Efficacy and safety of acupuncture for septic gastrointestinal dysfunction: a systematic review and meta-analysis of randomized controlled trials.

Background: Septic gastrointestinal dysfunction (S-GID) lacks effective therapeutic approaches. Acupuncture has been widely used to treat S-GID; however, its efficacy and safety lack high-quality evidence-based support, particularly from randomized controlled trials (RCTs). Methods: A comprehensive search of PubMed, Embase, The Cochrane Library, and four other Chinese databases was conducted for all years up to September 2023 of acupuncture for S-GID. Additionally, research progress was reviewed in the Chinese Clinical Trials Registry and ClinicalTrials.gov. The analysis was conducted using RevMan5.3 and STAT13.1. Continuous data were evaluated by the mean difference (MD)/the standard mean difference (SMD) and 95% confidence intervals (CIs). Dichotomous data were used to calculate the relative risk (RR)/the odds ratio (OR) with 95% CI. The quality of the data was assessed using the Risk of Bias Tool 2 and the GRADEpro GDT tool. Results: Thirteen RCTs with 865 patients were included for the analysis. Compared with the group of the standard treatment, the combination of acupuncture and the standard treatment for S-GID effectively reduced the intra-abdominal pressure (IAP; SMD = -0.71; 95% CI: -1.01, -0.41, Conclusion: This study indicated that, in S-GID patients, combining conventional treatment with acupuncture may reduce IAP, AP value, and AGI grade, increase FOB values, and lower the APACHE II score with good safety. However, the 28-day mortality data showed no significant difference, likely due to insufficient sample size. A multicenter, randomized, double-blind controlled study is required for further confirmation. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42022375480, identifier PROSPERO (CRD42022375480).