Evidence-Based Complementary and Alternative Medicine

Review Article

The Effectiveness of Acupuncture for Dysphagia after Stroke: A Systematic Review and Meta-Analysis

Table 1

Characteristics of included studies.


Reference	Participants	Intervention	Acupoints	Outcome measures	Main conclusion

Wang et al. [24]	G1 (50): 62.14 ± 12.14 G2 (50): 62.37 ± 5.34	G1: A + ST, G2: ST, F: 3 times/week, D: 4 weeks	GB20, GB12, BL10, RN23, ST5, ST40, EX-HN12, EX-HNl3	WST + IFRS	1 WST (G1 < G2) 2 IFRS (G1 > G2)
Jiang et al. [25]	G1 (65): 60 ± 10 G2 (65): 60 ± 9	G1: A + ST + NEST, G2: ST + NEST, F: 5 times/week, D: 4 weeks	Shesanzhen (extra)	HAMA + HAMD + SSA + sEMG	G1 < G2 in all outcomes
Wu et al. [26]	G1 (65): 44.00 ± 2.92 G2 (63): 44.35 ± 2.60	G1: A + ST, G2: ST, F: 5 times/week, D: 6 weeks	EX-HN1, GV20, EX-HN5, GB20, CV23	IFRS	IFRS (G1 > G2)
Wei et al. (2015) [27]	G1 (50): 61.50 ± 4.2 G2 (50): 62.50 ± 4.90	G1: A + ST, G2: ST, F: 7 times/week, D: 2 weeks	RN23, RN22, EX-HN12, EX-HNl3, LI4, PC6, ST36	VFSS + MBI + FIM	G1 > G2 in all outcomes
Xia et al. [28]	G1 (67): 67±9 G2 (63): 66 ± 10	G1: A + ST, G2: ST, F: 6 times/week, D: 6 weeks	PC6, DU26, SP6, HT1, LU5, BL40, GV20, GB20, CV23, Jialianquan (extra), EX-HN12, EX-HNl3	VFSS + SSA + BI + SWAL-QOL	1 SSA (G1 < G2) 2 G1 > G2 in other outcomes
Zeng et al. [29]	G1 (25): 58.01 ± 10.74 G2 (25): 57.98 ± 11.82	G1: A + ST, G2: ST, F: 7 times/week, D: 4 weeks	SJ17, GB12, Ex-HN14, SI17, RN22, ST9, Toupizhen (extra), RN23, EX-HN12, EX-HNl3, Tunyan (extra), Tiyan (extra), ST4, ST6, DU26, RN24	IFRS	IFRS (G1 > G2)
Chang et al. [30]	G1 (38): 46 ± 10 G2 (36): 44 ± 11	G1: A + BT + NEST, G2: BT + NEST, F: 6 times/week, D: 4 weeks	GV20, RN23, EX-HN12, EX-HNl3, Toupizhen (extra)	IFRS	IFRS (G1 > G2)
Chen et al. [31]	G1 (50): 67 ± 11 G2 (50): 67 ± 10	G1: A + ST, G2: ST, F: 6 times/week, D: 8 weeks	GB20, Ex-HN14, Gongxue (extra), Zhiqiang (extra), Tunyan (extra), Fayin (extra), RN23, EX-HN12, EX-HNl3	RSST + WST + SSA	1 WST (G1 < G2) 2 RSST (G1 > G2) 3 SSA (G1 < G2)
Feng et al. [32]	G1 (30): 60 ± 12 G2 (30): 58 ± 12	G1: A + ST, G2: ST, F: 7 times/week, D:3 weeks	RN23, SJ17, GB12, GB20, DU16, DU15, ST5, EX-HN12, EX-HNl3, Shezhen (extra)	VFSS + WST	1 WST (G1 < G2) 2 VFSS (G1 > G2)
Guo et al. [33]	G1 (50): 66.21 ± 8.03 G2 (50): 65.91 ± 7.85	G1: A + ST, G2: ST, F: 6 times/week, D: 4 weeks	DU15, DU16, BL10, Zhiqiang (extra), RN23	SSA + WST + BI	1 WST (G1 < G2) 2 BI (G1 > G2) 3 SSA (G1 < G2)
He et al. [34]	G1 (60): 62.16 ± 7.04 G2 (60): 61.83 ± 6.81	G1: A + ST, G2: ST, F: 5 times/week, D: 8 weeks	GB20, SJ17, RN23	SSA + WST + BI	1 WST (G1 < G2) 2 BI (G1 > G2) 3 SSA (G1 < G2)
Li et al. [35]	G1 (42): 57.4 ± 4.8 G2 (42): 57.4 ± 4.8	G1: A + BT + ST, G2: BT + ST, F: 6 times/week, D: 4 weeks	Shezhen (extra)	VFSS	VFSS (G1 > G2)
