuncture. Exp Biol Med (Maywood), 2011, 236(3):325-333.
5.	Hsing WT, Imamura M, Weaver K, et al. Clinical effects of scalp electrical acupuncturein stroke:a sham-controlled randomized clinical trial. J Altern Complement Med, 2012, 18(4):341-346.
6.	刘灵光, 张红星. 神经干细胞在头针治疗缺血性脑卒中研究的意义. 针刺研究, 2007, 32(4):277-280.
7.	Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8:Assessing risk of bias in included studies. In:Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
8.	肖晓华, 李瑞春, 朱红霞, 等. 头穴透刺电针治疗缺血性中风临床观察. 上海针灸杂志, 2008, 27(6):6-8.
9.	任素莲, 秦峰玲, 武梅. 头针治疗缺血性中风后遗症疗效观察. 长治医学院学报, 2012, 26(1):59-61.
10.	Li YK, Chen XJ. Study on scalp electro-acupuncture treatment of apoplexy and its influence on hemorheology in ischemic apoplexy patients apoplexy patients. World J Acup-Mox, 2001, 11(4):18-22.
11.	王萍. 头针治疗中风200例临床观察. 针灸临床杂志, 2006, 22(12):54-55.
12.	王金海, 杜小正, 赵敏, 等. 头穴透刺对缺血性中风病患者平衡功能影响的临床研究. 江西中医学院学报, 2013, 25(2):40-42.
13.	张学鉴. 头针疗法治疗脑梗塞的临床观察中国康复医学杂志, 1995, 10(2):85-86.
14.	丁建江, 张磊. 头穴透刺治疗脑梗塞及对血浆中β-内啡肽含量的影响. 时珍国医国药, 2007, 18(10):2535-2536.
15.	吴绪平, 杨毅红, 李家康, 等. 头穴透刺治疗急性脑梗塞及对血浆中β-内啡肽含量的影响. 中国针灸, 2000, (1):429-431.
16.	建江, 张磊. 头穴透刺治疗脑梗塞及对血浆中β-内啡肽含量的影响. 时珍国医国药, 2007, 18(10):2535-2536.
17.	王国书, 俞昌德, 李昌生, 等. 头针配合药物对急性脑梗死患者血清MDA的影响. 上海针灸杂志, 2009, 28(3):135-137.
18.	蔡敬宙, 潘锦瑶. 头针与脑梗塞后血管的早期再通. 上海针灸杂志, 2002, 21(4):9-10.
19.	孙世晓, 张秀花, 徐博佳. 头针治疗对急性脑梗塞S100B蛋白影响及临床疗效观察. 针灸临床杂志, 2005, 21(1):20-21.
20.	Bao CL, Huang XJ, Zhang LR, et al. Influence of Scalp Point-to-point Acupuncture on serum sICAMI in patients with acute cerebral infarctio. J Acupunct Tuina Sci, 2006, 4(4):213-214.
21.	韩舰华. 头皮针治疗急性缺血性中风120例疗效观察. 上海针灸杂志, 2004, 23(8):14-15.
22.	焦青峰. 头针配合脉络宁治疗脑梗死近期疗效观察. 实用医技杂志, 2006, 13(23):4212-4213.
23.	刘宁, 马国庆, 闫子生. 头针丛刺长留针治疗缺血性脑梗塞的临床观察. 针灸临床杂志, 2001, 17(3):31.
24.	刘建峰. 头针治疗急性脑梗死的疗效观察. 山西医药杂志, 2007, 36(2):961.
25.	任彦红, 王岱, 冯春祥. 头皮针提插动流综合手法治疗缺血性中风偏瘫临床对比研究. 中医杂志, 1997, 38(8):475-476.
26.	任素莲, 施晓瑜, 李莉. 头针配合血塞通治疗脑梗死110例疗效观察. 长治医学院学报, 2011, 25(1):57-59.
27.	王光义, 蒋乃昌, 贺志光. 头针对脑梗塞患者血浆ET-1、MDA、NO的影响. 中国针灸, 2001, 21(4):241-242.
