Efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis: a systematic review and meta-analysis of randomized controlled trials

ObjectiveTo systematically evaluate the efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis (OP) through a comprehensive synthesis of recent randomized controlled trial (RCT) evidence.MethodsA systematic literature search was conducted across PubMed, Web of Science, CNKI, and...

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Main Authors: Zixin Teng, Jingwei Zhu, Kuiwu Li, Tingting Tong, Wei Li, Haoran Chu, Peiyang Sun
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1561344/full
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author Zixin Teng
Jingwei Zhu
Kuiwu Li
Tingting Tong
Wei Li
Haoran Chu
Peiyang Sun
author_facet Zixin Teng
Jingwei Zhu
Kuiwu Li
Tingting Tong
Wei Li
Haoran Chu
Peiyang Sun
author_sort Zixin Teng
collection DOAJ
description ObjectiveTo systematically evaluate the efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis (OP) through a comprehensive synthesis of recent randomized controlled trial (RCT) evidence.MethodsA systematic literature search was conducted across PubMed, Web of Science, CNKI, and Wanfang databases (2014 – 2024) to identify RCTs investigating acupuncture combined with conventional therapy for OP. Study quality was appraised using the Cochrane Risk of Bias tool, and meta-analyses were performed using RevMan 5.4 and Stata 15.0, with subgroup analyses stratified by intervention type, population characteristics, and treatment duration.Results28 RCTs (n=2,758) were included. Meta-analysis revealed acupuncture significantly enhanced bone mineral density (BMD) versus controls: total (SMD = 0.47, p = 0.03), femoral neck (MD = 0.05, p = 0.01), lumbar spine (SMD = 0.40, p < 0.001), Ward’s triangle (MD = 0.07, p = 0.02), and hip (SMD = 0.55, p < 0.001), with particularly marked improvements in the postmenopausal osteoporosis subgroup. Acupuncture demonstrated significant improvements in treatment efficacy, biochemical markers, pain scores, and symptom assessments, while reducing adverse events. Warm needle moxibustion outperformed controls in femoral neck (MD = 0.07, p = 0.002) and hip BMD (SMD = 0.87, p < 0.001), while electroacupuncture significantly elevated serum calcium (MD = 0.18, p = 0.02). Short-term interventions (≤ 3 months) demonstrated optimal efficacy.ConclusionAcupuncture demonstrates efficacy and safety as an OP adjuvant therapy. Current evidence is limited by regional bias and methodological heterogeneity. Multicenter, large-sample RCTs are needed to standardize protocols and validate long-term therapeutic efficacy.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024499354.
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spelling doaj-art-6ca398bd38a74f09a9302fe85e0fa9352025-08-20T02:28:20ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-05-011610.3389/fendo.2025.15613441561344Efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis: a systematic review and meta-analysis of randomized controlled trialsZixin Teng0Jingwei Zhu1Kuiwu Li2Tingting Tong3Wei Li4Haoran Chu5Peiyang Sun6Second Clinical Medical College of Anhui University of Traditional Chinese Medicine, Hefei, ChinaSecond Clinical Medical College of Anhui University of Traditional Chinese Medicine, Hefei, ChinaSecond Clinical Medical College of Anhui University of Traditional Chinese Medicine, Hefei, ChinaDepartment of Encephalopathy, Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, ChinaDepartment of Encephalopathy, Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, ChinaMingyi Hall, Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, ChinaDepartment of Encephalopathy, Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, ChinaObjectiveTo systematically evaluate the efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis (OP) through a comprehensive synthesis of recent randomized controlled trial (RCT) evidence.MethodsA systematic literature search was conducted across PubMed, Web of Science, CNKI, and Wanfang databases (2014 – 2024) to identify RCTs investigating acupuncture combined with conventional therapy for OP. Study quality was appraised using the Cochrane Risk of Bias tool, and meta-analyses were performed using RevMan 5.4 and Stata 15.0, with subgroup analyses stratified by intervention type, population characteristics, and treatment duration.Results28 RCTs (n=2,758) were included. Meta-analysis revealed acupuncture significantly enhanced bone mineral density (BMD) versus controls: total (SMD = 0.47, p = 0.03), femoral neck (MD = 0.05, p = 0.01), lumbar spine (SMD = 0.40, p < 0.001), Ward’s triangle (MD = 0.07, p = 0.02), and hip (SMD = 0.55, p < 0.001), with particularly marked improvements in the postmenopausal osteoporosis subgroup. Acupuncture demonstrated significant improvements in treatment efficacy, biochemical markers, pain scores, and symptom assessments, while reducing adverse events. Warm needle moxibustion outperformed controls in femoral neck (MD = 0.07, p = 0.002) and hip BMD (SMD = 0.87, p < 0.001), while electroacupuncture significantly elevated serum calcium (MD = 0.18, p = 0.02). Short-term interventions (≤ 3 months) demonstrated optimal efficacy.ConclusionAcupuncture demonstrates efficacy and safety as an OP adjuvant therapy. Current evidence is limited by regional bias and methodological heterogeneity. Multicenter, large-sample RCTs are needed to standardize protocols and validate long-term therapeutic efficacy.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024499354.https://www.frontiersin.org/articles/10.3389/fendo.2025.1561344/fullacupunctureosteoporosisadjuvant therapymeta-analysissystematic review
spellingShingle Zixin Teng
Jingwei Zhu
Kuiwu Li
Tingting Tong
Wei Li
Haoran Chu
Peiyang Sun
Efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis: a systematic review and meta-analysis of randomized controlled trials
Frontiers in Endocrinology
acupuncture
osteoporosis
adjuvant therapy
meta-analysis
systematic review
title Efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis: a systematic review and meta-analysis of randomized controlled trials
title_full Efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis: a systematic review and meta-analysis of randomized controlled trials
title_fullStr Efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis: a systematic review and meta-analysis of randomized controlled trials
title_short Efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis: a systematic review and meta-analysis of randomized controlled trials
title_sort efficacy and safety of acupuncture as an adjuvant therapy for osteoporosis a systematic review and meta analysis of randomized controlled trials
topic acupuncture
osteoporosis
adjuvant therapy
meta-analysis
systematic review
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1561344/full
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