The Therapeutic Role of Acupuncture in Endometriosis-Related Pain Management: A Systematic Review and Meta-Analysis Protocol

Background: Pain is the most common and debilitating symptom of endometriosis. Unrelieved pain can deprive female patients of comfort and severely impair their quality of life and psychological health. The limitations of currently available pharmacologic treatment options make the treatment of endometriosis-related pain (ERP) a great challenge. Acupuncture has shown great potential in the management of ERP, but convincing evidence is still lacking. This systematic review aims to synthesise the latest available evidence regarding the clinical efficacy and safety of acupuncture for ERP. Methods: A systematic literature search of seven online databases will be conducted from its inception to July 2023, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, SinoMed, VIP Database, and Wanfang Database. Randomised controlled trials (RCTs) investigating the efficacy of acupuncture for ERP and meeting our predefined eligibility criteria will be included. The primary outcome of this study is the change in ERP as assessed by a validated scale, and secondary outcomes include patient quality of life, serum CA-125 levels, and adverse events. Study screening and data extraction will be conducted independently by two reviewers. The quantitative synthesis of data will be performed through RevMan 5.4 software. If applicable, subgroup analyses and sensitivity analyses will be conducted to identify potential causes of heterogeneity. The strength of evidence will be graded through the GRADE system. Discussion: This study will critically synthesise the evidence regarding the efficacy and safety of acupuncture for the treatment of ERP. The findings will influence evidence-based management decisions for clinicians in the treatment of ERP. PROSPERO registration number CRD42023442373.