A systematic review of the cost-effectiveness of acupuncture in stroke patients

doi:10.5847/wjem.j.1920-8642.2025.121

World Journal of Emergency Medicine ›› 2025, Vol. 16 ›› Issue (6): 603-608.doi: 10.5847/wjem.j.1920-8642.2025.121

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A systematic review of the cost-effectiveness of acupuncture in stroke patients

Dan Chai¹^,², Shanhua Mao³, Yuan Qian¹^,², Yujie Zhu¹, Desong Kong¹, Jinghua Zhang¹, Zhiwen Luo⁴, Ting Zhang⁵(), Changqing Wang²()

¹Nanjing Hospital of Chinese Medicine affiliated to Nanjing University of Chinese Medicine, Nanjing 210022, China
²Nanjing University of Chinese Medicine, Nanjing 210023, China
³Department of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China
⁴Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
⁵Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China

Received:2024-11-29 Accepted:2025-03-10 Online:2025-11-13 Published:2025-11-01
Contact: Ting Zhang, Email: cczthd18@gmail.com
Changqing Wang, Email: cloudcd@hotmail.com;

Abstract

Dan Chai, Shanhua Mao, Yuan Qian, Yujie Zhu, Desong Kong, Jinghua Zhang, Zhiwen Luo, Ting Zhang, Changqing Wang. A systematic review of the cost-effectiveness of acupuncture in stroke patients[J]. World Journal of Emergency Medicine, 2025, 16(6): 603-608.

Figures/Tables 3

Figure 1.

Table 1

Table 2

The primary outcomes and ICERs of the enrolled studies

Authors	Cost	Follow up	Main outcome	ICER
Ning et al^[14]	Direct medical costs	4 weeks	CSS: XingNao group was lower than the control group (P<0.05) BI: XingNao group was higher than the control group (P<0.01)	Cost: XingNao group were lower than the control group CSS was decreased 1 point and BI scores were increased 1 point: XingNao groups cost reduced 121.27 USD; Control groups cost reduced 28.43 USD
Jiang et al^[11]	Costs of inpatients and direct medical expenses during treatment, including clinical, nursing, diagnosis, treatment, Western medicine, Chinese medicine, laboratory examination, rehabilitation, and complication treatment fees	4 weeks	NIHSS & BI were improved in the treatment group than the control group (P<0.05) The average cost improved in both NIHSS and BI was less in the treatment group than in the control group (P<0.05)	No ICER
Qian et al^[13]	Direct medical expenses, direct non-medical costs, indirect costs	6 weeks	The lowest cost-effective ratio after 3 months of follow-up was 5.29 in the acupuncture and moxibustion group, and 5.98 in the control group The average cost-effective ratio was 13.52 in the acupuncture and moxibustion group and 5.98 in the control group	No ICER
He et al^[12]	Direct medical expenses, direct non-medical costs	4 weeks	The total cost for each NDS scores point of improvement in patients were 288.16 USD for the comprehensive group; 432.41 USD for the acupuncture group, and 297.63 USD for the recovery group (P<0.05) No significant differences in the cost of a 1-point increment in the FCA among the three groups were observed	No ICER
Yi et al^[15]	Direct medical expenses + direct non-medical costs	8 weeks	The average cost-effectiveness ratios: treatment group 52.4; control group 98.07. FCA values were 34.73 in the treatment group and 66.27 in the control group	No ICER
Zhang et al^[16]	Direct medical costs were calculated in terms of total hospital and outpatient costs	3 weeks	BI scores of the rehabilitation massage group increased by 5 points at a cost of 119.54 USD; rehabilitation needle spines cost 145.41 USD	Expenses decreased by 102.59 USD, BI increased every 5 points in acupuncture group

Table 2

References 18

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Author	Year	Disease	N	Intervention	Country	TRIAL or model based EE	Comparators	Outcome measure	Perspective	Intervention cost-effective
Ning et al^[14]	2015	Cerebral infarction during restoration	100	XingNao acupuncture	China	TRIAL based EE	Traditional acupuncture	CSS value and BI value	Healthcare	Yes
Jiang et al^[11]	2010	Stroke	60	Acupuncture & structural therapy	China	TRIAL based EE	Structural therapy	NIHSS and BI value	Healthcare	Yes
Qian et al^[13]	2015	Post-stroke depression	57	Resuscitation method	China	TRIAL based EE	Fluoxetine hydrochloride	HAMD and SERS scores	Healthcare	Yes
He et al^[12]	2013	Motor function of stroke survivors	205	Acupuncture	China	TRIAL based EE	Rehabilitation	NDS and FCA scores	Healthcare	Yes
Yi et al^[15]	2016	Stroke	100	Acupuncture	China	TRIAL based EE	Medicine	FCA	Healthcare	Yes
Zhang et al^[16]	2013	Post-stroke hemiplegia at recovery	60	Acupuncture	China	TRIAL based EE	Rehabilitation massage	BI value	Healthcare	Yes

A systematic review of the cost-effectiveness of acupuncture in stroke patients

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