Recurrent ischemic stroke represents a major unmet clinical challenge, contributing significantly to the global burden of neurological disability and morta

Objective: To systematically evaluate the efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis (OP) through a comprehensive synthesis of recent randomized controlled trial (RCT) evidence.Methods: A systematic literature search was conducted across PubMed, Web of Science, CNKI, and Wanfang databases (2014 – 2024) to identify RCTs investigating acupuncture combined with conventional therapy for OP. Study quality was appraised using the Cochrane Risk of Bias tool, and meta-analyses were performed using RevMan 5.4 and Stata 15.0, with subgroup analyses stratified by intervention type, population characteristics, and treatment duration.Results: 28 RCTs (n=2,758) were included. Meta-analysis revealed acupuncture significantly enhanced bone mineral density (BMD) versus controls: total (SMD = 0.47, p = 0.03), femoral neck (MD = 0.05, p = 0.01), lumbar spine (SMD = 0.40, p < 0.001), Ward’s triangle (MD = 0.07, p = 0.02), and hip (SMD = 0.55, p < 0.001), with particularly marked improvements in the postmenopausal osteoporosis subgroup. Acupuncture demonstrated significant improvements in treatment efficacy, biochemical markers, pain scores, and symptom assessments, while reducing adverse events. Warm needle moxibustion outperformed controls in femoral neck (MD = 0.07, p = 0.002) and hip BMD (SMD = 0.87, p < 0.001), while electroacupuncture significantly elevated serum calcium (MD = 0.18, p = 0.02). Short-term interventions (≤ 3 months) demonstrated optimal efficacy.Conclusion: Acupuncture demonstrates efficacy and safety as an OP adjuvant therapy. Current evidence is limited by regional bias and methodological heterogeneity. Multicenter, large-sample RCTs are needed to standardize protocols and validate long-term therapeutic efficacy.Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024499354.

Objective: This study aimed to comprehensively evaluate the clinical effectiveness and safety of acupuncture combined with repetitive transcranial magnetic stimulation (rTMS) in treating post-stroke cognitive impairment (PSCI) through meta-analysis and trial sequential analysis (TSA), moreover to provide an evidence-based basis for the treatment of PSCI in clinical practice. Methods: The study conducted a comprehensive search of eight major domestic and international databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP and China Biology Medicine (CBM). Four English and four Chinese databases of randomized controlled trials of acupuncture combined with rTMS for the treatment of PSCI from inception until July 2025. Systematic reviews and meta-analyses were conducted based on the Cochrane systematic review method by using RevMan5.4 and Stata/MP 18.0, and trial sequential analyses were performed by TSA 0.9. Results: Sixteen RCTs involving 1,058 patients were included, including 532 patients in the experimental group and 526 patients in the control group. Meta-analysis results showed that the experimental group had a higher clinical effectiveness rate in treating patients with PSCI compared to the control group [RR = 1.29, 95% CI (1.08, 1.55), p = 0.005]. The experimental group significantly improved scores on several scales: Montreal Cognitive Assessment (MoCA) [MD = 2.95, 95% CI (2.37, 3.53), p < 0.00001], Mini-Mental State Examination (MMSE) [MD = 2.89, 95% CI (2.13, 3.64), p < 0.00001], LOTCA [MD = 13.61, 95% CI (6.57, 20.65), p = 0.0002], Modified Barthel Index (MBI) [MD = 10.86, 95% CI (7.79, 13.94), p < 0.00001], Activity of Daily Life (ADL) [MD = 15.33, 95% CI (10.06, 20.61), p < 0.00001]. Also it was found to reduced the latency of P300 in the experimental group [MD = −18.18, 95% CI (−25.76, −10.61), p < 0.00001] and prolonged the amplitude of P300 [MD = 1.55, 95%CI (0.71, 2.39), p = 0.0003]. In addition, it could increase the Brain-derived Neurotrophic Factor (BDNF) level in the blood of the patients [MD = 0.93, 95%CI (0.52, 1.35), p < 0.0001], and decrease the Neuron-Specific Enolase (NSE) levels [SMD = −1.26, 95% CI (−1.59, −0.93), p < 0.00001]. There are two studies reported the adverse events. The TSA showed that the cumulative Z value of the meta-analysis of the clinical effectiveness rate, MoCA, and MMSE scales crossed the traditional and TSA boundaries, proving reliable conclusions. Conclusion: Acupuncture combined with rTMS can improve cognitive function, regulate daily living ability, and regulate neurotransmitter levels in patients with PSCI, which is worthy recommended in the clinic. However, due to limitations in sample size, inclusion quality and incomplete reporting, it is worth noting that more rigorously designed and high-quality studies are needed to further validate these conclusions.

Objective: To evaluate the comparative effectiveness of different acupuncture therapies in stroke rehabilitation using network meta-analysis. Methods: We systematically searched major databases for RCTs (2016–2025) comparing six acupuncture interventions. Frequentist network meta-analysis was conducted in Stata 17.0, with interventions ranked by SUCRA values. Primary outcomes included NIHSS, BI, mRS, MoCA, and MMSE scores. Results: Analysis of 120 RCTs ( n = 15,848) demonstrated distinct efficacy profiles: EA ranked highest for neurological recovery (NIHSS SUCRA 95.7%) and BI improvement (74.8%); WNM was optimal for disability reduction (mRS SUCRA 100%) and comprehensive cognition (MoCA 94.9%); while SA excelled in MMSE improvement (86.1%). Conclusion: Distinct acupuncture modalities exhibit unique advantages in the context of stroke rehabilitation. EA ranked first in the restoration of neurological function, whereas WNM and SA were identified as the optimal interventions for global disability and cognitive impairment, respectively. Given that the included studies originated exclusively from China, the external validity of the present findings in other populations warrants further verification. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO , CRD42025112036.