OBJECTIVE:The rapid economic development and demographic changes in Chinese society in the past 30 years may affect the prevalence of migraine. However, there are limited studies on the long-term trends and influencing factors of migraine burden in China. Using data from global burden of disease database (GBD2021), this study explores the changes in the migraine burden in China over a 30-year period and analyzes the main drivers. METHODS:Joinpoint regression analysis was used to evaluate the temporal trend of migraine prevalence, incidence, and years lived with disability (YLDs), and the age-period-cohort (APC) model was used to evaluate the effects of age, time and birth cohort. Decomposition analysis were used to calculate the contribution of population growth, ageing, and epidemiological changes to the burden of disease. RESULTS:In the past 30 years, the age-standardized prevalence rate (ASPR) and YLDs rate of migraine in China have increased significantly, and the disease burden of women is higher than that of men, especially in people aged 30-54 years. The main driver of the rising burden of disease is population growth. APC analysis showed that the younger generation had a higher burden of disease, which may be related to modern lifestyles and stressors. CONCLUSION:The burden of migraine continues to increase in China, which is mainly affected by population growth and epidemiological changes. In the future, attention should be paid to high-risk groups, and lifestyle interventions and disease management should be strengthened to reduce the socio-economic burden.

Background/objectivesAcupuncture is recommended for the treatment of cancer-related fatigue (CRF), but the strength of evidence remains limited. This study aims to comprehensively update the evaluation of the effectiveness of acupuncture for CRF and clarify the latest strength of evidence.MethodsEight databases were searched from inception to April 2025 to identify eligible randomized controlled trials (RCTs). The quality of the study was assessed using the Cochrane risk of bias tool version 2.0(ROB 2.0). Meta-analyses were performed using R studio 4.4 software and RevMan software (version 5.4). Subgroup analyses by acupuncture type were conducted to explore sources of heterogeneity and further elucidate the efficacy of different acupuncture modalities. Publication bias was assessed when applicable. Finally, evidence quality was rated using the GRADE system.ResultsThis meta-analysis included 28 RCTs. Risk of bias assessment indicated low overall study quality. The meta-analysis of the primary outcome(Piper Fatigue Scale, PFS) revealed that acupuncture intervention significantly improved fatigue levels compared to the control group (MD = -0.56, 95% CI: -0.74 to -0.38, I2 = 45%, P < 0.01). Subgroup analyses showed that different acupuncture type had distinct advantages, suggesting distinct targeted advantages. Other factors showed significant differences. Sensitivity analyses for multiple outcome measures yielded unstable results, with indications of publication bias. According to GRADE criteria, the most outcomes were rated as low or very low quality.ConclusionsCurrent evidence suggests that acupuncture may alleviate CRF. However, conclusive evidence supporting its therapeutic efficacy remains limited. Given the methodological concerns and low certainty of the available evidence, further high-quality studies are needed to confirm these findings.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024603184.

Background:Pharmacological treatment of motor disorders in early Parkinson (PD) has reached a bottleneck, and acupuncture as an important component of non-pharmacological therapy has demonstrated therapeutic potential. However, current evidence is limited in both quantity and quality, highlighting the need for further clarification of its efficacy. Methods:A multi-center, investigator and participant blinded, randomized parallel group design was employed. 136 eligible participants were randomly assigned in a 1:1 ratio to either the acupuncture or sham acupuncture group via a central randomization system, received 12 sessions over 4 weeks. The primary outcome was motor function, assessed using the Unified Parkinson's Disease Rating Scale-III (UPDRS-III). Secondary outcomes were objective gait metrics captured with the Ready system, disease stage assessed by the Hoehn and Yahr scale (HY), and quality of life measured by the Activities of Daily Living scale (ADL) and the Parkinson's Disease Questionnaire 39 (PDQ 39). Levodopa dosage was recorded before and after treatment. Assessments were conducted at four time points (weeks 1, 2, 3, and 4), with 8 weeks follow up. Blood samples were collected before and after treatment for LC-MS/MS untargeted metabolomics and deep proteomics analysis. Discussion:This study will aim to clarify the efficacy of acupuncture for early PD motor symptoms through an evidence-based randomized controlled trial (RCT), and explore the underlying mechanisms of acupuncture using multi-omics approaches.

