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Comparative Efficacy of Various Acupuncture-Related Therapies for Post-Stroke Sleep Disorders: A Network Meta-Analysis of Randomized Controlled Trials

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Titel: Comparative Efficacy of Various Acupuncture-Related Therapies for Post-Stroke Sleep Disorders: A Network Meta-Analysis of Randomized Controlled Trials
Autoren: Lian J, Jiang Y, Kong L, Zhou M
Quelle: Nat Sci Sleep
Nature and Science of Sleep, Vol Volume 17, Iss Issue 1, Pp 1217-1229 (2025)
Verlagsinformationen: Informa UK Limited, 2025.
Publikationsjahr: 2025
Schlagwörter: Acupuncture and moxibustion therapy, Psychiatry, Neurophysiology and neuropsychology, PSQI, QP351-495, 5-HT, RC435-571, Sleep disorders, Network meta-analysis, stroke, Original Research
Beschreibung: BACKGROUND: Post-stroke sleep disorders (PSSD) are among the most prevalent complications of stroke, significantly impeding neurological recovery and increasing the risk of recurrence. While Western medicine primarily relies on pharmacological treatments, these often come with side effects and inconsistent outcomes. Recent evidence supports the effectiveness of various acupuncture therapies for PSSD, but the optimal treatment strategy remains unclear. OBJECTIVE: To compare the efficacy of different acupuncture therapies for PSSD using a network meta-analysis. METHODS: We conducted systematic searches in multiple databases, including CNKI (since 1994), VIP (since 1989), CBM (since 1978), WanFang (since 1998), the Chinese Clinical Trial Registry (since 2005), PubMed (since 1966), EMBASE (since 1974), The Cochrane Library (since 1993), Web of Science (since 1900), and ClinicalTrials (since 2000). Randomized controlled trials (RCTs) on acupuncture therapies for PSSD were included up to May 31, 2024. Studies were screened based on predefined inclusion and exclusion criteria, and their quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Data were analyzed using RevMan 5.3 and Stata 14. RESULTS: A total of 53 RCTs involving 3973 patients were included. The network meta-analysis evaluated 12 interventions. Auricular acupressure combined with Western medicine ranked highest for improving PSQI scores (surface under the cumulative ranking curve [SUCRA]: 96.2%), followed by acupuncture (68.5%) and moxibustion combined with Western medicine (63.6%). For increasing serum 5-HT levels, moxibustion combined with Western medicine ranked highest (SUCRA: 89.3%), followed by acupuncture combined with Western medicine (79.1%). Acupuncture combined with Western medicine was most effective in reducing serum NE levels (SUCRA: 97%). CONCLUSION: Acupuncture therapies are effective for PSSD and it is more effective when used in combination with western medicine. These effects may be mediated by modulating neurotransmitter levels. However, further large-scale, multi-center RCTs are needed to confirm these findings. This study followed PRISMA guidelines and was registered with PROSPERO (CRD42023470398).
Publikationsart: Article
Other literature type
Sprache: English
ISSN: 1179-1608
DOI: 10.2147/nss.s507392
Zugangs-URL: https://doaj.org/article/cc8b4da1da884d36ade459ad53beac3f
Rights: CC BY NC
URL: http://creativecommons.org/licenses/by-nc/4.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at http://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v4.0) License (http://creativecommons.org/licenses/by-nc/4.0/ (http://creativecommons.org/licenses/by-nc/4.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (http://www.dovepress.com/terms.php).
Dokumentencode: edsair.doi.dedup.....d30b0613d7cb8045b242d669d7503c2c
Datenbank: OpenAIRE
Beschreibung
Abstract:BACKGROUND: Post-stroke sleep disorders (PSSD) are among the most prevalent complications of stroke, significantly impeding neurological recovery and increasing the risk of recurrence. While Western medicine primarily relies on pharmacological treatments, these often come with side effects and inconsistent outcomes. Recent evidence supports the effectiveness of various acupuncture therapies for PSSD, but the optimal treatment strategy remains unclear. OBJECTIVE: To compare the efficacy of different acupuncture therapies for PSSD using a network meta-analysis. METHODS: We conducted systematic searches in multiple databases, including CNKI (since 1994), VIP (since 1989), CBM (since 1978), WanFang (since 1998), the Chinese Clinical Trial Registry (since 2005), PubMed (since 1966), EMBASE (since 1974), The Cochrane Library (since 1993), Web of Science (since 1900), and ClinicalTrials (since 2000). Randomized controlled trials (RCTs) on acupuncture therapies for PSSD were included up to May 31, 2024. Studies were screened based on predefined inclusion and exclusion criteria, and their quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Data were analyzed using RevMan 5.3 and Stata 14. RESULTS: A total of 53 RCTs involving 3973 patients were included. The network meta-analysis evaluated 12 interventions. Auricular acupressure combined with Western medicine ranked highest for improving PSQI scores (surface under the cumulative ranking curve [SUCRA]: 96.2%), followed by acupuncture (68.5%) and moxibustion combined with Western medicine (63.6%). For increasing serum 5-HT levels, moxibustion combined with Western medicine ranked highest (SUCRA: 89.3%), followed by acupuncture combined with Western medicine (79.1%). Acupuncture combined with Western medicine was most effective in reducing serum NE levels (SUCRA: 97%). CONCLUSION: Acupuncture therapies are effective for PSSD and it is more effective when used in combination with western medicine. These effects may be mediated by modulating neurotransmitter levels. However, further large-scale, multi-center RCTs are needed to confirm these findings. This study followed PRISMA guidelines and was registered with PROSPERO (CRD42023470398).
ISSN:11791608
DOI:10.2147/nss.s507392