# Efficacy and safety of acupuncture for functional dyspepsia: an updated meta-analysis of randomized controlled trials

## TL;DR

Acupuncture likely improves symptoms and quality of life for people with functional dyspepsia compared to sham treatments, no treatment, and certain medications.

## Contribution

An updated meta-analysis provides high to moderate certainty evidence on acupuncture's efficacy for functional dyspepsia.

## Key findings

- Acupuncture improves FD symptoms and quality of life compared to sham acupuncture without increasing adverse events.
- Acupuncture outperforms no treatment or usual care in improving FD symptoms.
- Acupuncture may improve quality of life compared to prokinetic medications.

## Abstract

Acupuncture has been used for the treatment of functional dyspepsia (FD); however, its effects remain uncertain. We aimed to assess the efficacy and safety of acupuncture for FD using systematic review and meta-analysis of randomized trials (RCTs).

We searched six databases and two trial registries up to March 13, 2025. Paired reviewers screened literature, extracted data, and assessed the risk of bias. We performed meta-analyses using random-effects models and assessed the certainty of the evidence using GRADE approach.

We included 23 RCTs (2,454 participants). Compared to sham acupuncture, high to moderate certainty evidence shows that acupuncture probably improves FD symptoms (weighted mean difference [WMD] −14.46 points on the 195-point NDSI, 95% CI −16.31 to −12.62) and quality of life (WMD 10.39 points on the 100-point NDLQI, 95% CI 7.06 to 13.73) without an increase in adverse events (relative risk 1.15, 95% CI 0.63, 2.09). Compared to no treatment or usual care, moderate certainty evidence shows that acupuncture probably improves FD symptoms (WMD −20.19 points on the 195-point NDSI, 95% CI −30.22 to −10.15). When compared with prokinetics (itopride, mosapride, and domperidone), acupuncture probably improves quality of life (WMD 5.69 points on the 100-point NDLQI, 95% CI 4.36 to 7.02) and may improve FD symptoms (WMD −17.40 points on the 195-point NDSI, 95% CI −29.08 to −5.72).

Acupuncture probably improves FD symptoms and quality of life when compared with sham acupuncture, no treatment or usual care, and prokinetics.

https://doi.org/10.1002/14651858.CD008487