Table 1.
General characteristics of the included studies.
| Study ID | Sample size (A : B) |
Study of the country | Mean age (range; yr) | CGD duration (range) | Intervention group (A) | Control group (B) | Treatment duration | Follow-up | Outcome | Results | AE (n) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Bai [33] | 80 (40 : 40) |
China | (A) 35.6 ± 6.4 (22∼54) (B) 36.2 ± 7.2 (22∼55) |
(A) NR (1.5 days∼4 yr) (B) 1.0 ± 0.6 yr (2 days∼4 yr) |
Modified BYT + (B) | AT (1 time/day) | 20 days | NR | (1) SS (2) RVA-BF (3) LVA-BF (4) BA-BF (5) TER |
(1) (A) > (B)∗ (2) N.S. (3) (A) > (B)∗ (4) (A) > (B)∗ (5) (A) > (B)∗ |
NR |
| Chen [34] | 120 (60 : 60) |
China | (A) 43.81 ± 5.57 (25∼58) (B) 43.75 ± 5.61 (22∼57) |
(A) 7.65 ± 1.79 mon (2∼11 mon) (B) 7.63 ± 1.82 mon (2∼11 mon) |
Modified GGT + (B) | AD: flunarizine (10 mg bid) | 1 month | NR | (1) SS (2) RVA-BF (3) LVA-BF (4) BA-BF (5) TER |
(1) (A) > (B)∗ (2) (A) > (B)∗ (3) (A) > (B)∗ (4) (A) > (B)∗ (5) (A) > (B)∗ |
NR |
| Cheng [35] | 84 (42 : 42) |
China | Modified DXT + (B) | AD: flunarizine (10 mg qd) | 2 weeks | NR | (1) SS (2) TER (3) CGRP level |
(1) (A) > (B)† (2) (A) > (B)∗ (3) (A) > (B)† |
NR | ||
| Dai [36] | 82 (41 : 41) |
China | 46.2 ± 5.1 (24∼65) | NR (3∼11 mon) | Modified YCT + (B) | AT (1 time/day) | 4 weeks | NR | (1) TER (2) Fib level (3) TC level |
(1) (A) > (B)∗ (2) (A) > (B)∗ (3) (A) > (B)∗ |
NR |
| Gao [37] | 106 (53 : 53) |
China | (A) 54.3 ± 5.6 (24∼62) (B) 55.4 ± 5.2 (23∼63) |
(A) 5.4 ± 0.6 yr (3.0∼10.5 yr) (B) 5.6 ± 0.5 yr (3.5∼11.0 yr) |
Modified BBTT + (B) | AD: flunarizine (5∼10 mg·qd) | 2 weeks | NR | (1) RVA-BF (2) LVA-BF (3) BA-BF (4) TER |
(1) (A) > (B)∗ (2) (A) > (B)∗ (3) (A) > (B)∗ (4) (A) > (B)∗ |
NR |
| Gu [38] | 70 (35 : 35) |
China | 52.17 ± 6.34 (24∼65) | 3.08 ± 0.41 mon (2∼6 mon) | Modified YCT + (B) | AT (1 time/2 day) | 4 weeks | NR | (1) SS (2) OFS (3) RVA-BF (4) LVA-BF (5) BA-BF (6) TER (7) Fib level (8) TC level |
(1) (A) > (B)† (2) (A) > (B)† (3) (A) > (B)∗ (4) (A) > (B)∗ (5) (A) > (B)∗ (6) (A) > (B)∗ (7) (A) > (B)† (8) (A) > (B)† |
NR |
| Gu [39] | 80 (40 : 40) |
China | (A) 41.9 ± 5.6 (20∼64) (B) 41.3 ± 5.3 (21∼63) |
NR | Modified BBTT + (B) | AD: flunarizine (10∼20 mg·qd) | 2∼8 weeks | NR | (1) TER | (1) (A) > (B)† | NR |
