BACKGROUND: Acute ischemic stroke (AIS) is the major type of stroke, which highly risks human health and life quality. Governor vessel acupuncture (GV Ac) is one specific acupoint selection treatment. This study aimed to systematically evaluate the clinical value of GV Ac in AIS patients. METHODS: Seven electronic databases were searched for all related randomized controlled trials before December 2020. The included studies should meet the following criteria: all target patients were diagnosed as AIS; the experimental group used GV Ac as the only intervention or combined with routine neurology therapy as conventional treatment; the control group received ordinary acupuncture, or the same conventional treatment as the experimental group, or both. Evaluated the quality of all included trials and performed a meta-analysis of the extracted data. RESULTS: A total of 18 trials were included, involving 1,543 AIS patients. The results showed compared to the conventional treatment, GV Ac combining with conventional therapy resulted in Barthel Index (BI) (MD 14.16, 95% CI 7.34 to 20.79) improvement, mRS (MD -0.63, 95% CI -0.95 to -0.32, p < 0.0001) decrease, better National Institute of Health Stroke Scale (NIHSS) scores (MD -1.18, 95% CI -1.52 to -0.83), and lower China Stroke Score (CSS)/Modified Edinburgh-Scandinavia Stroke Scale (MESSS) scores (MD -3.77, 95% CI -4.98 to -2.57). Furthermore, GV Ac could better improve activities of daily living (ADL) (MD 8.27, 95% CI 4.29 to 12.26) and neurological deficit scores (NIHSS MD -1.32, 95% CI -2.18 to -0.47; CSS/MESSS MD -4.63, 95% CI -5.91 to -3.35), when compared to the ordinary acupuncture. DISCUSSION: According to the current evidence, GV Ac for AIS's efficacy appears to be better than that of ordinary acupuncture. When combined with conventional treatment, GV Ac may increase the benefit. But limited by the methodological quality of the included studies, more strictly designed large-scale randomized controlled trials are needed. TRIAL REGISTRATION NUMBER: CRD42020203480.

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