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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.

Author information

1
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.
2
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.
3
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
4
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.

Abstract

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.

KEYWORDS:

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

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