Acupuncture for Post-Stroke Spastic Hemiplegia: A Dual-Dimensional Evidence Synthesis Combining Bibliometric and Meta-Analysis

Purpose: This study aims to systematically evaluate the therapeutic effects of acupuncture on spastic hemiplegia after stroke and to reveal research trends and hotspots through bibliometric analysis. Materials and Methods: A total of 45 relevant randomized controlled trials published between 2000 and 2024 were included, and analyzed using tools such as VOSviewer, CiteSpace, RevMan 5.4, and Stata 17. Results: The results showed that the acupuncture treatment group significantly reduced muscle tone compared with the control group (MD = -0.52, 95% CI = -0.78 to -0.26, P < 0.001), improved motor function (MD = 8.32, 95% CI = 5.11 to 11.53, P < 0.001), and enhanced quality of life (MD = 12.15, 95% CI = 7.89 to 16.41, P < 0.001). Electroacupuncture was found to be more effective than traditional acupuncture, and treatment schemes lasting ≥4 weeks were more effective. Bibliometric analysis indicated that research hotspots in this field have shifted from "acupoint specificity" and "single-session efficacy evaluation" in the early years to "optimization of electroacupuncture parameters," Conclusions: "neural mechanisms," and "multimodal efficacy evaluation" in recent years, with China being the leading research country. The results of this study provide high-quality evidence for clinical practice, supporting electroacupuncture as the preferred treatment option for spastic hemiplegia after stroke, and recommending its combination with conventional rehabilitation therapies for a treatment duration of ≥4 weeks. Moreover, the study also provides references for future research directions, including the determination of optimal acupuncture parameters, exploration of neurobiological mechanisms, development of intelligent acupuncture devices, and strengthened international cooperation.