Would integrated Western and traditional Chinese medicine have more benefits for stroke rehabilitation? A systematic review and meta-analysis

作     者：Linda LD Zhong Ya Zheng Alexander Y Lau Norman Wong Liang Yao Xingyao Wu Tengteng Shao Zhenxing Lu Huijuan Li Chun Sum Yuen Jianwen Guo Suzanne Lo Janita Chau Kam Wa Chan Bacon Fung Leung Ng Zhaoxiang Bian Edwin Chau-leung Yu 

作者机构：Hong Kong Chinese Medicine Clinical Study CentreSchool of Chinese MedicineHong Kong Baptist UniversityHong Kong SARChina Department of Medicine and Therapeutics and Hong Kong Institute of Integrative MedicinePrince of Wales HospitalFaculty of MedicineThe Chinese University of Hong KongHong Kong SARChina Department of Health Research MethodsEvidence and ImpactMcMaster UniversityHamiltonOntarioCanada Clinical LaboratoryShanghai Traditional Chinese Medicine Integrated Institute of Vascular AbnomaliesShanghaiChina Institute of Medical ResearchNorthwestern Polytechnical UniversityXi'anShanxiChina Evidence Based Medicine CenterSchool of Basic Medical SciencesLanzhou UniversityLanzhouChina School of Chinese medicineHong Kong Baptist UniversityHong Kong SARChina Brain CenterGuangdong Procincial Hospital of Traditional Chinese MedicineGuangdong University of Chinese MedicineGuangzhouChina The Nethersole School of NuringFaculty of Medicinethe Chinese University of Hong KongHong Kong SARChina Department of MedicineLi Ka Shing Faculty of Medicinethe University of Hong KongHong Kong SARChina Department of Rehabilitation SciencesHong Kong Polytechnic UniversityHong Kong SARChina Hong Kong Association for Integration of Chinese-Western Medicine LimitedHong Kong SARChina 

出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学（英文）)

年 卷 期：2022年第7卷第1期

页      面：77-85页

核心收录：

学科分类：1005[医学-中医学] 1002[医学-临床医学] 100204[医学-神经病学] 100502[医学-中医临床基础] 10[医学] 

基　　金：funded by Innovative Technology Commission of the government of Hong Kong SAR(GSP/008/18). 

主　　题：acupuncture routine alone 

摘      要：Background Stroke is a major cause of death or long-term disability worldwide.Many patients with stroke receive integrative therapy consisting of Western medicine(WM)and routine rehabilitation in conjunction with Chinese medicine(CM),such as acupuncture and Chinese herbal medicine.However,there is no available evidence on the effectiveness of the combined use of WM and CM interventions in stroke rehabilitation.Aims The purpose of this meta-analysis is to evaluate the results of all individual studies to assess the combined use of CM and WM in stroke rehabilitation compared with WM only.Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed.MEDLINE,EMBASE,Cochrane and China National Knowledge Infrastructure(CNKI)were searched.The included outcomes were dependency,motor function,depression and swallowing function.Subgroup analysis was performed,and publication bias was assessed using funnel plots.Summary of review 58 studies and 6339 patients were included in the meta-analysis.Subgroup analysis revealed that combined therapy comprising both acupuncture and WM had a superior effect on improving dependency and swallowing function compared with standard WM therapy alone.Potential superiority of combined therapy comprising CM and WM in improving depression compared with standard WM therapy was also found.Conclusions Our results indicate that the combined use of CM and WM could be more efficacious in stroke rehabilitation compared with the use of WM therapy alone.However,most studies were short in duration(2 to 4 weeks)and prone to different types of biases,which prevents making any conclusion regarding the long-term effects and raises concerns regarding true efficacy in context of high likelihood of Hawthorn bias.So,more randomised controlled trials with more rigorous design and longer duration of treatment and follow-up need to be conducted to compare WM alone versus WM and CM combined.