# The efficacy of acupuncture and related treatments on chronic pelvic inflammatory disease: a network meta-analysis

**Authors:** Yitong Zheng, Jintao He, Yijun Zheng, Dongyi Ni, Yong Wang

PMC · DOI: 10.3389/fmed.2025.1731543 · 2026-01-12

## TL;DR

This study compares acupuncture and related treatments for chronic pelvic inflammatory disease, finding some more effective than conventional methods.

## Contribution

A network meta-analysis comparing multiple acupuncture therapies for chronic pelvic inflammatory disease and their effects on inflammatory factors.

## Key findings

- Moxibustion combined with warm needle therapy showed the highest total effectiveness (89.1%).
- Acupoint injection was best for regulating TNF-α (95.8%) and CRP (99.4%).
- Conventional treatment had the lowest effectiveness (0.2%).

## Abstract

To compare the efficacy of different acupuncture and related therapies for chronic pelvic inflammatory disease (CPID) and their effects on inflammatory factors via Network Meta-Analysis.

Eight databases were systematically searched (up to April 20, 2025) for randomized controlled trials (RCTs) of acupuncture-related therapies for CPID. Eighty-four RCTs involving 8,147 patients were included. Study quality was assessed using the Cochrane risk-of-bias tool, and data were analyzed with R software.

AI interventions showed higher total effectiveness than conventional treatment. SUCRA rankings for total effectiveness: moxibustion combined with warm needle (89.1%), acupoint application therapy combined with ultrasound drug penetration (88.0%), and acupuncture combined with cupping (86.8%) ranked highest, while conventional treatment was the lowest (0.2%). For inflammatory factors: acupuncture showed the best improvement in IL-2 (61.6%); acupoint injection was optimal for TNF-α regulation (95.8%); moxibustion combined with acupuncture best modulated IL-6 (92.6%); and acupoint injection was best for CRP regulation (99.4%).

Acupuncture and related therapies are effective for CPID, with differences in regulating specific inflammatory factors, providing an evidence-based foundation. However, limitations like publication bias exist, warranting validation by high-quality studies.

https://www.crd.york.ac.uk/prospero/, identifier CRD420250655000.

## Full-text entities

- **Genes:** MTOR (mechanistic target of rapamycin kinase) [NCBI Gene 2475] {aka FRAP, FRAP1, FRAP2, RAFT1, RAPT1, SKS}, IFNG (interferon gamma) [NCBI Gene 3458] {aka IFG, IFI, IMD69}, MOXD1 (monooxygenase DBH like 1) [NCBI Gene 26002] {aka MOX, PRO5780, dJ248E1.1}, CASP1 (caspase 1) [NCBI Gene 834] {aka ICE, IL1BC, P45}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, GSDMD (gasdermin D) [NCBI Gene 79792] {aka DF5L, DFNA5L, FKSG10, GSDMDC1}, TLR4 (toll like receptor 4) [NCBI Gene 7099] {aka ARMD10, CD284, TLR-4, TOLL}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, IL10 (interleukin 10) [NCBI Gene 3586] {aka CSIF, GVHDS, IL-10, IL10A, TGIF}, PIK3CB (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta) [NCBI Gene 5291] {aka P110BETA, PI3K, PI3KBETA, PIK3C1}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, IL2 (interleukin 2) [NCBI Gene 3558] {aka IL-2, TCGF, lymphokine}, NLRP3 (NLR family pyrin domain containing 3) [NCBI Gene 114548] {aka AGTAVPRL, AII, AVP, C1orf7, CIAS1, CLR1.1}
- **Diseases:** infertility (MESH:D007246), chronic (MESH:D002908), chronic pelvic pain (MESH:D011472), pain (MESH:D010146), antibiotic (MESH:D004761), hypersensitivity (MESH:D004342), Inflammatory (MESH:D007249), gouty arthritis (MESH:D015210), AI (MESH:C000719195), tissue damage (MESH:D017695), CPID (MESH:D000292), autoimmune disease (MESH:D001327), soreness (MESH:D063806), chronic pain (MESH:D059350), anti- (MESH:D006679), blood stasis (MESH:D014647)
- **Chemicals:** AI (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12805501/full.md

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Source: https://tomesphere.com/paper/PMC12805501