TY - JOUR
T1 - Would integrated Western and traditional Chinese medicine have more benefits for stroke rehabilitation? A systematic review and meta-analysis
AU - Zhong, Linda LD
AU - Zheng, Ya
AU - Lau, Alexander Y
AU - Wong, Norman
AU - Yao, Liang
AU - Wu, Xingyao
AU - Shao, Tengteng
AU - Lu, Zhenxing
AU - Li, Huijuan
AU - Yuen, Chun Sum
AU - Guo, Jianwen
AU - Lo, Suzanne
AU - Chau, Janita
AU - Chan, Kam Wa
AU - Ng, Bacon Fung Leung
AU - Bian, Zhaoxiang
AU - Yu, Edwin Chau Leung
N1 - Funding information:
This study was funded by Innovative Technology Commission of the government of Hong Kong SAR (GSP/008/18).
Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/2
Y1 - 2022/2
N2 - 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.
AB - 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.
KW - Acupuncture Therapy/adverse effects
KW - China
KW - Humans
KW - Medicine, Chinese Traditional
KW - Stroke/diagnosis
KW - Stroke Rehabilitation/adverse effects
UR - http://www.scopus.com/inward/record.url?scp=85120893324&partnerID=8YFLogxK
U2 - 10.1136/svn-2020-000781
DO - 10.1136/svn-2020-000781
M3 - Review article
C2 - 34446530
AN - SCOPUS:85120893324
SN - 2059-8688
VL - 7
SP - 77
EP - 85
JO - Stroke and Vascular Neurology
JF - Stroke and Vascular Neurology
IS - 1
ER -