28.	王焕英. 头针配合补阳还五汤治疗脑梗塞80例. 陕西中医, 2003, 24(2):165.
29.	吴芙蓉. 头穴透刺治疗急性脑梗死对血浆中β-内啡肽浓度的影响. 中国康复, 2009, 24(6):396.
30.	徐会彬, 周刚鑫, 李耐平, 等. 银杏达莫静滴联合头针治疗急性脑梗死. 临床和实验医学杂志, 2007, 6(8):140-141.
31.	杨富强. 头针治疗急性缺血性卒中120例. 中国实用神经疾病杂志, 2009, 12(11):58-59.
32.	谢冬玲, 朱丽芳, 刘惠宇, 等. 事件相关电位P300在头皮针治疗康复期脑梗死认知障碍应用. 上海针灸杂志, 2010, 29(3):152-153.
33.	俞昌德, 吴炳煌, 洪安辉, 等. 头针加药物治疗早期脑梗塞患者的疗效观察. 中国针灸, 2003, 23(2):67-69.
34.	张德祥, 王晓彤, 周佰玲. 头针配合康复训练治疗老年缺血性脑卒中疗效观察. 上海针灸杂志, 2013, 32(3):164-166.
35.	舒相平. 急性脑梗死在针灸治疗中临床疗效观察. 中外医疗, 2011, 30(34):10-11.
36.	张红星. 头针对中风病患者血液流变性、血脂、载脂蛋白的影响. 中国中医急症, 2003, 12(5):409.
37.	代杰, 项容, 陈勇, 等. 头针结合康复治疗急性脑梗死的最佳时间窗研究. 现代中西医结合杂志, 2014, 23(13):1381-1383.

1. 张子明. 中风临床与康复. 北京:华夏出版社, 2007.
2. 徐红君, 傅立新. 国内外缺血性卒中卫生经济学评价研究. 中国现代神经疾病杂志, 2009, 9(5):430-433.
3. 李忠. 缺血性脑血管疾病. 北京:北京科学技术出版社, 2002.
4. Pan S, Zhan X, Su X, et al. Proteomic analysis of serum proteins in acute ischemic stroke patients treated with acupuncture. Exp Biol Med (Maywood), 2011, 236(3):325-333.
5. Hsing WT, Imamura M, Weaver K, et al. Clinical effects of scalp electrical acupuncturein stroke:a sham-controlled randomized clinical trial. J Altern Complement Med, 2012, 18(4):341-346.
6. 刘灵光, 张红星. 神经干细胞在头针治疗缺血性脑卒中研究的意义. 针刺研究, 2007, 32(4):277-280.
7. Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8:Assessing risk of bias in included studies. In:Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
8. 肖晓华, 李瑞春, 朱红霞, 等. 头穴透刺电针治疗缺血性中风临床观察. 上海针灸杂志, 2008, 27(6):6-8.
9. 任素莲, 秦峰玲, 武梅. 头针治疗缺血性中风后遗症疗效观察. 长治医学院学报, 2012, 26(1):59-61.
10. Li YK, Chen XJ. Study on scalp electro-acupuncture treatment of apoplexy and its influence on hemorheology in ischemic apoplexy patients apoplexy patients. World J Acup-Mox, 2001, 11(4):18-22.
11. 王萍. 头针治疗中风200例临床观察. 针灸临床杂志, 2006, 22(12):54-55.
12. 王金海, 杜小正, 赵敏, 等. 头穴透刺对缺血性中风病患者平衡功能影响的临床研究. 江西中医学院学报, 2013, 25(2):40-42.
13. 张学鉴. 头针疗法治疗脑梗塞的临床观察中国康复医学杂志, 1995, 10(2):85-86.
14. 丁建江, 张磊. 头穴透刺治疗脑梗塞及对血浆中β-内啡肽含量的影响. 时珍国医国药, 2007, 18(10):2535-2536.
15. 吴绪平, 杨毅红, 李家康, 等. 头穴透刺治疗急性脑梗塞及对血浆中β-内啡肽含量的影响. 中国针灸, 2000, (1):429-431.
