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

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机构: [1]Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China [2]Department of Medicine and Therapeutics and Hong Kong Institute of Integrative Medicine, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China [3]Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada [4]Clinical Laboratory, Shanghai Traditional Chinese Medicine Integrated Institute of Vascular Abnomalies, Shanghai, China [5]Institute of Medical Research, Northwestern Polytechnical University, Xi'an, Shanxi, China [6]Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China [7]School of Chinese medicine, Hong Kong Baptist University, Hong Kong SAR, China [8]Brain Center, Guangdong Procincial Hospital of Traditional Chinese Medicine, Guangdong University of Chinese Medicine, Guangzhou, China [9]The Nethersole School of Nuring, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China [10]Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China [11]Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China [12]Hong Kong Association for Integration of Chinese-Western Medicine Limited, Hong Kong SAR, China
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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.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.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.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.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.CRD42020152050.© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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出版当年[2020]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学
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第一作者机构: [1]Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
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