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Meta-Analysis
. 2022 Feb;7(1):77-85.
doi: 10.1136/svn-2020-000781. Epub 2021 Aug 26.

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

Linda Ld Zhong  1 , Ya Zheng  2 , Alexander Y Lau  3 , Norman Wong  2 , Liang Yao  4 , Xingyao Wu  2 , Tengteng Shao  5 , Zhenxing Lu  6 , Huijuan Li  7 , Chun Sum Yuen  8 , Jianwen Guo  9 , Suzanne Lo  10 , Janita Chau  10 , Kam Wa Chan  11 , Bacon Fung Leung Ng  12 , Zhaoxiang Bian  2 , Edwin Chau-Leung Yu  13
Affiliations
Meta-Analysis

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

Linda Ld Zhong et al. Stroke Vasc Neurol. 2022 Feb.

Abstract

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.

Prospero registration number: CRD42020152050.

Keywords: stroke rehabilitation.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow diagram of study selection. RCT, randomised controlled trial.
Figure 2
Figure 2
The improvement of integrated medicine compared with western medicine only in dependency.
Figure 3
Figure 3
The improvement of integrated medicine compared with western medicine only in motor function.
Figure 4
Figure 4
The improvement of integrated medicine compared with western medicine only in depression.
Figure 5
Figure 5
The improvement of integrated medicine compared with western medicine only in swallowing function.
See this image and copyright information in PMC

References

    1. Fang J, Chen L, Chen L, et al. . Integrative medicine for subacute stroke rehabilitation: a study protocol for a multicentre, randomised, controlled trial. BMJ Open 2014;4:e007080. 10.1136/bmjopen-2014-007080 - DOI - PMC - PubMed
    1. Wang J, Xiong X. Current situation and perspectives of clinical study in integrative medicine in China. Evid Based Complement Alternat Med 2012;2012:1–11. 10.1155/2012/268542 - DOI - PMC - PubMed
    1. Tang J-L, Liu B-Y, Ma K-W. Traditional Chinese medicine. Lancet 2008;372:1938–40. 10.1016/S0140-6736(08)61354-9 - DOI - PubMed
    1. Junhua Z, Menniti-Ippolito F, Xiumei G, et al. . Complex traditional Chinese medicine for poststroke motor dysfunction: a systematic review. Stroke 2009;40:2797–804. 10.1161/STROKEAHA.109.555227 - DOI - PubMed
    1. Gaire BP. Herbal medicine in ischemic stroke: challenges and prospective. Chin J Integr Med 2018;24:243–6. 10.1007/s11655-018-2828-2 - DOI - PubMed

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