Efficacy of Filiform Fire Needle for Poststroke Shoulder–Hand Syndrome: A Meta-Analysis of Randomized Controlled Trials

Objective This study aimed to systematically review the clinical efficacy of filiform fire needle in treating poststroke shoulder–hand syndrome (PSSHS). Methods Randomized controlled trial (RCT) articles were retrieved from databases including China National Knowledge Infrastructure (CNKI), Wanfang, SinoMed, VIP, PubMed, Embase, Cochrane Library, and Web of Science, from their inception to July 18, 2025. Data extraction was performed on the included studies, followed by risk-of-bias assessment and meta-analysis using RevMan 5.4.1 and Stata 15.1 software. Results A total of 11 RCT articles were included, involving 812 patients. The results of the meta-analysis showed the following: (1) The total clinical efficacy rate of the experimental group was higher than that of the control group [OR = 3.35, 95% confidence interval (CI): 2.24–5.01, P < 0.00001]; (2) the experimental group showed better improvement in the visual analog scale (VAS) score compared with the control group (MD = −1.43, 95% CI: −1.67 to −1.19, P < 0.00001); (3) the simplified Fugl–Meyer assessment upper extremity scale (FMA-UE) score in the experimental group improved better than that of the control group (MD = 7.06, 95% CI: 5.81 to 8.31, P < 0.00001); (4) the improvement of shoulder–hand syndrome score (SHSS) in the experimental group was better than that in the control group (MD = −1.65, 95% CI:−1.99 to −1.31, P < 0.00001). Conclusion The filiform fire needle shows a definite curative effect in treating PSSHS, which is beneficial for patients in relieving pain, restoring upper limb function, and improving quality of life. More high-quality RCTs are still needed to provide stronger evidence in the future.