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Open Access Systematic Review Issue

Systematic reviews and meta-analysis of acupuncture for post-stroke dysphagia: an updated overview of the evidence

Lan Yuan, Zi-yu Tian, Xiao-yi Hu, Bing Liu, Nicola Robinson

Evidence-Based Chinese Medicine and Technology Assessment 2025, 1(2): 9570013

Published: 29 September 2025

Abstract

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Introduction

Dysphagia is a common post-stroke complication. Acupuncture is a widely used effective treatment for post-stroke dysphagia in China. Based on our previously published overview in 2019, this study aimed to provide an update on the current evidence regarding acupuncture for post-stroke dysphagia. Specifically, this study aimed to assess the quality of systematic reviews (SRs) and meta-analyses (MAs) published in the last 5 years using the new Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) tool to provide updated evidence for clinical decision-making.

Methods

The following databases were searched: China National Knowledge Infrastructure, Wanfang database, Chinese Scientific Journal Database, SinoMed, PubMed, Embase and Cochrane Library from January 1, 2019 to June 30, 2025. Two researchers independently performed data extraction. A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) and PRISMA 2020 were used to evaluate the methodological and reporting quality of the included SRs/MA, respectively.

Results

Eight SRs/MA met the inclusion criteria. Additionally, one article applied the Grading of Recommendations Assessment, Development Evaluation system. Most of the evidence was of very low quality, with the primary factors for downgrading being inconsistency and publication bias. Evaluation using AMSTAR 2 indicated that there were no high-quality SRs/MA and that all studies were of critically low quality. Quality issues included failure to provide a list of excluded studies and justify their exclusion. Moreover, not all studies were randomized controlled trials (RCTs) with a low risk of bias (RoB). Additionally, if the studies were RCTs with moderate or high risk of bias, the review did not provide a discussion of the likely impact of the RoB on the results.

Conclusion

Acupuncture combined with rehabilitation may improve post-stroke dysphagia symptoms. However, the methodological quality of SRs/MA remains very low and has not improved over the last 5 years. Studies should be designed in line with the AMSTAR 2 and PRISMA 2020 to provide reliable, high-quality evidence for supporting clinical practice.

Issue

"To be meridian or collateral" in meridian-collateral differentiation

Huiling ZENG, Bing LIU

Chinese Acupuncture&Moxibustion 2024, 44(5): 574-578

Published: 29 February 2024

Abstract

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Identifying the study subject, "to be in meridian or collateral", is the first step of meridian-collateral differentiation. Combined with the ancient literature and clinical practice of acupuncture and moxibustion, the methods of identifying "to be in meridian or collateral" and its values are elaborated. Through analyzing the onset location of symptoms and the body layers of lesions, as well as the palpation and observation in meridian-collateral detection, "to be meridian" or "to be collateral" is identified in disease diagnosis. It may guide the choice of techniques of acupuncture and moxibustion. Identifying "to be meridian or collateral" is crucial in meridian-collateral differentiation, which not only contributes to improving the therapeutic effect of acupuncture and moxibustion, but also to better recognizing diseases and understanding the relevant concepts of techniques of acupuncture and moxibustion in view of acupuncture and moxibustion, and perfecting the system of meridian-collateral differentiation.

Open Access Issue

New interpretation of “Miu Ci”

Yi-fei LIU, Bing LIU

Acupuncture Research 2024, 49(1): 94-98

Published: 24 October 2023

Abstract

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Based on the record of Miu Ci theory from Huangdi Neijing (The Yellow Emperor’s Internal Classic), and incorporating the relevant discussions of medical scholars from various dynasties, this article interprets and analyzes the Miu Ci technique, the points to be needled, and the diseases can be treated. The following innovative understandings are proposed: 1) The original meaning of “Miu” in Miu Ci is “to prick in a different way from the meridians (needle the major collaterals)”, not “needle left and right interchangeably”. Needle left and right interchangeably is not a necessary operation in Miu Ci. 2) The stimulation sites of Miu Ci are the “four extremities” of the human body, referred to as the “major collaterals of qi”, and the nail bed of the four extremities is not equivalent to the commonly recognized “Jing-well points”. 3) Miu Ci can treat critical illnesses, not just limited to musculoskeletal pain or mild conditions at the early stage of a disease. 4) Miu Ci is not equivalent to Luo Ci needling (pricking bloodletting therapy).