The intestinal flora is an important physiological component of the gastrointestinal system and one of the sources of neurotransmitters. About 90% of neurotransmitters in the brain are produced in the human intestine. Poststroke insomnia is caused by damage to the internal and external structures of the brain, characterized by difficulties in falling asleep, shallow sleep, easy awakenings, and challenges in returning to sleep, all impacting patients’ quality of life. Hypnotics have many adverse reactions in the treatment of insomnia, which can lead to drug resistance and relapse. The systematic review and meta-analysis of 41 randomized controlled trials (RCTs) with 3233 patients showed that all the results of RCTs were effective in acupuncture treating poststroke insomnia. Acupuncture regulates the imbalance of intestinal flora and controls the secretion of gut–brain peptides.
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