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Integr Med Res. 2019 Sep;8(3):145-159. doi: 10.1016/j.imr.2019.05.001. Epub 2019 May 15.

Overview of systematic reviews with meta-analyses on acupuncture in post-stroke cognitive impairment and depression management.

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Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, 9/F, Lui Che Woo Clinical Sciences Building, Shatin, Hong Kong.
The Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong, 4L, 4/F, Day Treatment Block, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong.
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Shatin, Hong Kong.


Background: Acupuncture has been using as an alternative non-pharmacological therapy in the management of post stroke depression and cognitive impairment but its effectiveness and safety remain controversial. We conducted an overview of systematic reviews with meta-analyses to evaluate the evidence on the effect of acupuncture in the treatment of stroke with conventional medicine intervention. Methods: Systematic reviews summarized the treatment effects of acupuncture for post stroke cognitive impairment and post stroke depression were considered eligible. Methodological quality of included systematic reviews was assessed using A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2). Results: Four systematic reviews on post stroke cognitive impairment and ten systematic reviews on post stroke depression with good methodological quality were included. Meta-analyses revealed that acupuncture plus cognitive rehabilitation; and acupuncture or moxibustion plus cognitive rehabilitation, versus cognitive rehabilitation demonstrated statistically significant increase in Mini-Mental State Examination scores in compared to cognitive rehabilitation after 4 weeks treatment [Pooled weighted mean difference (WMD) = 3.14, 95% confidence interval (CI) = 2.06 to 4.21, I2 = 36%]; and (Pooled WMD = 3.22, 95% CI = 2.09 to 4.34, I2 = 0%). Furthermore, acupuncture versus antidepressant demonstrated statistically significant improve depression measured by increasing in 17-item Hamilton Depression Rating Scale in comparing to cognitive rehabilitation after 2 weeks treatment (Pooled WMD= -2.34, 95% CI= -3.46 to -1.22, I2 = 5%). Acupuncture usage was not associated with increased risk of adverse events. Conclusions: Acupuncture is safe and improves cognitive function and depressive disorder without obvious serious adverse events for post stroke patients.


Child; Systematic review; acupuncture; cognitive impairment; depression; stroke

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