PT  - JOURNAL ARTICLE
AU  - Linda LD Zhong
AU  - Ya Zheng
AU  - Alexander Y Lau
AU  - Norman Wong
AU  - Liang Yao
AU  - Xingyao Wu
AU  - Tengteng Shao
AU  - Zhenxing Lu
AU  - Huijuan Li
AU  - Chun Sum Yuen
AU  - Jianwen Guo
AU  - Suzanne Lo
AU  - Janita Chau
AU  - Kam Wa Chan
AU  - Bacon Fung Leung Ng
AU  - Zhaoxiang Bian
AU  - Edwin Chau-leung Yu
TI  - Would integrated Western and traditional Chinese medicine have more benefits for stroke rehabilitation? A systematic review and meta-analysis
AID  - 10.1136/svn-2020-000781
DP  - 2021 Aug 26
TA  - Stroke and Vascular Neurology
PG  - svn-2020-000781
4099  - http://svn.bmj.com/content/early/2021/08/26/svn-2020-000781.short
4100  - http://svn.bmj.com/content/early/2021/08/26/svn-2020-000781.full
AB  - 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.