Ischemic stroke accounts for most cases of stroke and is one of the leading causes of death and disability worldwide. Despite many advances in treatment and management of ischemic stroke by conventional medicine, still there is not a single effective measure to reduce all the associated impairments and disabilities.
Objective
The aim of this review study is to investigate the benefits of acupuncture as an addition to standard western treatment in a synergic form for the acute and subacute stages of ischemic stroke.
Method
The literature search was performed using China Medical University library database searching PubMed, Web of Science, Cochrane and MedLine. The collected studies were further refined using the following inclusion criteria: 1) RCT human studies 2) Studies published in English language 3) Ischemic stroke 4) Acupuncture intervention within 4 weeks of onset. The relevant studies cited in these articles that met the criteria were also included.
Results and discussion
Eleven Randomised Control Trials with the total number of 2198 patients from age of 18 to 85 years old were included. Twelve criteria were adopted to ascertain useful information. The studies were conducted in 3 different countries. Manual acupuncture, electro acupuncture, scalp acupuncture or Xian Nao Kai Qiao style of acupuncture were used in the studies. There was a pool of around 47 standard acupuncture points and further 7 extra points as well as different scalp points used for these studies. CT scan, clinical observation at admission to hospital and other diagnostic tools such as the 1995 Chinese national criteria and Oxfordshire Community Stroke Project were used for diagnosis of ischemic stroke. In total at least fourteen different outcome measurements were used in the included studies. Acupuncture intervention started between 24 hours to 15 days from the stroke onset. Treatments lasted between 2 to 10 weeks with between 8 to 28 treatment sessions over the period of treatment. There were very limited cases of mild transient side effects reported in some acupuncture groups that were relieved spontaneously within half an hour. There was no report of any serious side effect. All studies except only one reported various degrees of improvement in acupuncture groups with fewer patients dead or dependent at the end of assessment periods.
Conclusion
Analysis of the included studies suggests that acupuncture is relatively safe, feasible and in combination with standard western treatment ameliorates the neurological and functional deficits post ischemic stroke. The best clinical outcome is achieved when the treatment is started early during the course of ischemic stroke.
