Improvement of Acupuncture Therapy on Relapse of Patients with Gouty Arthritis: A Pairwise and Bayesian Network Meta-analysis

Objective: The aim of this study is to investigate the impact of acupuncture therapy on relapse of patients with gouty arthritis (GA). Methods: "gout OR gouty arthritis" AND "acupuncture therapy OR acupuncture OR moxibustion OR electroacupuncture OR fire needle OR acupotomology OR blood-letting puncture OR plum blossom needle" were used as search strategies for searching related studies. Twenty-two studies involving 2394 patients were enrolled in this research through the analysis of databases of CNKI, Wanfang, VIP, PubMed, Embase and Cochrane Library. Results: The results of pairwise meta-analysis and network meta-analysis (NMA) indicated that patients with acupuncture therapy had a significantly lower relapse rate (RR) compared with those without acupuncture therapy (OR = 0.21, 95% CI: 0.16-0.26, P < 0.00001); the follow-up time (TFU) and serum urate concentration (SUA) before treatment had no significant effect on the reduction of RR caused by acupuncture therapy ( P > 0.05); and patients treated with acupuncture plus Western medicine (WM) had the lowest RR (surface under the cumulative acupuncture therapy ( P > 0.05); and patients treated with acupuncture plus Western medicine (WM) had the lowest RR (surface under the cumulative ranking [SUCRA] = 85.0%), followed by acupuncture plus traditional Chinese medicine (TCM, SUCRA = 73.5%), acupuncture only (SUCRA = 72.8%), fourthly acupuncture plus TCM and WM (SUCRA = 33.0%), then TCM (SUCRA = 28.7%), finally WM (SUCRA = 7.0%). Conclusion: Our finding may facilitate the application of acupuncture therapy in patients with GA. Our research also offered some information for the future research.