Comparative efficacy and safety of acupuncture and Western medicine for poststroke thalamic pain

Poststroke thalamic pain (PSTP) is one of the most common sequelae following stroke. Analgesics, antidepressants, anticonvulsants, and surgical treatment are conventional treatment methods of PSTP, but these methods have limited efficacy, cost more, and cause a likelihood of adverse reactions. Clinical studies have shown that acupuncture has a significant analgesic effect on PSTP without obvious side effects. But, there is a lack of high-quality evidence concerning its effectiveness and safety to support its use. Therefore, this study aimed to evaluate the clinical efficacy and safety of acupuncture versus Western medicine for the treatment of PSTP to provide evidence to support clinical PSTP treatment. Searches were conducted to identify randomized controlled trials investigating the use of acupuncture for PSTP across six databases, including PubMed, the Cochrane Library, EMBASE, the China National Knowledge Infrastructure, Wan Fang Database, and the Chinese Scientific Journal Database VIP. RevMan 5.3 software was used for the meta-analysis. The results showed that compared with Western medicine, acupuncture had a higher total effective rate for the treatment of PSTP, reduced visual analog scale scores, increased beta-endorphin content, and decreased incidence of adverse reactions. However, the sample sizes of the included studies were insufficient, and the quality of the articles was relatively poor. In future studies, the clinical study design should be standardized and the sample size should be expanded to validate these results.卒中后丘脑疼痛(Poststroke thalamic pain, PSTP)是卒中后最常见的后遗症之一。止痛药、抗抑郁药、抗惊厥药和手术治疗是目前PSTP的常规治疗方法，但这些方法疗效有限、费用高且可能出现不良反应。临床研究表明，针刺治疗PSTP镇痛作用疗效显著，且无明显副作用，但缺乏关于其有效性和安全性的高质量证据支持其使用。本研究旨在系统评价针刺治疗PSTP的有效性和安全性，以期为临床PSTP治疗提供依据。通过检索6个数据库PubMed、Cochrane Library、EMBASE、中国期刊全文数据库(CNKI)、万方数据库(WanFang Data)及维普数据库(VIP)以获取针刺治疗PSTP的随机对照试验(Randomized controlled trials, RCTs)文献。采用RevMan5.3软件对结果进行Meta分析。研究结果表明与西药相比，针刺治疗PSTP总有效率较高，且可改善患者视觉模拟评分(VAS)、提高患者β-内啡肽(β-EP)含量、降低不良反应的发生率。然而，目前相关研究的样本量不足和数据质量不高，还需进一步规范临床研究设计和扩大样本量对结果进行验证。.