[Meta-analysis on the Therapeutic Effect of Acupuncture at Meridian Sinew for Spastic Paralysis After Stroke].

OBJECTIVE: To review systematically the clinical effects of spastic paralysis after stroke treated with acupuncture at meridian sinew ("Jingjin", musculotendon).

METHODS: "Meridian sinew" "stroke" and "spasm" were taken as the key words to retrieve from the Chinese National Knowledge Infrastracture Database (CNKI), Chongqing VIP Chinese Science and Technology Periodical Database (VIP), Chinese Biomedical Library (CBM), Wanfang Data, PubMed and the Cochrane Library. The Cochrane"risk of bias" tool was used to conduct the methodological quality evaluation to the literature. RevMan 5.3 software was adopted for Meta-analysis.

RESULTS: Totally, 13 papers were included, with 820 patients involved. In reference to Cochrane Reviewers' Handbook 5.0.2, the randomized controlled trial (RCT) risk of bias was assessed and it was unclear for all of the 13 papers. The results of Meta-analysis showed that the clinical effect was improved with acupuncture at meridian sinew as compared with normal acupuncture technique[①total effective rate:OR=3.86, 95% CI (2.67,5.57), Z =7.20, P <0.00001; ②modified Ashworth spasm scale:OR=4.54, 95% CI (2.91,7.10), Z =6.64, P <0.00001; ③evaluation of limb motor function with Fugl-Meyer score:MD=4.18, 95% CI (-0.59,8.94), Z =1.72, P =0.09>0.05]. The publication bias of included papers was not obvious and therefore it could be neglected in the impact on the combined effect size.

CONCLUSIONS: Acupuncture at meridian sinew is effective in the treatment of spastic paralysis after stroke. The total clinical effect and the improvement in muscular tone with acupuncture at meridian sinew are better than those with normal acupuncture technique. The quality of the included literature is not high generally. Hence, it is necessary to have more clinical studies with high-quality and strict design.