Article Text

Acupuncture for the treatment of hiccups following stroke: a systematic review and meta-analysis
  1. Jinhuan Yue1,2,
  2. Ming Liu3,
  3. Jun Li4,
  4. Yuming Wang5,
  5. E-Sing Hung6,
  6. Xin Tong7,
  7. Zhongren Sun1,
  8. Qinhong Zhang1,2,
  9. Brenda Golianu2
  1. 1Department of Acupuncture and Moxibustion, College of Acupuncture and Moxibustion, Heilongjiang University of Chinese Medicine, Harbin, China
  2. 2Department of Anesthesia, Stanford University, Stanford, California, USA
  3. 3College of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, Harbin, China
  4. 4Department of Personnel, Heilongjiang University of Chinese Medicine, Harbin, China
  5. 5Department of Rehabilitation, Chinese Medicine Hospital of Daqing, Daqing, China
  6. 6Department of Education, Five Branches University, California, USA
  7. 7Department of Medical Clinic, Atlantic Institute of Oriental Medicine, Florida, USA
  1. Correspondence to Dr Qinhong Zhang, Department of Anesthesia, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA; qinhong{at} and Dr Brenda Golianu, Department of Anesthesia, Stanford University, 300 Pasteur Dr, Stanford, CA 94305, USA; bgolianu{at}


Objectives To assess the effectiveness and safety of acupuncture for hiccups following stroke.

Methods Medline, Embase, CENTRAL, CINAHL, and four Chinese medical databases were searched from their inception to 1 June 2015. The dataset included randomised controlled trials (RCTs) with no language restrictions that compared acupuncture as an adjunct to medical treatment (effectiveness) or acupuncture versus medical treatment (comparative effectiveness) in stroke patients with hiccups. The Cochrane risk of bias tool was used to assess the methodological quality of the trials.

Results Out of 436 potentially relevant studies, five met the inclusion criteria. When acupuncture was compared with other interventions (as sole or adjunctive treatment), meta-analysis revealed a significant difference in favour of cessation of hiccups within a specified time period (CHWST) following intervention when used as an adjunct (risk ratio (RR) 1.59, 95% CI 1.16 to 2.19, I2=0%), but not when used alone (RR 1.40, 95% CI 0.79 to 2.47, I2=65%, ie, high heterogeneity). No safety information was reported in these studies.

Conclusions Our systematic review and meta-analysis suggests that acupuncture may be an effective treatment for patients suffering from hiccups following stroke when used as an adjunct to medical treatment. However, due to the limited number of RCTs and poor methodology quality, we cannot reach a definitive conclusion, hence further large, rigorously designed trials are needed.


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