| 摘要 |
[Objectives] To systematically evaluate the effects of electroacupuncture (EA) on post-stroke apoptosis in animal models, focusing on key apoptotic markers (TUNEL-positive cells, caspase-3, Bcl-2/Bax ratio) and exploring potential sources of heterogeneity related to EA parameters and the timing of interventions. [Methods] A comprehensive search of PubMed, EMBASE, Web of Science, and the Cochrane Library (from inception to July 2025) was conducted to identify randomized controlled animal studies investigating EA in ischemic stroke models (tMCAO/pMCAO). Data pertaining to apoptotic outcomes were extracted, and the methodological quality was assessed using the CAMARADES checklist. A meta-analysis was conducted using random- or fixed-effects models in Stata 17.0, with subgroup analyses for EA timing (pre- vs. post-ischemia) and waveforms (continuous vs. disperse). Heterogeneity among studies was quantified via the I2 statistic. [Results] Thirty-two studies were included in the analysis. EA significantly reduced apoptosis, as evidenced by a decrease in TUNEL-positive cells (Hedges’ g=-3.38, 95% CI: -4.09 to -2.67), reduced caspase-3 expression (g=-2.67, 95% CI: -3.35 to -2.00), and an increased Bcl-2/Bax ratio (g=2.60, 95% CI: 1.72 to 3.47). Subgroup analyses showed comparable efficacy between pre- and post-ischemia EA (p=0.50) and revealed a non-significant trend favoring continuous over disperse waveforms (p=0.09). High heterogeneity (I2>50%) was observed, which was attributed to variations in animal models, EA protocols, and outcome assessments. [Conclusions] EA demonstrates robust anti-apoptotic effects in stroke models, likely mediated through the PI3K/Akt, NF-κB, and TRPV1 pathways. While both timing and waveforms show promise, standardizing EA protocols and conducting translational clinical trials are essential to optimize neuroprotective applications in stroke rehabilitation. |
