Global acupuncture randomized controlled trials: Evaluating status, guideline impact, and future research trends

This study aims to evaluate the current state of acupuncture randomized controlled trials (RCTs), their impact on guidelines, and future development trends, providing a reference for future research directions. Search for acupuncture-related RCT articles in the Web of Science Core Collection and confirm their guideline inclusion on Google Scholar. Analyze study characteristics to predict future research directions. The analysis covered 1,422 articles, reflecting a substantial rise in publications from 77 articles between 1993 and 2002 to 960 between 2013 and 2022. The Western Pacific region led in publication numbers with 622 articles (43.7%), followed by Europe (466 articles; 32.8%), Americas (250 articles; 17.6%), Eastern Mediterranean (62 articles; 4.4%), and Southeast Asia (22 articles; 1.5%), with Africa showing a research void. Regrettably, only 29.6% (421 articles) were incorporated into guidelines. The low rate of inclusion of research results in guidelines and the uneven distribution of research fields are particularly prominent. From 1993 to 2002, there were 77 articles, among which 51 (66.2%) were included in the guidelines; from 2003 to 2012, there were 385 articles, with 202 (52.5%) included; from 2013 to 2022, there were 960 articles, and only 168 (17.5%) were included, showing a decreasing trend in the inclusion rate year by year. Regarding geographical distribution, 1,167 articles were from the Eastern Hemisphere, with 326 (27.9%) included; 255 were from the Western Hemisphere, and 95 (37.3%) were included. Regionally, 179 articles (42.5%) from Europe were included, 140 (33.3%) from the Western Pacific, 95 (22.6%) from the Americas, 6 (1.4%) from the Eastern Mediterranean, and 1 (0.2%) from Southeast Asia. China, the United States, and Germany were the top publishing countries, with consistent growth in countries like China, South Korea, Spain, Brazil, Turkey, and Iran. Noteworthy researchers such as Cesar Fernandez-de-las-Penas, Zhi-shun LIU, Jing-wen YANG, Cun-zhi LIU, Li-xing LAO, Stefan N Willich, and Benno Brinkhaus have collaborated on research in areas such as pain management, cognitive impairments, insomnia, digestive system diseases, and urinary system diseases. There has been a particular increase in research focus on neck pain and myofascial trigger points. Despite the growth in acupuncture RCTs, their impact on revising medical guidelines remains disproportionate. The skewed geographic distribution underscores the urgent need for more comprehensive, regionally-targeted trials to foster globally applicable outcomes. 本研究旨在评估针灸随机对照试验 (RCT) 的现状,其对指南的影响以及未来发展趋势, 为后续研究方向提供参考. 在Web of Science核心合集中检索针灸相关RCT文献, 并通过Google Scholar确认其被指南收录情况.通过分析研究特征预测未来研究方向. 本次分析涵盖1,422篇文献, 反映出论文发表量从1993-2002年间的77篇显著增长至2013-2022年间的960篇.西太平洋地区以622篇 (43.7%) 的发表量领先, 其次为欧洲 (466篇;32.8%) ,美洲 (250篇;17.6%) ,东地中海地区 (62篇;4.4%) 和东南亚 (22篇;1.5%) , 而非洲地区呈现研究空白.遗憾的是, 仅29.6% (421篇) 的文献被纳入指南.研究成果纳入指南的比例偏低与研究领域分布不均的现象尤为突出.1993-2002年间77篇文献中有51篇 (66.2%) 被纳入指南;2003-2012年385篇中202篇 (52.5%) 被纳入指南;2013-2022年960篇中仅168篇 (17.5%) 被纳入指南, 呈现逐年递减趋势.地域分布方面, 东半球1,167篇文献中有326篇 (27.9%) 被纳入指南, 西半球255篇中95篇 (37.3%) 被纳入指南.分区域看, 欧洲179篇 (42.5%) ,西太平洋140篇 (33.3%) ,美洲95篇 (22.6%) ,东地中海6篇 (1.4%) ,东南亚1篇 (0.2%) 被纳入指南.中国,美国和德国是发文量前三的国家, 中国,韩国,西班牙,巴西,土耳其和伊朗等国持续保持增长态势.塞萨尔·费尔南德斯-德拉斯-佩尼亚斯,刘志顺,杨静雯,刘存志,劳力行,斯特凡·N·威利希和本诺·布林克豪斯等知名学者在疼痛管理,认知障碍,失眠症,消化系统疾病和泌尿系统疾病等领域开展合作研究.值得注意的是, 针对颈痛和肌筋膜触发点的研究关注度显著提升. 尽管针灸随机对照试验数量有所增长, 但其对修订医疗指南的影响力仍不相称.这种不均衡的地理分布凸显出亟需开展更具综合性,针对特定区域的临床试验, 以推动形成全球适用的研究成果.