Acupuncture Combined with Banxia Baizhu Tianma Tang for Cervical Vertigo

Cervical vertigo (CV) is caused by organic or functional changes in the cervical spine and surrounding soft tissues that stimulate and compress peripheral nerves and blood vessels. The lifetime prevalence of CV is 20–30%, and the annual incidence is up to 1.5%. Acupuncture combined with Banxia Baizhu Tianma Tang can significantly improve vertigo symptoms, function, and mean blood flow velocity (Vm) of the vertebrobasilar artery in patients with CV. However, no relevant meta-analysis or systematic review has been conducted to support this finding. This meta-analysis aimed to evaluate the efficacy of acupuncture combined with Banxia Baizhu Tianma Tang (a decoction of Pinellia ternata, Atractylodes, and Gastrodia elata) for the treatment of CV. Nine electronic databases were searched from their inception until June 30, 2025. Review Manager 5.4 software was used for data analysis. The results were verified using trial sequential analysis. Sensitivity analysis was performed for heterogeneity (I2 ≥ 50%). A funnel plot was used to assess publication bias. Eleven studies involving 859 patients were analyzed. The meta-analysis showed that acupuncture combined with Banxia Baizhu Tianma Tang significantly improved the evaluation scale for CV score, dizziness handicap inventory score, left vertebral artery Vm, right vertebral artery Vm, basilar artery Vm, and overall efficacy rate compared with controls. While the trial sequential analysis results suggested that the findings were stable, the Z-curve did not cross the required information size, indicating that additional studies are needed. The asymmetry of the funnel plot suggested potential publication bias. Insufficient blood supply to the vertebral artery is closely related to the occurrence of CV. This study indicates that acupuncture combined with Banxia Baizhu Tianma Tang Decoction is beneficial for patients with CV and is associated with improved vertebral artery blood supply. This study suggests that acupuncture combined with Banxia Baizhu Tianma Tang may improve vertigo symptoms, functional outcomes, vertebrobasilar blood flow, and overall effectiveness in patients with CV, with acceptable safety.