| Hu [40] | 200 (120 : 80) |
China | (A) 55.71 ± 6.93 (B) 56.43 ± 7.34 |
(A) 10.37 ± 3.23 yr (B) 10.53 ± 4.12 yr |
Modified GJT + (B) | AD: betahistine (6 mg tid) | 2 weeks | NR | (1) SS (2) TER |
(1) (A) > (B)∗ (2) (A) > (B) † |
NR |
| Huagn [41] | 98 (49 : 49) |
China | (A) 67.82 ± 5.95 (B) 65.26 ± 5.43 |
(A) 3.28 ± 0.69 yr (B) 3.34 ± 0.75 yr |
Modified GGT + (B) | AD: betahistine (6 mg·tid) | 2 weeks | NR | (1) OFS (2) RVA-BF (3) LVA-BF (4) BA-BF (5) TER |
(1) (A) > (B)† (2) (A) > (B)† (3) (A) > (B)† (4) (A) > (B)† (5) (A) > (B)∗ |
NR |
| Huang [42] | 120 (60 : 60) |
China | (A) 43.63 ± 4.72 (25∼57) (B) 43.72 ± 4.54 (27∼58) |
(A) 5.70 ± 1.14 yr (4 mon∼10 yr) (B) 5.65 ± 1.21 yr (3 mon∼10 yr) |
Modified BBTT + (B) | MT: Tuina (1 time/2 days) | 1 month | NR | (1) SS (2) OFS (3) TER |
(1) (A) > (B)∗ (2) (A) > (B)∗ (3) (A) > (B)∗ |
NR |
| Ji [43] | 60 (30 : 30) |
China | NR (40∼70) | NR | Modified DXT + (B) | AD: flunarizine (5 mg·qd) | 2 weeks | NR | (1) SS (2) TER |
(1) (A) > (B)∗ (2) (A) > (B)∗ |
NR |
| Ju [44] | 120 (60 : 60) |
China | (A) 67.82 ± 2.41 (60∼75) (B) 67.91 ± 2.37 (64∼74) |
(A) 5.12 ± 0.82 yr (1∼9 yr) (B) 5.30 ± 0.85 yr (1∼10 yr) |
Modified GGT + (B) | AT (6 times/week) | 4 weeks | 6 months | (1) SS (2) RVA-BF (3) LVA-BF (4) BA-BF (5) TER |
(1) (A) > (B)∗ (2) (A) > (B)∗ (3) (A) > (B)∗ (4) (A) > (B)∗ (5) (A) > (B)∗ |
NR |
| Li [45] | 68 (34 : 34) |
China | (A) 52.60 ± 2.58 (25∼68) (B) 42.58 ± 2.65 (24∼65) |
(A) 3.95 ± 0.78 mon (2∼8 mon) (B) 3.92 ± 0.85 mon (1∼8 mon) |
Modified YCT + (B) | AT (1 time/day) | 4 weeks | NR | (1) SS (2) TER |
(1) (A) > (B)† (2) (A) > (B)∗ |
NR |
| Li [46] | 116 (58 : 58) |
China | (A) 42.98 ± 9.21 (33∼63) (B) 42.91 ± 9.45 (32∼62) |
(A) 5.37 ± 0.65 yr (1 mon∼10 yr) (B) 5.32 ± 0.61 yr (1 mon∼10 yr) |
Modified DXT + (B) | AD: diphenidol (tid) | 1 month | NR | (1) SS (2) RVA-BF (3) LVA-BF (4) BA-BF (5) TER (6) ET level (7) CGRP level |
(1) (A) > (B)∗ (2) (A) > (B)∗ (3) (A) > (B)∗ (4) (A) > (B)∗ (5) (A) > (B)∗ (6) (A) > (B)∗ (7) (A) > (B)∗ |
NR |
| Liu [47] | 126 (63 : 63) |
China | (A) 52.64 ± 8.25 (26∼68) (B) 52.47 ± 8.14 (22∼65) |
(A) 3.98 ± 1.02 yr (0.6∼5 yr) (B) 3.94 ± 1.05 yr (0.8∼6 yr) |
