Network meta-analysis of the effectiveness of different acupuncture and moxibustion therapies for post-stroke motor dysfunction
Objective To evaluate the effects of different acupuncture and moxibustion therapies on patients with post-stroke motor dysfunction by network meta-analysis.Methods PubMed,Embase,Cochrane,CNKI,Wanfang Data,and VIP were searched by computer for randomized controlled trials of acupuncture and moxibustion in the treatment of post-stroke motor dysfunction from the establishment of the database to October 2022.The quality of the included literatures was evaluated based on the Cochrane 5.1 tool for assessing bias risk.ADDIS software and Stata 15.0 software were used for network meta-analysis.Results A total of 21 literatures were included,involving eight interventions and 1 971 patients.The total Fugl-Meyer motor function assessment(FMA)scores of rehabilitation + electroacupuncture(MD=14.39,95%CI:4.14-24.92),rehabilitation + thunder-fire moxibustion(MD=16.41,95%CI:1.68-31.38),rehabilitation + head acupuncture(MD=16.94,95%CI:5.46-27.88),rehabilitation + acupuncture(MD=13.28,95%CI:8.10-18.62),and rehabilitation + acupuncture(MD=13.28,95%CI:8.10-18.62)were higher than that of rehabilitation alone(P＜0.05).There was no statisti-cally significant difference in the FMA scores of the upper limbs between rehabilitation + acupuncture,rehabilitation + moxibustion,rehabilitation + acupoint catgut embedding,and rehabilitation alone(P＞0.05).The FMA score of lower limbs of rehabilitation + acupuncture(MD=3.52,95%CI:0.31-6.49)was higher than that of rehabilitation alone(P＜0.05).The comparison of the total FMA scores of different acupuncture and moxibustion interventions in patients with post-stroke mo tor dysfunction showed that some studies were far from the central location and had poor symmetry,which may have publication bias.Only one of the included studies mentioned the occur-rence of adverse reactions,and the total incidence was 1.5%.Conclusion Compared with rehabilitation therapy alone,acupuncture and moxibustion combined therapy has better clinical effects on post-stroke motor dysfunction.More high-quality clinical trials are needed to provide high-quality evi-dence-based medical evidence in the future.
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