[Network Meta-analysis of 4 acupuncture therapies for shoulder hand syndrome after stroke]. 2021

Rui-Qi Wang, and Qing-Zhong Wu, and Chun-Hua Huang, and Wang-Fu Rao
Graduate School of Jiangxi University of TCM, Nanchang 330006, China.

OBJECTIVE A network Meta-analysis of randomized controlled trials (RCT) of 4 commonly used acupuncture therapies (electroacupuncture, fire needling, warming acupuncture and filiform needling) for shoulder hand syndrome (SHS) after stroke was performed. METHODS The RCTs regarding electroacupuncture, fire needling, warming acupuncture and filiform needling for SHS after stroke before March 10, 2020 were searched in databases of CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase and Cochrane Library. The included literature was screened and evaluated by Cochrane bias risk assessment tool, and the data analysis was performed by RevMan5.3, Gemtc0.14.3 and Stata14.2. RESULTS A total of 21 RCTs were included, involving 1508 patients, 814 cases in the observation group and 694 cases in the control group. In term of effective rate and visual analogue scale (VAS) score, warming acupuncture, electroacupuncture and fire needling needling were superior to western medication and rehabilitation (P<0.05), and warming acupuncture was most likely to be the best treatment. In term of joint swelling score, warming acupuncture was superior to rehabilitation (P<0.05), and warming acupuncture was most likely to be the best treatment. In term of Fugl-Meyer assessment (FMA) score, fire needling was superior to western medication and rehabilitation (P<0.05), warming acupuncture was superior to filiform needling (P<0.05), fire needling was most likely to be the best treatment (P<0.05). CONCLUSIONS The curative effect of 4 acupuncture therapies for SHS after stroke is better than the western medication and rehabilitation, and warming acupuncture has the best clinical efficacy.

UI MeSH Term Description Entries
D012019 Reflex Sympathetic Dystrophy A syndrome characterized by severe burning pain in an extremity accompanied by sudomotor, vasomotor, and trophic changes in bone without an associated specific nerve injury. This condition is most often precipitated by trauma to soft tissue or nerve complexes. The skin over the affected region is usually erythematous and demonstrates hypersensitivity to tactile stimuli and erythema. (Adams et al., Principles of Neurology, 6th ed, p1360; Pain 1995 Oct;63(1):127-33) Algodystrophy,Complex Regional Pain Syndrome, Type I,Pain Syndrome Type I, Regional, Complex,Shoulder-Hand Syndrome,Sudek Atrophy,Algodystrophic Syndrome,CRPS Type I,Cervical Sympathetic Dystrophy,Pain Syndrome Type I, Complex Regional,RSD (Reflex Sympathetic Dystrophy),Reflex Sympathetic Dystrophy Syndrome,Sudek's Atrophy,Sympathetic Reflex Dystrophia,Syndrome, Reflex Sympathetic Dystrophy,Type I Complex Regional Pain Syndrome,Algodystrophies,Atrophies, Sudek's,Atrophy, Sudek,Atrophy, Sudek's,CRPS Type Is,Cervical Sympathetic Dystrophies,Dystrophies, Cervical Sympathetic,Dystrophies, Reflex Sympathetic,Dystrophy, Cervical Sympathetic,Dystrophy, Reflex Sympathetic,RSDs (Reflex Sympathetic Dystrophy),Reflex Dystrophia, Sympathetic,Reflex Sympathetic Dystrophies,Shoulder Hand Syndrome,Shoulder-Hand Syndromes,Sudek's Atrophies,Sudeks Atrophy,Sympathetic Dystrophies, Cervical,Sympathetic Dystrophies, Reflex,Sympathetic Dystrophy, Cervical,Sympathetic Dystrophy, Reflex,Sympathetic Reflex Dystrophias,Syndrome, Algodystrophic,Syndrome, Shoulder-Hand,Syndromes, Shoulder-Hand,Type I, CRPS
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000071076 Network Meta-Analysis Meta-analysis of randomized trials in which estimates of comparative treatment effects are visualized and interpreted from a network of interventions that may or may not have been evaluated directly against each other. Common considerations in network meta-analysis include conceptual and statistical heterogeneity and incoherence. Mixed Treatment Meta-Analysis,Multiple Treatment Comparison Meta-Analysis,Meta-Analyses, Mixed Treatment,Meta-Analyses, Network,Meta-Analysis, Mixed Treatment,Meta-Analysis, Network,Mixed Treatment Meta Analysis,Mixed Treatment Meta-Analyses,Multiple Treatment Comparison Meta Analysis,Network Meta Analysis,Network Meta-Analyses
D015669 Acupuncture Points Designated locations along nerves or organ meridians for inserting acupuncture needles. Acupoints,Acupoint,Acupuncture Point,Point, Acupuncture,Points, Acupuncture
D015670 Acupuncture Therapy Treatment of disease by inserting needles along specific pathways or meridians. The placement varies with the disease being treated. It is sometimes used in conjunction with heat, moxibustion, acupressure, or electric stimulation. Acupotomy,Acupuncture Treatment,Pharmacoacupuncture Therapy,Pharmacoacupuncture Treatment,Therapy, Acupuncture,Acupotomies,Acupuncture Treatments,Therapy, Pharmacoacupuncture,Treatment, Acupuncture,Treatment, Pharmacoacupuncture
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D020521 Stroke A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810) Apoplexy,Cerebral Stroke,Cerebrovascular Accident,Cerebrovascular Apoplexy,Vascular Accident, Brain,CVA (Cerebrovascular Accident),Cerebrovascular Accident, Acute,Cerebrovascular Stroke,Stroke, Acute,Acute Cerebrovascular Accident,Acute Cerebrovascular Accidents,Acute Stroke,Acute Strokes,Apoplexy, Cerebrovascular,Brain Vascular Accident,Brain Vascular Accidents,CVAs (Cerebrovascular Accident),Cerebral Strokes,Cerebrovascular Accidents,Cerebrovascular Accidents, Acute,Cerebrovascular Strokes,Stroke, Cerebral,Stroke, Cerebrovascular,Strokes,Strokes, Acute,Strokes, Cerebral,Strokes, Cerebrovascular,Vascular Accidents, Brain

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