16. 建江, 张磊. 头穴透刺治疗脑梗塞及对血浆中β-内啡肽含量的影响. 时珍国医国药, 2007, 18(10):2535-2536.
17. 王国书, 俞昌德, 李昌生, 等. 头针配合药物对急性脑梗死患者血清MDA的影响. 上海针灸杂志, 2009, 28(3):135-137.
18. 蔡敬宙, 潘锦瑶. 头针与脑梗塞后血管的早期再通. 上海针灸杂志, 2002, 21(4):9-10.
19. 孙世晓, 张秀花, 徐博佳. 头针治疗对急性脑梗塞S100B蛋白影响及临床疗效观察. 针灸临床杂志, 2005, 21(1):20-21.
20. Bao CL, Huang XJ, Zhang LR, et al. Influence of Scalp Point-to-point Acupuncture on serum sICAMI in patients with acute cerebral infarctio. J Acupunct Tuina Sci, 2006, 4(4):213-214.
21. 韩舰华. 头皮针治疗急性缺血性中风120例疗效观察. 上海针灸杂志, 2004, 23(8):14-15.
22. 焦青峰. 头针配合脉络宁治疗脑梗死近期疗效观察. 实用医技杂志, 2006, 13(23):4212-4213.
23. 刘宁, 马国庆, 闫子生. 头针丛刺长留针治疗缺血性脑梗塞的临床观察. 针灸临床杂志, 2001, 17(3):31.
24. 刘建峰. 头针治疗急性脑梗死的疗效观察. 山西医药杂志, 2007, 36(2):961.
25. 任彦红, 王岱, 冯春祥. 头皮针提插动流综合手法治疗缺血性中风偏瘫临床对比研究. 中医杂志, 1997, 38(8):475-476.
26. 任素莲, 施晓瑜, 李莉. 头针配合血塞通治疗脑梗死110例疗效观察. 长治医学院学报, 2011, 25(1):57-59.
27. 王光义, 蒋乃昌, 贺志光. 头针对脑梗塞患者血浆ET-1、MDA、NO的影响. 中国针灸, 2001, 21(4):241-242.
28. 王焕英. 头针配合补阳还五汤治疗脑梗塞80例. 陕西中医, 2003, 24(2):165.
29. 吴芙蓉. 头穴透刺治疗急性脑梗死对血浆中β-内啡肽浓度的影响. 中国康复, 2009, 24(6):396.
30. 徐会彬, 周刚鑫, 李耐平, 等. 银杏达莫静滴联合头针治疗急性脑梗死. 临床和实验医学杂志, 2007, 6(8):140-141.
31. 杨富强. 头针治疗急性缺血性卒中120例. 中国实用神经疾病杂志, 2009, 12(11):58-59.
32. 谢冬玲, 朱丽芳, 刘惠宇, 等. 事件相关电位P300在头皮针治疗康复期脑梗死认知障碍应用. 上海针灸杂志, 2010, 29(3):152-153.
33. 俞昌德, 吴炳煌, 洪安辉, 等. 头针加药物治疗早期脑梗塞患者的疗效观察. 中国针灸, 2003, 23(2):67-69.
34. 张德祥, 王晓彤, 周佰玲. 头针配合康复训练治疗老年缺血性脑卒中疗效观察. 上海针灸杂志, 2013, 32(3):164-166.
35. 舒相平. 急性脑梗死在针灸治疗中临床疗效观察. 中外医疗, 2011, 30(34):10-11.
36. 张红星. 头针对中风病患者血液流变性、血脂、载脂蛋白的影响. 中国中医急症, 2003, 12(5):409.
37. 代杰, 项容, 陈勇, 等. 头针结合康复治疗急性脑梗死的最佳时间窗研究. 现代中西医结合杂志, 2014, 23(13):1381-1383.

Chinese Journal of Evidence-Based Medicine

Effectiveness of Scalp Acupuncture for Ischemic Stroke: A Meta-analysis

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