Modified DXT + (B) | MT: Tuina (1 time/day) | 4 weeks | NR | (1) SS (2) OFS (3) RVA-BF (4) LVA-BF (5) BA-BF (6) TER (7) ET level (8) CGRP level |
(1) (A) > (B)∗ (2) (A) > (B)† (3) (A) > (B)∗ (4) (A) > (B)∗ (5) (A) > (B)∗ (6) (A) > (B)∗ (7) (A) > (B)∗ (8) (A) > (B)† |
NR |
| Lyu [48] | 54 (27 : 27) |
China | (A) 35.24 ± 2.15 (20∼59) (B) 31.17 ± 1.53 (18∼60) |
NR | Modified BYT + (B) | AT (1 time/day) | 20 days | NR | (1) SS (2) RVA-BF (3) LVA-BF (4) BA-BF (5) TER |
(1) (A) > (B)∗ (2) N.S. (3) (A) > (B)∗ (4) (A) > (B)∗ (5) (A) > (B)∗ |
NR |
| Pan [49] | 100 (50 : 50) |
China | (A) 42.41 ± 5.93 (B) 40.87 ± 6.25 |
(A) 3.91 ± 0.74 mon (B) 4.18 ± 0.81 mon |
Modified BBTT + (B) | MT: Tuina (1 time/day) | 2 weeks | NR | (1) SS (2) TER (3) ET level (4) CGRP level |
(1) (A) > (B)† (2) (A) > (B)∗ (3) (A) > (B)† (4) (A) > (B)† |
Gastrointestinal discomfort (1) |
| Qin [50] | 163 (79 : 84) |
China | 54.78 ± 10.36 | NR | Modified YCT + (B) | AD: betahistine (6 mg·tid) | 2 weeks | 3 months | (1) SS | (1) (A) > (B)∗ | NR |
| Qiu [51] | 110 (55 : 55) |
China | (A) 53.8 ± 5.5 (43∼65) (B) 52.6 ± 4.7 (42∼63) |
(A) 4.5 ± 0.7 mon (1∼8 mon) (B) 4.4 ± 0.8 mon (2∼9 mon) |
Modified YCT + (B) | AT (1 time/day) | 1 month | NR | (1) SS (2) BA-BF (3) TER (4) Fib level (5) TC level |
(1) (A) > (B)∗ (2) (A) > (B)∗ (3) (A) > (B)∗ (4) (A) > (B)∗ (5) (A) > (B)∗ |
NR |
| Shang [52] | 82 (41 : 41) |
China | 40.2 ± 1.7 (31∼67) | 3.1 ± 0.5 yr (0.33∼8 yr) | Modified GGT + (B) | MT (qd) | 2 weeks | NR | (1) SS (2) TER |
(1) (A) > (B)∗ (2) (A) > (B)∗ |
NR |
| Shang [53] | 134 (67 : 67) |
China | (A) 36.21 ± 4.74 (19∼63) (B) 36.51 ± 4.43 (18∼64) |
(A) 1.35 ± 0.82 yr (2 mon∼5 yr) (B) 1.21 ± 0.78 yr (1 mon∼4 yr) |
Modified GGT + (B) | AD: nimodipine (4 mg/day) | 2 weeks | NR | (1) RVA-BF (2) LVA-BF (3) BA-BF (4) TER |
(1) (A) > (B)† (2) (A) > (B)† (3) (A) > (B)† (4) (A) > (B)∗ |
NR |
| Shen [54] | 120 (60 : 60) |
China | (A) 54.22 ± 5.31 (42∼67) (B) 54.53 ± 5.07 (43∼66) |
NR | Modified YCT + (B) | AT (1 time/day) | NR | NR | (1) SS (2) TER |
(1) (A) > (B)† (2) (A) > (B)† |
NR |
| Shi [55] | 74 (37 : 37) |
China | (A) 54.8 ± 8.9 (B) 55.6 ± 8.4 |
(A) 3.3 ± 0.9 days (B) 3.5 ± 0.6 days |
