title: Systematic review of long-term Xingnao Kaiqiao needling effcacy in ischemic stroke treatment.
abstract: OBJECTIVE
  To systematically evaluate the long-term effect and safety of Xingnao Kaiqiao needling method in ischemic stroke treatment.
  
  
  METHODS
  We retrieved relevant random and semi-random controlled trials that used the Xingnao Kaiqiao needling method to treat ischemic stroke compared with various control treatments such as conventional drugs or other acupuncture therapies. Searched databases included China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and PubMed, from May 2006 to July 2014.
  
  
  METHODS
  Two authors independently conducted literature screening, quality evaluation, and data extraction. The quality of articles was evaluated according to the Cochrane Reviewers' Handbook 5.1, and the study was carried out using Cochrane system assessment methods. RevMan 5.2 was used for meta-analysis of the included studies.
  
  
  METHODS
  Mortality rate, recurrence rate, and disability rate were observed.
  
  
  RESULTS
  Nine randomized and semi-randomized controlled trials treating 931 cases of ischemic stroke were included in this review. Meta-analysis results showed that there were no significant differences in mortality reduction (risk ratio (RR) = 0.58, 95% confidence interval (CI): 0.17-1.93, Z = 0.89, P = 0.37) or recurrence rate (RR = 0.55, 95%CI: 0.18-1.70, Z = 1.04, P = 0.30) of ischemic stroke patients between the Xingnao Kaiqiao needling and control treatment groups. However, the Xingnao Kaiqiao needling method had a tendency towards higher efficacy in mortality reduction and recurrence rates. The Xingnao Kaiqiao needling method was significantly better than that of the control treatment in reducing disability rate (RR = 0.51, 95%CI: 0.27-0.98, Z = 2.03, P < 0.05).
  
  
  CONCLUSIONS
  The Xingnao Kaiqiao needling method has a better effect than control treatment in reducing disability rate. The long-term effect of Xingnao Kaiqiao needling against ischemic stroke is better than that of control treatment. However, the limitations of this study limit the strength of the conclusions. Randomized controlled trials with a strict, reasonable design, and multi-center, large-scale samples and follow-up are necessary to draw conclusions about Xingnao Kaiqiao needling.
authors.affiliation: Department of Traditional Chinese Medicine, Chengde Medical University, Chengde, Hebei Province, China.
authors.forename: Zhi-Xin
authors.initials: ZX
authors.lastname: Yang
authors.affiliation: Key Laboratory of Traditional Chinese Medicine Research and Development, Institute of Traditional Chinese Medicine, Chengde Medical University, Chengde, Hebei Province, China.
authors.forename: Jia-Hong
authors.initials: JH
authors.lastname: Xie
authors.affiliation: Key Laboratory of Traditional Chinese Medicine Research and Development, Institute of Traditional Chinese Medicine, Chengde Medical University, Chengde, Hebei Province, China.
authors.forename: Yong-Ping
authors.initials: YP
authors.lastname: Liu
authors.affiliation: Department of Traditional Chinese Medicine, Chengde Medical University, Chengde, Hebei Province, China.
authors.forename: Guang-Xin
authors.initials: GX
authors.lastname: Miao
authors.affiliation: Key Laboratory of Traditional Chinese Medicine Research and Development, Institute of Traditional Chinese Medicine, Chengde Medical University, Chengde, Hebei Province, China.
authors.forename: Ying-Han
authors.initials: YH
authors.lastname: Wang
authors.affiliation: Chicheng Hospital of Traditional Chinese Medicine, Chicheng, Hebei Province, China.
authors.forename: Sheng-Mei
authors.initials: SM
authors.lastname: Wu
authors.affiliation: Chicheng Hospital of Traditional Chinese Medicine, Chicheng, Hebei Province, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
keywords: Xingnao Kaiqiao needling method; adverse reactions; disability; health economics indicators; ischemic stroke; long-term efficacy; meta-analysis; mortality; nerve regeneration; neural regeneration; randomized controlled trial; recurrence; systemic reviews