Key Finding
This network meta-analysis will provide the first systematic comparison and efficacy ranking of multiple TCM interventions for post-stroke emotional disorders within a syndrome differentiation framework, establishing evidence-based selection criteria for personalized treatment approaches.
Emotional problems like depression and anxiety are common after stroke, affecting up to half of all stroke survivors. These post-stroke emotional disorders not only reduce quality of life but can also slow physical recovery and increase the risk of having another stroke. While Western medications can help, they often work slowly, don't work for everyone, and can cause side effects. Traditional Chinese Medicine (TCM) approaches—including acupuncture, herbal remedies, and combination therapies—may offer benefits by addressing multiple aspects of post-stroke emotional health simultaneously and typically have fewer side effects. However, doctors haven't had clear guidance on which TCM treatments work best. Researchers are planning a comprehensive study that will compare all available evidence on different TCM treatments for post-stroke emotional disorders. They'll search medical databases worldwide for clinical trials and use advanced statistical methods to rank how well each treatment works. The study will look at both depression and anxiety separately, and will consider traditional Chinese diagnostic patterns to help match treatments to individual patients. This research aims to give both patients and healthcare providers clear, evidence-based information about which TCM therapies are most effective for emotional problems after stroke, and whether combining TCM with conventional medicine works better than either approach alone. If you're considering acupuncture or other TCM therapies for post-stroke emotional concerns, consult with a licensed acupuncturist or integrative medicine physician experienced in treating stroke patients.
This protocol describes a planned network meta-analysis examining Traditional Chinese Medicine interventions for post-stroke emotional disorders (PSED), including depression, anxiety, and comorbid conditions. Researchers will systematically search nine Chinese and English databases plus grey literature for RCTs comparing TCM therapies (acupuncture, herbal medicine, integrated approaches) with conventional Western medicine or placebo in adult PSED patients. Primary outcomes include clinical effective rates and standardized scale score changes. The Bayesian random-effects NMA model will quantify efficacy differences and generate ranking probabilities across interventions. Notably, subgroup analyses will stratify results by PSED subtypes (depression vs. anxiety) and TCM syndrome patterns, addressing treatment heterogeneity within the syndrome differentiation framework. GRADE methodology will assess evidence quality. No sample size is reported as this is a protocol for future analysis. The study aims to provide clinicians with evidence-based hierarchical selection criteria for acupuncture, herbal medicine, and integrated TCM-Western medicine approaches, filling a significant gap in personalized PSED management protocols.
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