Modified DXT + (B) | AD: betahistine (12 mg·tid) | 2 weeks | NR | (1) RVA-BF (2) LVA-BF (3) BA-BF (4) TER |
(1) (A) > (B)∗ (2) (A) > (B)∗ (3) (A) > (B)∗ (4) (A) > (B)∗ |
NR |
| Tan [56] | 154 (77 : 77) |
China | 23.6 ± 2.5 (18∼30) | 37.6 ± 7.9 days (7∼60 days) | Modified BBTT + (B) | AD: betahistine (8 mg·bid) | 10 days | NR | (1) TER | (1) (A) > (B)† | NR |
| Wang [57] | 66 (34 : 32) |
China | (A) 35.34 ± 3.24 (20∼64) (B) 35.63 ± 2.89 (20∼65) |
(A) 3.63 ± 1.45 yr (0.2∼10 yr) (B) 3.74 ± 1.63 yr (0.8∼12 yr) |
Modified DXT + (B) | MT: Tuina (5 times/week) | 4 weeks | NR | (1) SS (2) TER |
(1) (A) > (B)† (2) (A) > (B)† |
NR |
| Wang [58] | 160 (80 : 80) |
China | 49.37 ± 7.48 (33∼78) | 3.29 ± 1.44 yr (0.5∼9.5 yr) | Modified BBTT + (B) | AD: flunarizine (5 mg·qd) | 4 weeks | NR | (1) TER | (1) (A) > (B)∗ | NR |
| Wang [59] | 86 (43 : 43) |
China | (A) 44.76 ± 3.69 (23∼67) (B) 45.01 ± 3.12 (22∼68) |
(A) 1.04 ± 0.63 yr (4 mon∼2 yr) (B) 1.13 ± 0.64 yr (3 mon∼2 yr) |
Modified YCT + (B) | AT (1 time/day) | 4 weeks | NR | (1) RVA-BF (2) LVA-BF (3) BA-BF (4) TER (5) Fib level (6) TC level |
(1) (A) > (B)† (2) (A) > (B)† (3) (A) > (B)† (4) (A) > (B)∗ (5) (A) > (B)† (6) (A) > (B)† |
NR |
| Wang [60] | 80 (40 : 40) |
China | (A) 54.23 ± 9.09 (25∼73) (B) 54.71 ± 9.91 (25∼72) |
3.29 ± 1.44 yr (7 days∼3 mon) | Modified BBTT + (B) | AT (5 times/week) | 2 weeks | NR | (1) TER | (1) (A) > (B)∗ | Abdominal pain (1) Fainting during acupuncture (1) |
| Xu [61] | 112 (56 : 56) |
China | (A) 41.12 ± 3.24 (18∼65) (B) 40.92 ± 3.38 (18∼67) |
(A) 2.67 ± 3.24 yr (1∼4 yr) (B) 2.71 ± 0.92 yr (1∼5 yr) |
Modified GGT + (B) | MT: Tuina (3 times/day) | 4 weeks | NR | (1) SS (2) RVA-BF (3) LVA-BF (4) BA-BF |
(1) (A) > (B)∗ (2) (A) > (B)∗ (3) (A) > (B)∗ (4) (A) > (B)∗ |
NR |
| Yang [62] | 146 (73 : 73) |
China | (A) 35.72 ± 6.66 (18∼54) (B) 35.37 ± 6.51 (19∼55) |
(A) 3.14 ± 0.75 mon (1∼5 mon) (B) 3.37 ± 0.81 mon (2∼5 mon) |
Modified YCT + (B) | AT (1 time/day) | 2 weeks | NR | (1) RVA-BF (2) LVA-BF (3) BA-BF (4) TER |
(1) (A) > (B)∗ (2) (A) > (B)∗ (3) (A) > (B)∗ (4) (A) > (B)∗ |
NR |
| Yang [63] | 143 (73 : 70) |
China | (A) 37.4 ± 1.5 (20∼70) (B) 36.5 ± 1.2 (18∼69) |
(A) 2.4 ± 0.3 yr (0.5 mon∼8 yr) (B) 2.5 ± 0.2 yr (1 mon∼7 yr) |
