Evidence-based And Clinical Study On Acupuncture For Stroke Complications

ObjectiveThrough the way of the re-evaluation,systematic evaluation and clinical research for the therapeutic effect of acupuncture on target stroke complications(urinary tract infection,urinary retention,depression,pain,falls),get systematic evidence-based acupuncture effect.MethodsChinese and English literature databases(2012-2017)were retrieved from May 2017.A randomized controlled trial was conducted to evaluate the efficacy of acupuncture and moxibustion in treating target complications of adult stroke(urinary tract inf'ection,urinary retention,depression,pain and falls).AMSTAR was used to evaluate the scientific quality of the system,and the meta-analysis results of the high-quality system with a qualitative comprehensive score of 8-11 were evaluated and the GRADE evidence quality was evaluated.Systematic reviews with AMSTAR scores below 8 will be redesigned.Chinese and English literature databases were retrieved from the database until November 2017.Randomized controlled trials were included.The methodological quality was evaluated by ROB,and the GRADE evidence quality was evaluated by combining the effects.A retrospective cohort study will be used to identify target complications that cannot be evaluated systematically.From January 2017 to September 2018,the patients discharged from Guangdong Provincial Hospital of Traditional Chinese Medicine were diagnosed as apoplexy with target complications.According to whether they received acupuncture treatment as an exposure factor and the urinary white blood cell count as an evaluation index,the matching cases were observed after baseline level,and the clinical efficacy was evaluated by propensity scorer.ResultsAMSTAR results showed that 10 systems were evaluated as high quality,and the types of complications included depression,pain and falls.Meta-analysis showed that electro-acupuncture could reduce HAMD score by 0.77(12RCT,95%Cl[-1.47,-0.07])and GRADE of depressive patients after treatment,and that acupuncture could enhance the curative effect of basic treatment and reduce VAS score by 2.88(6RCT,95%CI[-82.46,-33.94])and motor function by 0.48(12RCT,95%Cl[-0.62,-0.35],GRADE of patients with falls.Acupuncture can enhance the curative effect of basic treatment,improve the self-care ability of fallen patients,improve Bl score by 9.19(9RCT,95%Cl[4.34,14.05]),and GRADE is of very low quality.Renewal acupuncture treatment for urinary retention after stroke included 9 RCTs(649 patients).Meta analysis showed that acupuncture combined with basic treatment could reduce 58.20 ml residual urine volume(95%Cl[-82.46,-33.94]),the cure rate was 1.61 times higher(95%Cl[1.20,2.18]),the cure rate of acupuncture was 1.71 times higher(95%Cl[1.19,2.46]),and GRADE was of medium quality.Clinical retrospective study showed that for patients with urinary tract infection after stroke,the urinary white blood cell count(number/ul)of the acupuncture and non-acupuncture groups after treatment was P5044(11-172),P5047(10-233),P>0.05 had no significant difference.ConclusionAcupuncture is effective in the treatment of urinary retention after stroke(GRADE of medium quality).Acupuncture is superior to medication in the treatment of post-stroke depression(GRADE of medium quality).Acupuncture combined with other treatments(basic and rehabilitation)is effective for patients with skeletal muscle pain and falls after stroke(GRADE of low quality).Acupuncture treatment of urinary tract infection after stroke showed no obvious advantage.