Background:Acupuncture shows potential in treating nausea and vomiting (CINV) induced by highly emetogenic chemotherapy (HEC). However, the certainty of its efficacy evidence remains unclear, warranting a comprehensive evaluation. Method:Two independent reviewers systematically searched eight databases from inception to December 2024 to identify eligible randomized controlled trials (RCTs). Relevant data were extracted using a standardized form, and risk of bias was assessed using the Cochrane risk of bias tool version 2.0 (ROB 2.0). Meta-analysis was performed using R Studio 4.4 software. Subgroup analysis was conducted based on acupuncture type. Additionally, publication bias was detected using appropriate methods according to the heterogeneity of different outcomes, where appropriate. Finally, evidence quality was rated using the GRADE system. Result:A total of 58 RCTs were included in this meta-analysis. Rob 2.0 result indicated that most studies were at high risk of bias, with low methodological quality. For the primary outcome, acupuncture significantly improved the complete control rate during the overall (RR 1.54, 95% CI 1.36-1.75; P < 0.001; I 2 = 36%) and the delayed phase (RR 1.56, 95% CI 1.32-1.86; P < 0.001; I 2 = 0%). For other CINV outcomes, acupuncture demonstrated considerable therapeutic potential for vomiting-related outcomes, while uncertainty in alleviating nausea symptoms. Subgroup analyses showed that different acupuncture types had distinct advantages. Sensitivity analyses for several outcomes were unstable, and there were indications of publication bias. According to GRADE, only the acute vomiting duration score was rated as moderate quality; all other outcomes were rated as low or very low quality. Conclusion:Although acupuncture for HEC-induced CINV shows some positive effects, there are various limitations that render the current evidence insufficient to conclusively establish its efficacy; therefore, further high-quality studies are required. Systematic review registration:PROSPERO, identifier: CRD42024588165.

BackgroundPost-stroke dysphagia (PSD) remains a frequent and disabling sequela of ischemic stroke, and effective pharmacotherapy is still lacking. Acupuncture has demonstrated significant efficacy in improving swallowing function, yet its neural mechanisms remain unclear. Research into the functional reorganization of brain networks following acupuncture treatment remains insufficient.ObjectiveThis protocol describes a randomized, single-blind, sham-controlled trial designed to evaluate the clinical effects and central neural mechanisms of Tiao Shen Li Yan acupuncture for PSD, using multimodal neuroimaging with resting-state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI).MethodsForty-six PSD patients will be randomized 1:1 to active or sham acupuncture (30 minutes sessions, 5 times per week for 6 weeks). The primary outcomes are rs-fMRI and DTI metrics reflecting functional and structural connectivity changes (ALFF, ReHo, FC, FA, MD). Secondary outcomes include Standardized Swallowing Assessment (SSA), videofluoroscopic swallowing study (VFSS)-based measures, Montreal Cognitive Assessment (MoCA), and Swallowing Quality-of-Life Questionnaire (SWAL-QOL). Twenty healthy volunteers will provide baseline neuroimaging reference data.Expected ResultsThe study aims to clarify how Tiao Shen Li Yan acupuncture modulates structure-function coupling in swallowing-related brain networks and promotes functional reorganization of the brain, and to determine whether these imaging biomarkers correlate with clinical improvement.DiscussionBy integrating clinical assessments with multimodal neuroimaging under a rigorous randomized design and by incorporating healthy controls to identify abnormal brain network sites in PSD, this study predefines structure-function coupling metrics and clinical endpoint measures to further explore the neural mechanisms of brain network reorganization underlying acupuncture treatment for PSD. This protocol may provide mechanistic evidence for acupuncture-induced neuroplasticity and support the development of treatment strategies for PSD.Trial registrationhttps://www.chictr.org.cn/hvshowproject.html?id=286791&v=1.1, identifier: ChiCTR2400086748.

