Table 5.
Summary of included interventional studies.
| Author (year); study design | Intervention, frequency; duration | Acupoints | Outcomes | Significant findings | |
|---|---|---|---|---|---|
| Treatment group | Control group | ||||
| Li (2022); RCT | Acupoint paste 1/d, Jianpiyifei decoction 1/d, oral Western medicine; 2 w | Oral Western medicine; 2 w | BL43, ST36, GV13, BL20, SP6 | TCM syndrome score, ER, PaO2, PaCO2, ALSFRS | Improved shortness of breath, dyspnea, fatigue, anorexia, sweating, PaO2, and score of limb symptom and total scores of ALSFRS in treatment group. The total ER in treatment group and control group were 88.46% and 62.50% (P < 0.05) |
| Zhang (2019); RCT | Shallow needling 1/d, Shenqiqiangli capsule 3/d; 20 d | Acupuncture 1/d, Shenqiqiangli capsule 3/d; 20 d | EX-HN14, GB20, CV23, Gongxue, Zhiqiang, Tunyan, Fayin, ST9, LI18, SI17, LI4, ST36, ST40, KI3, LR2, GV15, GV20, CV22, Tounge three needles, Juquan, EX-HN12, EX-HN13 | Water-swallowing test, Frenchay dysarthria assessment, ER, symptoms relief time | The total ER (84.00%) of treatment group was significantly higher than that of control group (60.00%) (P < 0.05); no adverse events |
| Xu (2019); RCT | Riluzole 2/d, acupuncture 2/w; 3 m | Riluzole 2/d; 3 m | GV20, GB20, GV14, GB21, BL13, BL15, BL17, BL18, BL20, BL23, GV3, GB30, KI1, GV24, CV22, CV17, LU2, PC3, PC8, CV14, CV12, CV10, CV6, EX-LE2, GB34, LR3, GV16, GV15, EX-B1, GV12, BL42, GV11, BL44, GV9, BL46, GV7, GV4, GV26, ST7, ST6, CV24, CV23, CV22, ST12, CV17, PC1, LI4, SP6 | Clinical symptoms, ER | The total ER (95.00%) of treatment group was significantly higher than that of control group (50.00%) (P < 0.05) |
| Li (2019); RCT | Acupoint massage 1/d, Jianpiyifei decoction 2/d, oral Western medicine; 3 m | Oral Western medicine; 3 m | BL43, BL20, BL15, GV12, GV13, EX-B1, BL10, BL23 | TCM syndrome score, ALSFRS, Appel scale, EMG | TCM syndrome score ↓, ALSFRS ↑, Apple scale ↓, greater improvement in treatment group (P < 0.05); less denervated potentials and simplex patterns of sternocleidomastoid muscle and biceps brachii muscle in treatment group (p < 0.05) |
| Wei (2018); before-and-after study | Electroacupuncture 1/d, moxibustion 1/d; 4 w | EX-B2, CV4, ST36 | ALSFRS-R, MMT, ER | ER: 29.40%; ALSFRS-R: 23.70 ± 4.34 → 26.40 ± 4.10 (P < 0.05); MMT: 26.47 ± 3.12 → 33.53 ± 3.89 (P < 0.01) | |
| Li (2017); RCT | Vitamin, acupuncture 2/d, stellate ganglion block 1/d; 1 m | Vitamin, acupuncture 2/d; 1m | NR | ER, ADL-Barthel index, neurological deficit score | The total ER (80.00%) of treatment group was significantly higher than that of control group (50.00%) (P < 0.05); ADL-Barthel: control group: 29.50 ± 3.80 → 39.60 ± 3.10, treatment group: 39.30 ± 3.90 → 51.00 ± 2.60 (p < 0.05); neurological deficit score: control group: 21.47 ± 7.14 → 8.60 ± 2.39, treatment group: 21.50 ± 6.83 → 14.00 ± 3.02 (p < 0.05); no adverse events |
| Meng (2017); RCT | Acupuncture 1/d, riluzole 50 mg 2/d; 6 m | Riluzole 50 mg 2/d; 6 m | GV2, GV3, GV4, GV6, GV7, GV8, GV9, GV10, GV11, GV12, GV13, GV14, GV20, GV24 | TCM syndrome score, Appel scale, ER | ER: treatment group: 86.70%, control group: 69.20% (P < 0.05); TCM syndrome score: treatment group: 5.53 ± 3.14↓, control group: 1.08 ± 3.04↓ (P < 0.05); Apple scale: treatment group: 7.08 ± 2.43↓, control group: 5.27 ± 2.09↓ (P < 0.05) |
| Li (2017); RCT | Needle warming through moxibustion 1/d, oral Western medicine; 6 w | Oral Western medicine; 6 w | CV4, CV6, ST36, BL23, BL25 | ADL-Barthel index, ER, NDS | ADL-Barthel: treatment group: 30.56 ± 4.32 → 50.36 ± 5.49, control group: 30.53 ± 4.10 → 30.35 ± 6.18 (P < 0.05); ER: treatment group: 81.81%, control group: 50.00% (P < 0.05); NDS: treatment group: 22.48 ± 7.23 → 8.54 ± 2.38, control group: 22.53 ± 6.73 → 13.80 ± 3.15 (P < 0.05) |
| Sun (2016); RCT | Shenzhejiangqi decoction 3/d, acupuncture 1/d, bloodletting 1/d; 4 w | Shenzhejiangqi decoction 3/d; 4 w | GB20, GV20, CV23, CV12, EX-HN12, EX-HN13 | Water-swallowing test, ER | Treatment group: markedly effective: 15, effective: 20, total ER: 87.50%; control group: markedly effective: 7; effective: 14, total ER: 52.50% (p < 0.05) |
