Scalp Acupuncture for Acute Ischemic Stroke: A Meta-Analysis of Randomized Controlled Trials

Table 1

Characteristics of the included studies.

Included; trials	Eligibility; criteria1	Study; designs	Gender (male/female); age (years)		Course of disease	Interventions (𝑛); Drug/dosage		Course of; treatment	Outcomes	Intergroup; differences
			Trial	Control		Trial	Control
Tang and Sun 1996 [22]	CMADS in 1986	RCT	𝑛=63 (30 : 33), Average of 64.2	41/22;	<7 d	SA#	WCM##	15 d	(1) clinical efficacy; (2) Limb power recovery; (3) Level of rehabilitation; (4) SOD, MDA, PGI2, TAX2; (5) SEP	(1) 𝑃<0.05; (2) 𝑃<0.05; (3) 𝑃<0.05; (4) 𝑃<0.05; (5) 𝑃<0.05
Yu et al. 2004 [23]	CMADS in 1995	RCT	19/11; 45–74	18/12; 46–74	<7 d	SA#	WCM##	10 d	(1) NDS; (2) ADL (BI); (3) Blood MDA content	(1) 𝑃<0.05; (2) 𝑃<0.05; (3) 𝑃<0.05
Wei et al. 2005 [24]	CMADS in 1995	RCT	20/16; Average of 59.44	22/14; Average of 62.26	Average of 5.1 d	SA#	WCM##	8 w	(1) clinical efficacy; (2) NDS; (3) ADL (FIM); (4) SIAS score	(1) 𝑃<0.05; (2) 𝑃<0.05; (3) 𝑃<0.05; (4) 𝑃<0.05
Xu et al. 2007 [25]	CMADS; in 1995	RCT	33/28; Average of 62.33	29/32; Average of 59.83	6 h–3 d	SA#	WCM##	14 d	(1) clinical efficacy; (2) NDS	(1) 𝑃<0.05; (2) 𝑃<0.05
Chen and Jing 2008 [26]	CMADS; in 1995	RCT; (statistical software)	18/14; —	14/16; —	<7 d	SA#	WCM##	2 w	(1) clinical efficacy; (2) Kubota's water drinking test	(1) 𝑃<0.01; (2) 𝑃<0.01
Yu et al. 2010 [27]	CMADS; in 1995	RCT (random number form)	𝑛=40 (20 : 20), 45–75 y	26/14;	<7 d	SA#	WCM##	10 d	(1) NDS; (2) TCM symptom accumulated points; (3) SOD activity; (4) MDA content	(1) 𝑃<0.05; (2) 𝑃<0.05; (3) 𝑃<0.05; (4) 𝑃<0.05
Zhang et al. 2011b* [28]	CMADS; in 1995	RCT	A group: 14/9; 59.8 ± 7.1	12/11; 58.0 ± 6.8	24 h	SA#	WCM##	30 d	(1) NDS; (2) VEGF (test at 10th d)	(1) 𝑃<0.05; (2) 𝑃<0.05
Zhang et al. 2011a* [28]			B group: 13/10; 56.5 ± 6.5				WCM ##			(1) 𝑃<0.05; (2) 𝑃<0.05
Zhu and Huang 2011 [29]	CMADS; in 1995	RCT	9/11; 59.07 ± 11.49	14/6; 56.03 ± 8.70	<7 d	SA#	WCM##	30 d	(1) NDS; (2) Ca^2+ content in serum	(1) 𝑃<0.05; (2) 𝑃<0.05

ADL: Activity of Daily Living Scale; BI: Bathel Index; CMADS: Chinese Medical Association Diagnosis Standard; d: day(s); FIM: Functional Independence Measure; h: hour(s); FMA: Fugl-Meyer Motor Assessment; m: months; MDA: Malondialdehyde; NDS: neurological deficit score; PGI2: prostacyclin; RCT: randomized controlled trial; SA: scalp acupuncture; SEP: Somatosensory Evoked Potentials; SIAS: Stroke Impairment Assessment Set; SOD: Superoxide Dismutase; TAX2: thromboxane A2; TCM: Traditional Chinese Medicine; VEGF: Vascular endothelial growth factor; w: week(s); WCM: western conventional medication; #: the same as the control group. WCM## refer to the combination of needed therapies of the following aspects: (1) general supportive care mainly includes (A) airway, ventilatory support and supplemental oxygen, (B) cardiac monitoring and treatment, (C) temperature, (D) blood pressure, (E) blood sugar, and (F) nutrition; (2) specialized care mainly include a variety of measures to improve cerebral blood circulation (such as antiplatelet agents, anticoagulants, fibrinogen-depleting agents, volume expansion, and vasodilators, except thrombolytic agents) and neuroprotective agents; (3) treatment of acute complications mainly includes (A) brain edema and elevated intracranial pressure, (B) seizures, (C) dysphagia, (D) pneumonia, (E)voiding dysfunction and urinary tract infections, and (F) deep vein thrombosis. *A group: bilateral scalp penetration needling; B group: ipsilateral (disease-side) scalp penetration needling.