ObjectiveTo evaluate the effectiveness of “Tongdu Tiaoshen” acupuncture for cancer-related fatigue （CRF）.MethodsSixty patients with CRF were randomly assigned， via a team-developed central randomization system， to an acupuncture group （n=30， with 3 dropouts） and a sham acupuncture group （n=30， with 3 dropouts）. Both groups received the usual care. In the acupuncture group， Baihui （GV20）， Shenting （GV24）， and Dazhui （GV14） were selected as the primary acupoints according to the “Tongdu Tiaoshen” acupuncture. The sham acupuncture group used the same acupoint locations as the acupuncture group， but received a control intervention using a sham acupuncture device designed to simulate the sensation of needling. Needles were retained for 30 min per session， for a total of 10 sessions over 14 days. The primary outcome， the Functional Assessment of Chronic Illness Therapy-Fatigue （FACIT-Fatigue）， and the secondary outcomes， including the Brief Fatigue Inventory （BFI）， the Pittsburgh Sleep Quality Index （PSQI）， and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 （EORTC QLQ-C30）， were assessed at baseline and after 14 d of treatment. In addition， the James Blinding Index （JBI） was used to evaluate blinding， and adverse events in both groups were recorded for safety assessment.ResultsAfter 14 d of treatment， compared with the sham acupuncture group， the acupuncture group showed a significant increase in FACIT-Fatigue scores （reflecting the core symptoms of CRF） （P<0.01）， a significant decrease in BFI scores （P<0.05）， and a significant increase in EORTC QLQ-C30 scores （reflecting quality of life） （P<0.01）， whereas no significant difference was found in PSQI scores reflecting sleep status， P>0.05）. In addition， the JBI indicated successful blinding， and there was no statistically significant difference in adverse events between the two groups， suggesting overall good safety.Conclusion“Tongdu Tiaoshen” acupuncture can effectively improve the core symptoms of CRF and enhance quality of life， but its effect on sleep quality has not yet been fully established.

BackgroundAlthough acupuncture is recommended for managing breast cancer-related hot flashes, the level of evidence is limited. With the updating of randomized controlled trials, it is necessary to reassess its efficacy.ObjectiveTo assess the effectiveness of acupuncture in the treatment of hot flashes in patients with breast cancer.MethodsUp to March 2024, we retrieved data from nine databases and used Stata software (version 14.0, version 17.0) and RevMan software (version 5.3) to conduct a meta-analysis. The Cochrane Collaboration’s risk of bias assessment tool was used for methodological assessment of the risk of bias, and the GRADEpro GDT online assessment tool was used for evidence evaluation.ResultsIn total, 11 randomized controlled trials (RCTs) involved 963 participants were included in the meta-analysis. The result of risk of bias revealed that the included RCTs exhibited a high risk of bias, primarily attributable to deficiencies in randomization and blinding methods. The results of primary meta-analysis indicated that acupuncture can improved the hot flash symptom scale score (SMD, -0.54; 95% CI, -0.83 to -0.24; P < 0.05). However, acupuncture does not reduce the frequency of hot flashes(SMD, -0.20; 95% CI, -0.75 to 0.36; P = 0.48). Further subgroup analyses, including the type of control group and the duration of needle retention, etc. showed different results, highlighting the necessity for further research. Sensitivity analysis confirmed the reliability of these finding. In addition, due to various issues, the level of evidence is low.ConclusionsAlthough acupuncture treatment for hot flashes in breast cancer shows potential, the evidence for the efficacy of acupuncture is still lacking due to various factors such as bias risk and significant differences between studies, and more high-quality RCTs are needed to confirm the efficacy of acupuncture.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024531542.

