Table 2.
Summary of clinical acupuncture studies in posterior circulation ischemic vertigo (PCIV).
| Study (design) | Diagnostic criteria for PCIV | TCM pattern differentiation | n | Intervention (type; acupoints; parameters) | Comparator/co-interventions | Duration/follow-up | Main outcomes | Adverse events |
|---|---|---|---|---|---|---|---|---|
| Li et al. (34) (systematic review & meta-analysis of 20 RCTs) | WHO stroke criteria (1989) with imaging-confirmed posterior circulation infarction vertigo | No included trial enrolled by phlegm-dampness pattern; two trials restricted to qi/yang-deficiency patterns | 1,541 (20 RCTs) | Manual acupuncture (17/20), manual + electroacupuncture (3/20); 33 main acupoints across trials, GB20 most frequent (15/20) | 19/20 acupuncture + drug vs. drug alone (flunarizine, betahistine, aspirin, others); 1/20 acupuncture vs. flunarizine | 7–42 days; follow-up not pooled | Basilar artery Vm SMD 0.58 (0.40–0.76); LVA 0.48 (0.22–0.73); RVA 0.44 (0.19–0.69); clinical effective rate RR 1.22 (1.15–1.29); RoB low in 6/20 | 7/20 trials reported safety; no acupuncture-related AEs |
| Dong et al. (35) (single RCT) | PCIV; detailed criteria not reported in accessible abstract | No; fixed prescription for all patients | 90 (45/45) | Manual acupuncture: EX-HN3, PC6, SP6, GV20, GB20, GB12, BL10; needles retained 30 min, once daily | Flunarizine 5 mg once daily; both groups received background neurological medication | 21 days; 3-month follow-up | TCM vertigo symptom score; TCD Vm and PI of LVA/RVA/BA; total effective rate 91.1% vs. 75.6%; recurrence at 3 months 19.5% vs. 50.0% (single unblinded trial) | Not reported |
| Wen et al. (36) (four-arm randomized safety trial) | WHO Task Force on Stroke (1989) criteria: vertigo + vertebrobasilar insufficiency on TCD/MRI ± neurological signs | Adjunct acupoints individualized by pattern (not an inclusion criterion) | 136 randomized (120 completed) | Manual acupuncture at GB20 (0.5–0.8 cun), two insertion directions × two twisting frequencies (60 vs. 120/min); adjunct CV12, CV6, ST36, ST40, KI3, KI6, PC6, PC8 | No drug comparator (safety design) | 14 sessions over 3–4 weeks | Safety laboratory panels and ECG before/after course; adverse events after every session | 5 mild events (needling pain, small hematoma, transient chest tightness); no serious AEs |
Cervical/cervicogenic vertigo studies are excluded here and discussed separately as indirect evidence (Section 6.2).
Vm, mean flow velocity; PI, pulsatility index; BA, basilar artery; LVA/RVA, left/right vertebral artery; SMD, standardized mean difference; RR, relative risk; RoB, risk of bias; TCD, transcranial Doppler; AE, adverse event.