The Affection of Temporal Factors on Acupuncture for Insomnia after Stroke: A Systematic Review and Meta-Analysis

Abstract

Objective

The aim of this systematic review and meta-analysis was to analyze the affection of temporal factors on acupuncture for insomnia after stroke.

Methods

Eight databases were searched from inception through September 2019 without language restrictions. Randomized controlled trials (RCTS) were included if pure acupuncture was compared to Western medicine for the treatment of insomnia after stroke.

Results

Thirty-two studies involving a total of 2347 participants were included. Comparing to Western medicine, the subgroup analysis showed there was no statistical significance among 9-12 am, 3-6 pm, and 2 hours before sleep to start the acupuncture for post-stroke insomnia on improving the effective rate (P=0.66) or the sleep quality (P=0.95). The cumulative meta-analysis showed that with the amount of treatment increased, the confidence interval was narrowed and the accuracy of the effect value was improved gradually.

Conclusions

The results of this study showed that acupuncture therapy was performed 2 hours before sleep, the insomnia could be improved by calming the mind and inducing the Yang into the Yin based on the theory of midnight-midday ebb flow. The most commonly used needle retention time of 30 minutes was effective in clinical, and with the amount of stimulation increases, the therapeutic effect of acupuncture could be sustained and stable. Since the overall risk of bias was evaluated as unclear, application of these conclusions needs to be cautious.

Keywords

acupuncture temporal factors stroke insomnia systematic review meta-analysis

Get full access to this article

View all access options for this article.

References

Chen

J. L

Liu

Chen

. The effects of sleep disorder in cerebral infarction and the mechanism. Jilin Medical Journal, 2016,37 (01)55-57.

Liang

X.W

. Meta analysis of insomnia after stroke and the research of acupoint selection rules for acupuncture. Heilongjiang University of Traditional Chinese Medicine,2015.

Hou

Z.T.

Sun

Z.R.

, Sun

S.T

. Impacts of the repetitive trans cranial acupuncture stimulation on the content of serum orexin A in patients with post-stroke insomnia. Chinese Acupuncture & Moxibustion.2018,38 (10)1039-1042+1052.

Zhang

S. M.

, Qiu

C.Y.

Zhu

W.F.

, LI

Y. B

. Meta-analysis of acupuncture treatment of post-stroke insomnia. Chinese Archives of Traditional Chinese Medicine.2019,37 (12)2843-2852.

Lee

S.H.

, Lim

S. M

. Acupuncture for insomnia after stroke: a systematic review and meta-analysis. BMC Complementary and Alternative Medicine. (2016), 16 228. https://doi.org/10.1186/s12906-016-1220-z.

Lin

L. L

Wang

L. Q

Yang

J. W

. Researches status on time-effect of acupuncture. Chinese Acupuncture & Moxibustion. 2019,39 (05)565-569.

G. Z.

Yue

Z. H.

Yang

, Xie

The influence of time factor on the compatibility of acupoints. Hunan Journal of Traditional Chinese Medicine.

2014,30 (04)101-102.

S.G.

Experiment of acupuncture and moxibustion, People's Medical Publishing House,

2012: 121–125.

Higgins

J. P. T.

Green

Cochrane

andbook for Systematic Review of Interventions Version 5.1.O, The Cochrane Collaboration. 2011, http://training.cochrane.org/handbook/.

10.

Feng

J.F

. Clinical observation and experimental study of using reinforcing or reducing acupuncture treatment to insomnia after ischemic stroke occurred. Guangzhou University of Chinese Medicine,2016.

11.

Jin

F.W

. Clinical Observation on Acupuncture and Moxibustion for Treating 30 Cases of Insomnia of Heart Disturbance by Phlegm-heat after Stroke. World Latest Medicine Information.2016,16 (38);71–72.

12.

Jiang

The clinical study of Jin's Three-Needle therapy in treating insomnia after stroke Guangzhou University of Chinese Medicine,

2014.

13.

Song

Y. R

. “Fiv. heart” acupoints for the treatment of TCM symptoms of insomnia after stroke. Tianjin University of Traditional Chinese Medicine, 2018.

14.

F.W.

Y. L.

Chen

J.W.

Xie

Z. M.

, Wu

Y.Y

. Effect of Pittsburgh Sleep Quality Index with regulating Du acupuncture. Gansu Journal of Traditional Chinese Medicine.2011, 24 (01)36-38.

15.

Gou

Y. H.

, Yang

Z.X

. Clinical observation of Tiao Ren Tong Du needling for post-stroke insomnia. Shanghai Journal of Acupuncture and Moxibustion.2015,34 (06);505–507.

16.

X. M

Yang

Z. X

H. B

. Clinical efficacy on insomnia after stroke treated by techniques of needling in Ren and Du meridians for adjustment and smoothing. China Medical Herald. 2016, 13 (11)150-154.

17.

J.X

. Clinical observation on the effect of acupuncture therapy on blood pressure and sleep Quality in Patients with Stroke. Chinese Journal of Ethnomedicine and Ethnopharmacy.2017, 26 (02)114-116.

18.

Tan

Y. J

. The clinical study on Tong DU Tiao SHEN acupuncture for the treatment of insomnia after stroke. Anhui University of Chinese Medicine,2016.

19.

J.P.

N.Y.