Background:Upper extremity functional reconstruction remains a major clinical challenge in post-stroke neurorehabilitation. Acupuncture has unique advantages as a complementary alternative therapy. Thus, in this study, we aim to compare sham acupuncture to reveal the efficacy and safety of acupuncture in the treatment of upper limb dysfunction post-stroke with surface electromyography (sEMG), a validated objective assessment tool, and a subjective index. Methods:In this prospective, principal-investigator-blinded randomized controlled trial, 74 patients who meet the inclusion criteria are randomly assigned to the acupuncture and sham acupuncture groups in a 1:1 ratio using a central randomization system. The patients receive the same routine basic treatment. The core acupoints selected in the acupuncture group are GV20 (Bai hui), DU14 (Da zhui), and LI11 (Qu chi). Six non-meridian acupuncture points are selected for the sham acupuncture group. The treatment cycle lasts for 4 weeks, five times per week, for 20 treatments. The Fugl-Meyer Upper Limb Assessment scale score is used as the main outcome. Secondary outcomes include the Motor Status Scale, Action Research Arm Test, Motor Assessment Scale, Self-rating Anxiety Scale, and Self-rating Depression Scale scores. Simultaneously using sEMG as an auxiliary efficacy indicator. Conclusion:This study assesses the effectiveness and safety of acupuncture for post-stroke upper limb impairment in multiple aspects and elucidates the underlying neuromuscular effect mechanism of acupuncture to provide clinical evidence. Registration:International Traditional Medicine Clinical Trials Registry. Registration No. ITMCTR2025000228. November 27, 2024. The study was approved by the Ethics Committee of Guangzhou University of Traditional Chinese Medicine, Shenzhen Hospital (Futian), Ethics. No. GZYLL (KY)-2024-045-01. November 13, 2024.

Purpose:Acupuncture shows potential as a treatment for sciatica, but the credibility and consistency of supporting evidence remain unclear, warranting critical and comprehensive evaluation. This overview is aims to assess the reliability, adequacy, and limitations of current evidence on acupuncture for sciatica using a multidimensional approach and further examine its efficacy through a secondary meta-analysis. Methods:Systematic reviews and meta-analyses (SRs/MAs) meeting PICOS criteria were identified from eight databases by two independent reviewers. Evidence reliability was assessed using AMSTAR-2, ROBIS, PRISMA-A, and the GROOVE tool across four domains: methodological quality, bias risk, reporting accuracy, and study overlap. Duplicate randomized controlled trials (RCTs) were excluded based on the Corrected Covered Area (CCA) analysis, and a secondary meta-analysis was conducted. Sensitivity analyses and funnel plots assessed robustness and publication bias. Results:Seven SRs/MAs were included. AMSTAR-2 revealed significant methodological flaws, particularly due to a lack of protocol pre-registration. ROBIS assessments showed a high risk of bias, with most studies relying on single-database searches and lacking comprehensive strategies. PRISMA-A indicated generally low reporting quality, especially regarding descriptions of acupuncture sensation. The GROOVE tool yielded a CCA of 7.23%, reflecting moderate study overlap. The secondary meta-analysis showed that acupuncture significantly improved treatment effectiveness (RR = 1.23; 95% CI: 1.20-1.26; P = 0.008), reduced pain intensity, and increased pain threshold. Sensitivity analyses confirmed the robustness of results, while funnel plots suggested some publication bias. Acupuncture was generally considered safe across studies. Conclusion:Although current evidence is limited by methodological flaws, publication bias, and poor reporting quality, acupuncture shows promising clinical potential for sciatica. High-quality, rigorously designed studies are needed to confirm its efficacy.

Background: Acupuncture shows promise in treating cancer-related insomnia (CRI); however, the evidence level for its effectiveness remains low. This study systematically examined research quality and used evidence mapping (EM) to map and present evidence information to identify gaps and inform future research. Methods: Two reviewers searched eight databases from inception to May 2024, screened eligible randomized controlled trials (RCTs), and extracted key characteristics from included studies. The quality of studies was assessed using the Cochrane Risk of Bias 2.0 (RoB 2.0) tool, and key characteristics visualized EM. Finally, Acupoint data were systematically summarized. Results: 37 RCTs were included in this study. RoB 2.0 results showed only three studies at ''low risk,'' while most had notable quality issues. EM indicated that common comparisons involved manual acupuncture (MA), alone or combined, versus sleep medications. Measures involved six assessment tools, with Pittsburgh Sleep Quality Index (PSQI) most frequently used. Meanwhile, EM revealed considerable uncertainty regarding acupuncture for CRI efficacy. Acupoint analysis identified Yintang (GV24+), Shenting (GV24), Baihui (GV20), Sanyinjiao (SP6), Neiguan (PC6), and Shenmen (HT7) as core acupoints. Analysis identified five key gaps: study reliability, participant selection, placebo effect, outcome measurement, and acupoint selection. Conclusions: Research on acupuncture for CRI has various gaps, and more high-quality evidence is still needed. This study comprehensively mapped the current evidence on acupuncture for CRI and identified five key gaps, providing directions and references for future research. Protocol registration: INPLASY, INPLASY202460052.

