The Health Thread | Nepal Health News & IPAC

[Analysis on principles of acupoint selection and characteristics of stimulation parameters based on randomized controlled trials of electroacupuncture for dysfunction after ischemic stroke].

Researchers

Gengzhao Chen, Yulong Zou, Linlin Wang, Zhichen Wang, Senlin Chen, Qiuyi Luo, Qianhong Zhu, Saie Huang

Abstract

To analyze the characteristics of acupoint selection and stimulation parameters in randomized controlled trials (RCTs) of electroacupuncture for motor dysfunction after ischemic stroke. The search was conducted in Chinese and English Databases, including China National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biomedical Literature Database, PubMed, Cochrane Library, Web of Science, and Embase, from the inceptions of these databases to December 31, 2025. RCTs of electroacupuncture for motor dysfunction after ischemic stroke in patients were included. Data on participant characteristics, the location or type of motor dysfunction, acupoint selection, and electroacupuncture stimulation parameters were extracted. Descriptive statistics and frequency analysis were used to summarize the distribution and characteristics of acupoints and stimulation parameters. Methodological quality assessment was performed to evaluate the included studies, and association rule analysis, hierarchical clustering, and network visualization were applied to identify structural patterns of high-frequency acupoint combinations. A total of 208 RCTs were included, involving 192 acupoints with a total use frequency of 1948. The main high-frequency acupoints were Quchi (LI11), Zusanli (ST36), Hegu (LI4), Waiguan (TE5), Jianyu (LI15), Yanglingquan (GB34), Shousanli (LI10) and Sanyinjiao (SP6). Acupoint selection varied to some extent in accordance with the location or type of motor dysfunction. For motor dysfunction in the upper limbs, Quchi (LI11), Hegu (LI4), Waiguan (TE5), Shousanli (LI10) and Jianyu (LI15) were commonly used, whereas for that in the lower limbs and feet, Zusanli (ST36), Yanglingquan (GB34), Sanyinjiao (SP6), Taichong (LR3) and Jiexi (ST41) were frequently selected. Association rule and cluster analysis suggested that the core acupoint group was primarily composed of Quchi (LI11), Hegu (LI4), Waiguan (TE5), LI10, and LI15 for the motor impairment of upper limbs；that for the motor impairment of lower limbs included ST36, GB34, SP6, ST41 and Xuanzhong (GB39). Regarding stimulation parameters of electroacupuncture, the low frequency and its variants were predominated, while dense-disperse and continuous waves were the common waveform types；current intensity and pulse width were mostly depended on "patient's tolerance" or "mild local muscle twitching". The duration of each treatment session was 30 minutes, treatment schedules were reported as once daily, 5 or 6 times per week, and the treatment course was ranged from 2 to 4 weeks. Among the included RCTs of electroacupuncture for motor dysfunction after ischemic stroke, acupoint selection is characterized as a certain of centrality, stability and diversity. The stimulation parameters of electroacupuncture exhibit significant heterogeneity and are not reported in accordance with the relevant guidelines. In the future, based on the clarification of different functional subtypes, it needs to enhance the quantification and standardized reporting of the intervention parameters of electroacupuncture, so as to improve inter-study comparability and protocol reproducibility. 目的: 分析电针治疗缺血性脑卒中后运动功能障碍随机对照试验（RCT）的腧穴选择及刺激参数特征。方法: 检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Cochrane Library、Web of Science及Embase等中英文数据库，检索时限为建库至2025年12月31日。纳入以缺血性脑卒中后运动功能障碍患者为研究对象的电针RCT，提取研究对象特征、运动功能障碍部位或类型、腧穴选择及电针刺激参数等信息。采用描述性统计与频数分析总结腧穴及刺激参数分布特征，并对纳入研究进行方法学质量评价，结合关联规则分析、系统聚类及网络可视化分析高频腧穴组合结构。结果: 共纳入RCT文献208篇，涉及腧穴192个，总使用频次1 948次。高频腧穴主要包括曲池、足三里、合谷、外关、肩髃、阳陵泉、手三里及三阴交等。不同运动功能障碍部位或类型的选穴存在一定差异，上肢相关障碍多选用曲池、合谷、外关、手三里、肩髃等，下肢及足部相关障碍则以足三里、阳陵泉、三阴交、太冲及解溪等较为常用。关联规则与聚类分析提示，曲池、合谷、外关、手三里、肩髃等更偏向于构成上肢相关的核心穴群;足三里、阳陵泉、三阴交及解溪、悬钟等为与下肢运动恢复相关的核心穴群。刺激参数方面，电针刺激频率总体以低频及其变式为主，波形以疏密波和连续波较为常见;电流强度及脉宽多以“患者可耐受”或“局部肌肉轻度抽动”等方式描述，单次治疗时间多为30 min，治疗频次以每日1次、每周5~6次最为常见，治疗疗程多为2~4周。结论: 在纳入的RCT中，电针治疗缺血性脑卒中后运动功能障碍的腧穴选择具有一定集中性、组合稳定性及分型差异性;但刺激参数报告仍存在明显异质性和不规范性。未来应在明确不同功能亚型的基础上，加强电针干预参数的量化与规范报告，以增强研究间可比性及方案可重复性。.