Acupuncture-induced pain relief and anti-inflammatory effects in chronic pelvic inflammatory disease: a systematic review and meta-analysis.

OBJECTIVE: To systematically evaluate the effects of acupuncture and moxibustion on pain relief, inflammatory biomarkers, and reproductive outcomes in patients with chronic pelvic inflammatory disease (CPID). METHOD: A systematic search was conducted in PubMed, Embase, Cochrane Library, CNKI, and Wanfang for studies published between January 2010 and December 2023. Randomized controlled trials (RCTs) comparing acupuncture with sham/conventional control interventions in CPID patients were included. The primary outcomes included pain intensity (visual analog scale, VAS), inflammatory biomarkers (C-reactive protein [CRP], interleukin-6 [IL-6], tumor necrosis factor alpha [TNF-α]), and CPID specific indicators (fallopian tube patency and pelvic mass regression). Data were analyzed using a random-effects model (RevMan 5.3/Stata 16). RESULT: Thirteen RCTs involving 658 patients were included. Acupuncture significantly reduced pain intensity (standardized mean deviation [SMD]=-1.42, 95% confidence interval [CI]: -1.66 to -1.18), CRP (SMD=-3.89), IL-6 (SMD=-5.00), TNF-α (SMD=0.60) (all P<0.001). CPID-specific outcomes were improved, with higher rates of fallopian tube patency (hazard ratio [RR] =1.35) and pelvic mass regression (RR=1.44; both P<0.01). Moreover, acupuncture improved quality of life (SMD=0.55, P<0.0001), increased pregnancy rate (RR=1.32), and reduced recurrence rates (RR=0.68; both P<0.05). Electroacupuncture combined with herbal medicine (≥8 weeks) showed the most pronounced therapeutic benefits. CONCLUSION: Electroacupuncture combined with herbal medicine significantly alleviates pelvic pain, reduces systemic inflammation, and enhances reproductive outcomes in patients with CPID.