| Wu (2016); RCT | Acupuncture, Gegen injection; NR | Swallowing nerve and muscle electrical stimulator 1~2/d; NR | GV20, KI3, GV4, BL20, GB20, LR3, LI10, PC6, CV17, CV4, SP6, CV6, GV14, LI4, LI11, TE5, ST36 | Water-swallowing test, ER | Treatment group: cured: 11, effective: 14, total ER: 89.29%; control group: cured: 5, effective: 12, total ER: 60.71% (p < 0.05) |
| Zhang (2014); before-and after-study | Vatimin B1 3/d, Mecobalamin, herbal decoction 2/d, acupuncture 1/d, moxibustion 1/d; 2 m | ST36, LI11, LI4, SP9, GB20, BL20, BL23, GV14, EX-B2, CV6, CV4, GV4, ST40, ST44, SP6 | Clinical symptoms, muscle strength, neurological deficit score, sIL-2R, ER | Markedly effective: 18, effective: 12, total ER: 93.75%; neurological deficit score: 13.92 ± 2.10 → 6.33 ± 2.12 (p < 0.01); sIL-2R: 289.25 ± 52.18 → 162.16 ± 30.22 (p < 0.01) | |
| Zhang (2014); RCT | Acupuncture 1/d, Shenzhejiangqi decoction 2/d, dysphagia therapeutic apparatus 1/d; 4 w | Dysphagia therapeutic apparatus 1/d; 4 w | GV20, CV23, GB20, TE17, GB12, CV12, Juquan, EX-HN12, EX-HN13 | Water-swallowing test, ER | ER: 86.67% in treatment group and 43.33% in control group (P < 0.05) |
| Lee (2013); before-and-after study | Sa-am acupuncture 2/d; 5 d | SP3, LU9, HT8, LU10 | EtCO2, SpO2, RR, pulse, K-ALSFRS-R | significant difference in pulse rate and SpO2; patients in earlier stages with high K-ALSFRS-R scores responded better to acupuncture treatment | |
| Zhou (2012); RCT | Acupoint massage 1/d, Yifei decoction 2/d, oral Western medicine; 2 w | Oral Western medicine; 2 w | GV12, GV13, BL15, BL20, BL43, EX-B1, BL10, BL23 | Body temperature, sputum excretion volume, ventilator parameters, sign, SpO2, PaO2, PaCO2, lung X-ray/CT, WBC, CRP, ER | ER: treatment group: 93.74%; control group: 69.24% (P < 0.01); treatment group showed better improvement in sputum excretion volume, ventilator parameters, respiratory function, and blood test (P < 0.05); no adverse events |
| Shen (2012); RCT | Acupoint massage 1/d, Liqitongbian decoction 2/d, oral Western medicine; 2 w | Oral Western medicine; 2 w | CV8, ST25, CV12, CV6, TE6 | Stool frequency and character, ventilator parameters, ER | ER: treatment group: 100%; control group: 83.30% (P < 0.05); stool character and ventilator parameters improved more in treatment group (P < 0.05); 2 cases of diarrhea in treatment group |
| Chen (2012); RCT | Acupoint injection 1/d, moxibustion 1/d, Shengjizhichan decoction 2/d; 12 w | Riluzole 50mg 2/d; 12 w | PC6, ST36, GV20, GV14, GV6, GV4, GV3, BL-meridian | ER, ALSFRS | ER: treatment group: 66.67%; control group: 36.36% (P < 0.05) |
| Yuan (2005); RCT | Acupuncture 2/d, Jiweiling injection 1/d; 4 w | Qingkailing injection 1/d, oral Western medicine; 4 w | PC6, GV26, GV23, GV20, GV29, GB20, TE17, CV23 | Clinical symptoms, ER | ER: treatment group: 88.33%; control group: 5.56% (P < 0.01) |
| Wu (2000); before-and-after study | Acupuncture (shaohuoshan) 1/d in first month, then 1/2d; NR | GV20, BL20, BL23, GV4, KI3, CV17, CV4, CV6, SP6, GV14, LI11, TE5, LI4, ST36, GB20, LI10, PC6, GB34, LR3 | Clinical symptoms, ER | Clinically cured: 15 | |
| Zhao (1999); before-and-after study | Acupuncture 2/d, scalp acupuncture 2/d; 3 m | PC6, GV26, GV23, GV20, GV29, GB20, GB12, BL10, TE17, CV23, Lower 2/5th motor region | Clinical symptoms, ER | ER: 83.33% | |
RCT, randomized controlled trial; TCM, traditional Chinese medicine; ER, effective rate; PaO2, partial pressure of oxygen; PaCO2, partial pressure of carbon dioxide; ALSFRS, Amyotrophic Lateral Sclerosis Functional Rating Scale; EMG, electromyogram; ALSFRS-R, Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised; MMT, Manual Muscle Testing; ADL, Activity of Daily Living; NDS, Neurological Deficiency Score; sIL-2R, soluble interleukin-2 receptor; EtCO2, end-tidal carbon dioxide; SpO2, peripheral oxygen saturation; RR, respiratory rate; K-ALSFRS-R, Korean version of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised; WBC, white blood cell; CRP, C-reactive protein.