Li et al. [36]	G1 (50): 42.6 ± 2.3 G2 (50): 42.5 ± 2.2	G1: A + ST, G2: ST, F: 7 times/week, D: 3 weeks	GB20, Ex-HN14, Gongxue (extra), Zhiqiang (extra), Tunyan (extra) RN23, EX-HN12, EX-HNl3	IFRS + WST	1 WST (G1 < G2) 2 IFRS (G1 > G2)
Li and Gu [37]	G1 (40): 61.9 ± 7.9 G2 (40): 63.6 ± 6.9	G1: A + BT + ST, G2: BT + ST, F: 6 times/week, D: 4 weeks	GB20, DU16, HT5, LR3	PAS + SSA + WST	G1 < G2 in all outcomes
Liu et al. [38]	G1 (36): 57.6 ± 8.2 G2 (36): 58.5 ± 8.7	G1: A + BT, G2: BT, F: 6 times/week, D: 8 weeks	GB20, Ex-HN14, CV23, Ex-HN12, Ex-HN13, SP6, LR3, ST40, LI4	WST	WST (G1 < G2)
Qiao et al. [39]	G1 (43): 52.27 ± 10.45 G2 (43): 52.86 ± 10.72	G1: A + BT + ST, G2: BT + ST, F: 3 times/week, D: 2 weeks	GB20, DU16, EX-HN15, RN23, Jialianquan (extra), EX-HN12, EX-HNl3, LI4, LR3, HT5	IFRS + WST	1 WST (G1 < 2) 2 IFRS (G1 > G2)
Wang et al. [40]	G1 (35): 64 + 8 G2 (35): 65 ± 9	G1: A + ST, G2: ST, F: 5 times/week, D: 3 weeks	Shesanzhen (extra)	SSA + WST + SWAL-QOL	1 WST (G1 < G2) 2 SWAL-QOL (G1 > G2) 3 SSA (G1 < G2)
Wang [41]	G1 (30): 57.6 ± 9.1 G2 (30): 59.6 ± 8.9	G1: A + BT + NEST, G2: BT + NEST, F: 7 times/week, D: 2 weeks	RN23, Jialianquan (extra), HT5, DU20, Zuqianjin (extra), Zuwujin (extra)	WST	WST (G1 < G2)
Xu [42]	G1 (38): 62.74 ± 5.19 G2 (38): 63.19 ± 4.38	G1: A + BT, G2: BT, F: 5 times/week, D: 4 weeks	GB20, BL10, DU16, RN23, EX-HN12, EX-HNl3, PC6, HT5, SP6, ST36, RN12, BL23, SP3, KI3	WST	WST (G1 < G2)
Yang et al. [43]	G1 (30): 65.8 G2 (30): 67.3	G1: A + BT, G2: BT, F: 5 times/week, D: 2 weeks	GV20, SJ17, RN23, SP6, ST36	WST	WST (G1 < G2)
Yu et al. [44]	G1 (40): 63 ± 10 G2 (38): 64 ± 11	G1: A + ST, G2: ST, F: 7 times/week, D: 3 weeks	DU26, LI4, DU15, DU16, GB20, RN23	IFRS + WST	1 WST (G1 < G2) 2 IFRS (G1 > G2)
Zhu [45]	G1 (50): 65.05 ± 8.99 G2 (48): 64.03 ± 9.83	G1: A + BT + ST, G2: BT + ST, F: 6 times/week, D: 4 weeks	GB20, GB12, SJ17, Shanglianquan (extra), ST9	SSA + SWAL-QOL	1 SWAL-QOL (G1 > G2) 2 SSA (G1 < G2)
Zhou et al. [46]	G1 (34): 59.90 ± 3.87 G2 (34): 60.43 ± 4.07	G1: A + ST + NEST, G2: ST + NEST, F: 6 times/week, D: 4 weeks	Toupizhen (extra)	SSA + SWAL-QOL + CT7R	1 SSA (G1 < G2) 2 G1 > G2 in other outcomes
Zhou et al. [47]	G1 (30): 68.30 ± 13.84 G2 (30): 70.26 ± 11.97	G1: A + ST + NEST, G2: ST + NEST, F: 6 times/week, D: 2 weeks	Toupizhen (extra)	SSA + VFSS + WST + CT7R	1 CT7R (G1 > G2) 2 VFSS (G1 > G2) 3 SSA (G1 < G2) 4 WST (G1 < G2)
Zhi et al. [48]	G1 (39): 63.16 ± 6.92 G2 (39): 62.78 ± 6.78	G1: A + BT + ST, G2: BT + ST, F: 6 times/week, D: 12 weeks	RN23, Jialianquan (extra), EX-HN12, EX-HNl3, Shexiaxue (extra)	WST + GUSS + BI + FMA	1 WST (G1 < G2) 2 G1 > G2 in other outcomes
Zhang and Li [49]	G1 (46): 66.2 ± 7.4 G2 (46): 67.5 ± 6.7	G1: A + ST + NEST, G2: ST + NEST, F: 7 times/week, D: 4 weeks	RN23, Tunyan (extra), Toupizhen (extra)	VFSS + WST + IFRS	1 WST (G1 < G2) 2 VFSS (G1 > G2) 3 IFRS (G1 > G2)
