Effectiveness of acupuncture as auxiliary combined with Western medicine for epilepsy: a systematic review and meta-analysis

Epilepsy is a neurological condition characterized by abnormal electrical discharges in the brain that affects millions of people worldwide, representing approximately 0.5 to 0.7% of the global population. The disease manifests through diverse symptoms such as convulsions, loss of consciousness, involuntary limb movements, and behavioral disturbances. Conventional treatment is based primarily on the use of anticonvulsant medications such as carbamazepine, sodium valproate, and lamotrigine, which control seizures through regulation of ion channels in the nervous system. Although effective, these medications can cause significant side effects such as drowsiness, dizziness, nausea, vomiting, and, in severe cases, liver and kidney damage.

The need for prolonged use also contributes to poor treatment adherence, negatively impacting patients' quality of life.

In this context, Chinese researchers conducted a systematic review and meta-analysis to evaluate the effectiveness of acupuncture as a complementary treatment combined with Western medicine for epilepsy. The primary objective was to analyze whether combining acupuncture with conventional medications offers advantages compared to medication use alone. To this end, the researchers conducted a comprehensive search of multiple electronic databases, including PubMed, Embase, Cochrane Library, and Chinese databases, looking for randomized controlled clinical trials published through April 2023. Inclusion criteria covered studies with patients diagnosed with primary epilepsy who received acupuncture combined with drug treatment, compared with control groups who received only Western medications.

The methodological quality of studies was assessed using standardized risk-of-bias assessment tools.

The analysis encompassed 17 randomized controlled clinical trials, totaling 1,389 participants, with 693 in the experimental group (acupuncture plus medications) and 696 in the control group (medications only). The studies were published between 2014 and 2023, with sample sizes ranging from 40 to 160 participants. Results demonstrated consistent benefits of combined treatment across multiple parameters. The treatment efficacy rate was significantly higher in the group receiving acupuncture combined with medications, with an odds ratio of 4.28 times greater clinical improvement.

Epileptic seizure frequency showed substantial reduction in the experimental group, indicating that acupuncture potentiates the anticonvulsant effect of medications. Additionally, electroencephalogram exams revealed a decrease in the frequency of abnormal electrical discharges in the brain, suggesting improvement in brain electrical activity. Patient quality of life, assessed through epilepsy-specific scales, showed significant improvements in the group receiving combined treatment.

These findings have important implications for both patients and healthcare professionals. For patients, acupuncture represents a complementary therapeutic option that can improve epileptic seizure control while reducing medication adverse effects. The study demonstrated that the combination resulted in lower incidence of side effects compared to medication use alone, with a 62% reduction in the risk of adverse events. This is particularly relevant considering that side effects are one of the main causes of treatment discontinuation in epilepsy.

For healthcare professionals, the results suggest that acupuncture may be considered a safe and effective adjunctive therapeutic modality, especially in settings where traditional Chinese medicine is culturally accepted and practiced. The improvement in quality of life observed is especially significant, as epilepsy frequently impacts multiple dimensions of patients' lives, including physical, emotional, and social aspects.

However, it is crucial to recognize the important limitations of this study that should be considered when interpreting the results. The methodological quality of included studies was classified as low to moderate, with several risks of bias identified. All 17 studies were conducted in China, which may limit the generalizability of results to other populations and cultural settings. Acupuncture implementation varied between studies in aspects such as acupoint selection and manipulation techniques, introducing potential heterogeneity in results.

In addition, the nature of the intervention makes adequate blinding of patients and professionals difficult, which may influence outcome assessment. The patient follow-up period was relatively short in most studies, limiting evaluation of long-term effects of the therapeutic combination.

In conclusion, although results suggest that acupuncture combined with Western medicine may offer benefits in epilepsy treatment, including better seizure control, reduction of adverse effects, and improvement in quality of life, these conclusions should be interpreted with caution due to the methodological limitations identified. The authors emphasize the need for future studies with greater methodological rigor, including larger samples, longer follow-up periods, standardization of acupuncture techniques, and inclusion of geographically more diverse populations. For patients interested in considering acupuncture as a complementary treatment, it is essential to discuss with qualified medical professionals who can individually assess the potential benefits and risks, considering the specific characteristics of each case.