BackgroundThis study systematically evaluates the clinical efficacy and safety of 12 Chinese Patent Medicines (CPMs) combined with conventional Western medicine (CWM) in treating Functional Dyspepsia (FD), aiming to provide robust evidence for optimizing treatment strategies.MethodsWe systematically searched eight Chinese and international databases up to September 2025, including China National Knowledge Infrastructure, Wanfang Data, VIP Information, China Biology Medicine Disc, PubMed, Embase, Web of Science, and the Cochrane Library. Risk of bias was assessed using the Cochrane tool, and evidence certainty was appraised with CINeMA. Network meta-analysis was performed within a frequentist framework using random-effects models, and treatments were ranked by the surface under the cumulative ranking curve (SUCRA).ResultsA total of 76 RCTs involving 7,575 participants were included. All CPM + CWM regimens were more effective than CWM alone. The most significant benefit for total effective rate was observed with Jinghua Weikang Capsules (JWC) + CWM (RR = 1.46, 95% CI 1.28–1.67; SUCRA = 98.4%), Wuling Capsules (WLC) + CWM (RR = 1.29, 95% CI 1.18–1.42; SUCRA = 80.9%), and Qizhi Weitong Granules (QWG) + CWM (RR = 1.26, 95% CI 1.14–1.38; SUCRA = 69.2%). For motilin, WLC + CWM, Zhizhu Kuanzhong Capsules (ZKC) + CWM, and Simo Tang Oral Liquid (STOL) + CWM showed significant improvements. For gastrin, Liuwei Nengxiao Capsules (LNC) + CWM, Dalitong Granules (DLTG) + CWM, and STOL + CWM ranked highest. No CPM + CWM regimen was associated with a significant increase in adverse events, except for a higher risk with WLC + CWM versus QWG + CWM (OR = 4.82, 95% CI 1.02–22.87). Sensitivity analyses and meta-regression supported the robustness of these findings, while CINeMA rated the certainty of evidence as low for most comparisons.ConclusionCPM combined with CWM was more effective than CWM alone in improving symptom response and gastrointestinal hormone levels, without increasing adverse events. These findings support CPMs as promising adjuncts to standard therapy, though higher-quality RCTs are needed to confirm their role in personalized management of functional dyspepsia.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/ CRD42024562649.

The prevalence of depression is as high as about 30% within five years after stroke, while there is still no breakthrough in the Western medical treatments for post-stroke depression (PSD) in clinical practice. The traditional acupuncture treatment has been practiced to be effective for the therapy of PSD, but its mechanism still needs to be elucidated. With a combination of methods, including behavioral testing, immunofluorescence, in vivo electrophysiological recording, mRNA sequencing, genetic modulation, and in vivo fiber recording techniques, this study showed that electroacupuncture (EA) at Baihui (GV20) and Shenting (GV24) acupoints improved the depressive-like behaviors and neuronal electrophysiological activities in PSD model mice, which was established by bilateral injection of collagenase IV into the medial prefrontal cortex (mPFC). Moreover, it was found that the EA-mediated improvement was comparable to that of fluoxetine. The mRNA sequence analysis indicated that the 5-hydroxytryptamine (5-HT) system was involved in the pathogenesis of PSD. Meanwhile, the number of 5-HT positive neurons in the dorsal raphe nucleus (DRN) and 5-HT in the mPFC was significantly decreased, and ablation of neurons in the DRN could prevent the efficacy of EA. The neuronal activity of excitatory and inhibitory neurons in mPFC can be modulated by chemogenetic activation or inhibition of the TPH2-positive neurons in the DRN projecting to the mPFC. Together, our results have provided the insight of the biological mechanism underlying acupuncture in the treatment of PSD and revealed the scientific connotation of acupuncture in both clinical and scientific value.