Zhang et al. [50]	G1 (19): 64.10 ± 8.20 G2 (18): 65.58 ± 10.64	G1: A + rTMS + BT, G2: rTMS + BT, F: 6 times/week, D: 4 weeks	DU20, EX-HN1, ST8, DU16, GB20, RN23, Jialianquan (extra), ST4, ST6, ST7	MBSImP + OTT	G1 < G2 in all outcomes
Zhang et al. [51]	G1 (87): 64.61 ± 9.70 G2 (87): 63.86 ± 10.55	G1: A + ST, G2: ST, F: 3 times/week, D: 8 weeks	DU16, GB20, RN23, Jialianquan (extra), EX-HN15, EX-HN12, EX-HNl3, HT5, LR3, LI4	IFRS + WST	1 WST (G1 < G2) 2 IFRS (G1 > G2)
Zhang and Yin [52]	G1 (62): 70 ± 1 G2 (56): 68 ± 2	G1: A + ST, G2: ST, F: 5 times/week, D: 4 weeks	Shenguan (extra), KI3, LR3	SSA + WST + IFRS	1 WST (G1 < G2) 2 SSA (G1 < G2) 3 IFRS (G1 > G2)
Zhang et al. [53]	G1 (20): 58.3 ± 10.1 G2 (20): 58.2 ± 10.1	G1: A + ST + NEST, G2: ST + NEST, F: 5 times/week, D: 4 weeks	Tunyan (extra), RN23, DU16, SJ17, EX-HN12, EX-HNl3	VFSS + sEMG	1 VFSS (G1 > G2) 2 sEMG (G1 < G2)
Yin et al. [54]	G1 (18): 69.52 ± 6.01 G2 (20): 65.41 ± 7.01	G1: A + ST + NEST, G2: ST + NEST, F: 5 times/week, D: 3 weeks	ST9, RN22, RN23, EX-HN12, EX-HNl3	IFRS + WST	1 WST (G1 < G2) 2 IFRS (G1 > G2)
Gao et al. [55]	G1 (30): 64 ± 5 G2 (30): 65 ± 5	G1: A + BT + ST, G2: BT + ST, F: 5 times/week, D: 4 weeks	DU16, BL10, GB12, RN23, Jialianquan (extra), EX-HN12, EX-HNl3	VFSS + SSA + sEMG	1 VFSS (G1 > G2) 2 sEMG (G1 < G2) 3 SSA (G1 < G2)
Dong [56]	G1 (60): 55.3 ± 6.4 G2 (60): 55.3 ± 6.4	G1: A + ST, G2: ST, F: 5 times/week, D: 2 weeks	EX-HN12, EX-HNl3, DU16, DU15, RN23	VFSS + WST	1 WST (G1 < G2) 2 VFSS (G1 > G2)
Deng et al. [57]	G1 (53): 59.2 ± 11.6 G2 (52): 59.8 ± 13.2	G1: A + ST + NEST, G2: ST + NEST, F: 5 times/week, D: 3 weeks	PC6, DU26, SP6, GB20, SJ17, GB12, Yanhoubi (extra), RN23	WST + SSA	1 WST (G1 < G2) 2 SSA (G1 < G2)
Zhu et al. [58]	G1 (35): 54.97 ± 5.10 G2 (35): 56.26 ± 6.17	G1: A + BT + ST, G2: BT + ST, F: 6 times/week, D: 2 weeks	Yushizhen (extra), LI15, LI11, LI10, SJ5, SJ3, LI4, ST32, GB34, ST36, ST40, GB40, LR3, SP6	IFRS + WST	1 WST (G1 < G2) 2 IFRS (G1 > G2)

G1 > G2/G1 < G2 indicates that the difference between the two groups was statistically significant, ; G1 = G2 indicates that no significant differences were noted between the two groups, . G: group; G1: experimental group; G2: control group; A: acupuncture; ST: swallowing treatment; BT: basic treatment; NEST: neuromuscular electrical stimulation; rTMS: repetitive transcranial magnetic stimulation; F: frequency; D: duration; WST: Watian swallowing test; SSA: standard swallowing assessment; VFSS: videofluoroscopic swallowing study; IFRS: Ichiro Fujishima rating scale; SWAL-QOL: swallow quality-of-life questionnaire; BI: Barthel index; FMA: Fugl–Meyer assessment; CT7R: Caiteng 7 rank; sEMG: surface electromyography; HAMA: Hamilton anxiety scale; HAMD: Hamilton depression scale; RSST: repetitive saliva swallowing test; MBSImP: modified barium swallow impairment profile; OTT: oral transit time.