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

ObjectiveTo systematically evaluate the effects of acupuncture and moxibustion on pain relief, inflammatory biomarkers, and reproductive outcomes in patients with chronic pelvic inflammatory disease (CPID).MethodA 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).ResultThirteen 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.ConclusionElectroacupuncture combined with herbal medicine significantly alleviates pelvic pain, reduces systemic inflammation, and enhances reproductive outcomes in patients with CPID.