Modified DXT + (B) | AD: flunarizine (10 mg·qd) and betahistine (20 mg/day) | 2 weeks | 6 months | (1) SS (2) RVA-BF (3) LVA-BF (4) BA-BF (5) TER |
(1) (A) > (B)∗ (2) (A) > (B)∗ (3) (A) > (B)∗ (4) (A) > (B)∗ (5) (A) > (B)∗ |
Rash (1) Gastrointestinal discomfort (1) Diarrhea (1) Fatigue (2) |
| Yao [64] | 78 (39 : 39) |
China | (A) 42.17 ± 4.35 (22∼58) (B) 42.59 ± 5.38 (23∼62) |
(A) 5.86 ± 1.35 yr (0.04∼9 yr) (B) 6.19 ± 1.34 yr (0.04∼11 yr) |
Modified BBTT + (B) | AT (1 time/5 days) | 6 weeks | NR | (1) RVA-BF (2) LVA-BF (3) BA-BF (4) TER |
(1) (A) > (B)† (2) (A) > (B)† (3) (A) > (B)† (4) (A) > (B)† |
NR |
| Zhang [65] | 290 (145: 145) |
China | (A) 57.97 ± 3.54 (47∼76) (B) 58.45 ± 3.36 (46∼76) |
(A) 2.56 ± 1.42 yr (1.5∼4.5 yr) (B) 2.85 ± 1.36 yr (1.5∼5 yr) |
Modified BBTT + (B) | AT + MT (AT: 1 time/day, MT: Tuina, 1 time/2 days) | 4 weeks | NR | (1) OFS (2) TER |
(1) (A) > (B)∗ (2) (A) > (B)∗ |
NR |
| Zhu [66] | 120 (60 : 60) |
China | (A) NR (31∼59) (B) NR (33∼58) |
(A) NR (10 days∼3 yr) (B) NR (7 days∼4 yr) |
Modified DXT + (B) | MT: Tuina (1 time/day) | 2 weeks | NR | (1) SS (2) RVA-BF (3) LVA-BF (4) BA-BF (5) TER |
(1) (A) < (B)† (2) (A) > (B)† (3) (A) > (B)† (4) (A) > (B)∗ (5) (A) > (B)∗ |
NR |
| Zhu [67] | 60 (30 : 30) |
China | (A) 45.5 ± 3.4 (20∼67) (B) 42.3 ± 2.1 (21∼65) |
(A) NR (5 days∼9 yr) (B) NR (7 days∼10 yr) |
Modified GGT + (B) | AT (1 time/day) | 2 weeks | NR | (1) SS (2) TER |
(1) (A) > (B)∗ (2) (A) > (B)∗ |
NR |
Significant differences between the two groups are indicated as follows: ∗p < 0.05 and †p < 0.01. Insignificant differences between the two groups (p > 0.05) are indicated by N.S. AD, anti-vertigo drug; AE, adverse events; AT, acupuncture therapy; BA-BF, basilar artery blood flow; BBTT, Banxia Baizhu Tianma Tang; BYT, Buzhong Yiqi Tang; CGD, cervicogenic dizziness; CGRP, calcitonin gene-related peptide; DXT, Dingxuan Tang; ET, endothelin; Fib, fibrinogen; GGT, Gegen Tang; GJT, Gegen Jieji Tang; LVA-BF, left vertebral artery blood flow; MT, manual therapy; NR, not reported; OFS, Overall functional score; RVA-BF, right vertebral artery blood flow; SS, simple score; TC, total cholesterol; TER, total effective rate; and YCT, Yiqi Congming Tang.