Page 185 - 2025中醫藥與天然藥物聯合學術研討會-中醫藥與天然藥物的挑戰Ｘ機遇與未來大會手冊

PP-03

Purpose-directed acupuncture for improving the pharyngeal phase in stroke-

related dysphagia: A systematic review and meta-analysis

1
Intsam Aslam, #,1 Muhammad Asif Javed, Hung-Rong Yen* ,2,3

1 Graduate Institute of Acupuncture Sciences, College of Chinese Medicine, China Medical

University, Taichung 404328, Taiwan
2 International Master Program in Acupuncture, College of Chinese Medicine, China Medical
University, Taichung 404328, Taiwan
3 Department of Chinese Medicine, China Medical University Hospital, Taichung 404327,

Taiwan
* E-mail: hungrongyen@mail.cmu.edu.tw

Abstract
Post-stroke dysphagia, especially during the pharyngeal phase, contributes to high morbidity
and delayed rehabilitation. Purpose-directed acupuncture (PDA) has been proposed as an
adjunctive therapy, but evidence of its effectiveness remains uncertain. To evaluate the
effectiveness of PDA on swallowing function using both clinical outcomes and surface
electromyography (sEMG). A systematic review and meta-analysis of randomized controlled
trials was performed (databases searched to May 2024). Six RCTs involving 430 participants
were included. Outcomes comprised Videofluoroscopic Swallowing Study (VFSS),
Standardized Swallowing Assessment (SSA), Functional Oral Intake Scale (FOIS), Modified
Mann Assessment of Swallowing Ability (MMASA), and sEMG parameters. Methodological
quality and risk of bias were independently appraised using the Cochrane RoB-2 tool; PEDro
scores were extracted where reported. Compared with controls, PDA significantly improved
swallowing measures. VFSS scores increased (MD 8.06, 95 % CI 6.06–10.05, p<0.00001);
SSA scores decreased (MD –3.80, 95 % CI –4.33 to –3.28, p<0.00001); FOIS improved (MD
0.85, 95 % CI 0.62–1.07, p<0.00001); and MMASA rose (MD 10.06, 95 % CI 6.37–13.75,
p<0.00001). sEMG amplitude and RMS parameters also increased (overall MD 0.44, 95 % CI
0.20–0.69, p=0.0003). Most trials were rated low-to-moderate risk of bias. No serious adverse
events were reported. PDA appears to enhance both objective swallowing-muscle activity and
clinical swallowing outcomes after stroke. Although promising, the evidence is constrained by
modest sample sizes, moderate heterogeneity, and geographic concentration. Larger,
multicenter, rigorously designed trials are required to confirm these findings.

Keywords: Post-stroke dysphagia; Purpose-directed acupuncture; Surface electromyography;
Meta-analysis