, Zhao

X.H

. Observation on the Therapeutic Effect of “Xing Nao Tiao Zang” therapy on 40 Cases of insomnia after stroke. Liaoning Journal of Traditional Chinese Medicine.2009, 36 (10)1723-1724.

20.

Y.L.

Chen

J.W.

, Ye

F.W

. Clinical Study on the Treatment of Post-stroke Insomnia by Acupuncture at Baihui Point. Chinese Manipulation & Rehabilitation Medicine.2012, 03 (11)25-16.

21.

Yang

Clinical effect of acupuncture on sleep disorders after stroke and its influence on nerve function. Diet science.

2019, (6):64–65.

22.

Y.Y.

Z.Z.

, Ye

F.W

. Clinical Observation on the treatment of 25 cases of post-stroke insomnia by acupuncture. Jiangsu Journal of Traditional Chinese Medicine. 2008 (07)59-61.

23.

Znang

Study on clinical efficacy evaluation of “Xingnao Tiaofu” acupuncturein treating insomnia after stroke. Ningxia Medical University,2019.

24.

Chen

X. J.

Fang

Chen

L. F.

Yang

D. H

. & Li, X. Efficacy evaluation of treating post-stroke insomnia majorly by acupuncture at four insomnia acupoints. Shanghai Journal of Acupuncture and Moxibustion. 2012,31 (12)864-866.

25.

Tang

, Zhang

S.X

. Clinical observation of acupuncture at “Sanshen Points” mainly treating insomnia after stroke. Chinese Journal of Integrative Medicine on Cardio-/Cerebrovascular Disease.2015,13 (16)1885-1887.

26.

F.W.

Y. L.

Chen

J. W

Xie

Z. M.

, Wu

Y.Y

. Clinical observation on 30 cases of post-stroke insomnia treated by acupuncture at Baihui point. Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine.2010,10 (05)21-22.

27.

Jia

R.Z

. Clinical study on acupuncture to improve insomnia of patients after stroke Guangming Journal of Chinese Medicine.2010,25 (11)2070-2071.

28.

F.Q

. Effect of acupuncture at Wuji Points on sleep quality of patients after cerebral infarction. World Journal of Sleep Medicine.2018,5 (10)1124-1126.

29.

Zhang

W. M

. The influence of acupuncture on insomnia after stroke. China Health Care & Nutrition.2012,11 (14)239-240.

30.

Zheng

J.G.

, Yang

H.L

. Clinical observation on acupuncture treatment of sleep disturbance after acute stroke. Chinese Society of Acupuncture and Moxibustion.2014:212–218.

31.

C.H.

C.D.

Z. J.

, He

Y.H

. Clinical observation on acupuncture treatment of post-stroke insomnia. Chinese Journal of New Clinical Medicine.2013,6 (07)665-667.

32.

T.B

. Effect of acupuncture on post stroke insomnia. Chinese Journal of Rehabilitation Theory and Practice. 2007 (07)656-657.

33.

Liu

J.H.

Huang

J.H.

, Liu

X.H

. Observation on the therapeutic effect of acupuncture on 32 cases of post-stroke insomnia. International Medicine & Health Guidance News. 2006 (16): 107–108.

34.

Wang

G.M.

, Zhao

H.S

. Clinical observation on acupuncture treatment of 32 cases of insomnia after stroke. Shanxi Journal of Traditional Chinese Medicine.2012,28 (05)33.

35.

Zhu

Clinical observation on acupuncture treating insomnia after stroke. Guangxi Journal of Traditional Chinese Medicine.

2014,12 (37)35-36.

36.

Ruan

B. K

. Treating sleep disorders after stroke by acupuncture and drug therapy. Clinical Journal of Chinese Medicine.2015,7 (19)31-32.

37.

Huang

, Gao

S.H

. Observation on the effect of acupuncture treatment on patients with sleep disorders after stroke. Journal of Clinical Acupuncture and Moxibustion.2012,28 (10)15-16.

38.

Zhao

, Wang

Acupuncture treatment of insomnia after stroke. World Latest Medicine Information.

2014,14 (30)293.

39.

Xie

X. J

. Clinical effect of acupuncture on sleep disorders after stroke and its influence on nerve function. Modern Journal of Integrated Traditional Chinese and Western Medicine.2018, 27 (29)3271-3273.

40.

Wang

Observation on the clinical effect of acupuncture in the treatment of sleep disturbance after stroke. Nei Mongol Journal of Traditional Chinese Medicine.

2017, 36(Z1):197.

41.

Liu

J.X

. Study on the effect of acupuncture on the state of wakefulness and the related electrophysiological effects in patients with insomnia after stroke. Acta Chinese Medicine.2017, 32 (12)2544-2548.

42.

Bai

Jin

C.Y.

, Dong

G.R

. Clinical observation on 56 cases of insomnia treated by acupuncture at Shenmen point. Journal of Clinical Acupuncture and Moxibustion. 2004 (04) 44–45.

43.

Wang

Chen

T.Q.

Wang

Zhao

Y. H.

, Yang

Z.N

. The effect of acupuncture on brainstem serotonin in insomnia rats. Jiangsu Journal of Traditional Chinese Medicine.2011,43 (01)88-89.

44.

Bai

Zhang

Dong

H.S.

Dong

G.R

. The Mechanism of Regulation of Taiyang and Yintang Electro-acupuncture on the sleep of Rats Caused by Sodium Pentobarbital. Journal of Clinical Acupuncture and Moxibustion. 2006 (02)36-37+56.