BackgroundThe use of acupuncture in cancer treatment is expanding. Nevertheless, the efficacy and safety of acupuncture in alleviating cancer-related hiccups remains uncertain and inconclusive.MethodsWe conducted a systematic search across eight databases: PubMed, China National Knowledge Infrastructure Database, WanFang, China Science and Technology Journal Database, SinoMed, Web of Science, Cochrane, and Embase, covering the period from their inception to July 2023. Literature was screened based on predefined PICOS inclusion and exclusion criteria, and the risk of bias was assessed using the Cochrane Risk of Bias tool. Data synthesis was performed using Review Manager 5.3 software and R studio 4.4. Additionally, we conducted a frequency analysis of acupoint usage.ResultsA total of nine randomized controlled trials (RCTs) involving 580 patients were included in the analysis. The risk of bias assessment indicated a high risk of bias in all nine RCTs, primarily due to blinding of participants and personnel and random sequence generation (selection bias). The meta-analysis revealed that acupuncture significantly reduced the symptoms of cancer-related hiccups compared to pharmacological treatment (relative risk (RR) = 1.83, 95% confidence interval (CI) [1.53, 2.20], p < 0.001, I2 = 27%). In terms of onset time, acupuncture demonstrated a shorter duration of onset compared to pharmacological treatment (mean difference (MD) = −8.71, 95% CI [−23.32 5.89], p < 0.01, I2 = 100%). Furthermore, acupuncture exhibited a significant improvement in sleep, eating, and appetite scores compared to pharmacological treatment (MD = 0.68, 95% CI [0.07, 1.29], p = 0.03; MD = 0.68, 95% CI [0.07, 1.30], p = 0.03; MD = 0.66, 95% CI [0.08, 1.25, p = 0.03]). The frequency of acupoint usage was analyzed, with ST36 and PC6 being the most frequently used acupoints. Regarding adverse events, acupuncture exhibited favorable safety profiles compared to other control groups.ConclusionThe meta-analysis results suggest that acupuncture has a positive effect on the efficacy rate for cancer-related hiccups, as well as improvements in quality of life and time to effect response. However, due to the high risk of bias and quality limitations of the included studies, no conclusive evidence currently supports the efficacy of acupuncture. High-quality, evidence-based research is still needed to confirm the effectiveness of acupuncture in treating cancer-related hiccups.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, CRD42023451403.

Background The number of systematic reviews and meta-analyses (SRs/MAs) on acupuncture therapy for CRI is increasing; however, the credibility of the evidence remains unclear with controversial results, necessitating a comprehensive evaluation. Objective We aimed to critically assess the evidence in SRs/MAs regarding the effectiveness of acupuncture therapy for CRI from various aspects and conduct an exploratory analysis to identify potential issues. Method Two reviewers conducted comprehensive searches in eight databases. SRs/MAs of randomized controlled trials are included. After screening according to inclusion and exclusion criteria, two reviewers extracted data from eligible SRs/MAs and conducted a detailed assessment of methodological quality, risk of bias, and quality of evidence using AMSTAR-2, ROBIS, and GRADE tools. Meanwhile, we calculated the Corrected Covered Area (CCA) leveraging the GROOVE tool. After manually excluding duplicate studies, we assess the risk of bias of primary studies extracted from SRs/MAs and conducted exploratory meta-analysis. Result The comprehensive analysis included 10 SRs/MAs. The AMSRAT-2 results indicate significant methodological flaws in SRs/MAs, with the main issues focusing on the lack of provision of exclusion checklist for the studies. Furthermore, over half of the SRs/MAs have a high risk of bias due to incomplete retrieval and failure to follow the protocol. Most SRs/MAs demonstrated considerable completeness in reporting quality. Notably, the overall level of evidence is low. High overlap indicates redundant SRs/MAs. Exploratory analysis suggests that acupuncture therapy may be effective for CRI; however, with a high risk of bias, caution is needed in interpreting the results. Sensitivity analysis results are stable, and the funnel plot indicates no publication bias. Most SRs/MAs acknowledge the safety of acupuncture. Conclusion Currently, the credibility of acupuncture therapy for treating CRI is low and improvements are needed in methodology, risk of bias, and quality of reporting. Acupuncture therapy shows potential but lacks sufficient support; high-level evidence is warranted to elucidate the effectiveness of acupuncture in treating CRI.