Improvement of endocrine and metabolic conditions in patients with polycystic ovary syndrome through acupuncture and its combined therapies: a systematic review and meta-analysis

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder among women of reproductive age that significantly impacts their reproductive health. Acupuncture and its combined therapies may have beneficial effects on the endocrine and metabolic states of women with PCOS. This systematic review and meta-analysis evaluated the treatment effects and potential mechanisms of acupuncture and its combined therapies compared to oral metformin in treating PCOS patients. The evaluation focused on three sets of outcomes: hormonal indicators, metabolic indicators, and body weight indicators. Studies that involved additional therapies beyond the specified interventions or included patients with other diseases were excluded. Additionally, data mining methods were used, including frequency statistics to analyze the frequency of acupuncture points and the meridians involved, and the Apriori algorithm to perform association rule analysis for the most effective interventions. The study included 46 articles (51 studies) involving six interventions: acupuncture combined with metformin, acupuncture treatment, acupuncture with Chinese herbal medicine and metformin, acupuncture with Chinese herbal medicine, acupuncture combined with cupping, and auricular acupuncture combined with metformin showed significant improvements in all evaluated indicators. Data mining revealed the Stomach meridian of foot yangming was the most frequently used, and the most commonly used combination of points included CV4, SP6, and ST36. This study suggests that acupuncture and its combined therapies may benefit PCOS. However, risk of bias and heterogeneity observed were noted. Future high-quality, rigorously designed randomized controlled trials are needed to confirm these findings and provide stronger clinical recommendations for acupuncture in PCOS treatment.

多囊卵巢综合征（Polycystic Ovary Syndrome，PCOS）是育龄女性群体中常见的内分泌紊乱性疾病，对其生殖健康具有显著负面影响。针灸及其联合疗法或可改善PCOS患者的内分泌与代谢状态。本项系统评价与荟萃分析对比了针灸及其联合疗法与口服二甲双胍治疗PCOS患者的临床疗效及潜在作用机制。本次评价聚焦三类核心结局指标：激素指标、代谢指标及体质量指标。本研究排除了两类研究：一是涉及指定干预措施以外附加疗法的研究，二是纳入合并其他疾病患者的研究。此外，本研究采用了数据挖掘分析方法，包括通过频数统计剖析穴位及所涉经脉的使用频次，并借助Apriori算法针对最优干预方案开展关联规则分析。本研究共纳入46篇文献（合计51项研究），涉及6种干预方式：针灸联合二甲双胍、单纯针灸治疗、针灸联合中药与二甲双胍、针灸联合中药、针灸联合拔罐，以及耳穴疗法联合二甲双胍。上述干预方式均可显著改善所有评估指标。数据挖掘结果显示，足阳明胃经为使用频次最高的经脉，临床最常用的穴位组合为关元（CV4）、三阴交（SP6）与足三里（ST36）。本研究表明，针灸及其联合疗法或可使PCOS患者获益，但本研究仍存在偏倚风险与异质性问题。未来亟需开展高质量、设计严谨的随机对照试验，以验证上述研究结论，并为针灸治疗PCOS提供更具说服力的临床推荐依据。