Abstract
BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in women. In recent years, traditional Chinese medicine (TCM) treatment has had a positive effect on PCOS, and it is simple, convenient, and inexpensive. The purpose of this study was to compare the efficacy and safety of different external treatments in the treatment of PCOS using a network meta-analysis method. METHODS: The databases examined comprised Web of Science, Embase, PubMed, The Cochrane Library, China National Knowledge Infrastructure, VIP, Wanfang Data Knowledge Service Platform, and the China Biomedical Literature Database. Since the establishment of the database, randomized controlled trials related to TCM external treatment for PCOS have been screened. The literature was derived from follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH ratios, body mass index, and testosterone, with detrimental impacts identified as the primary outcomes of the screening process. Odds ratio values with 95% confidence intervals and standardized mean difference values were used as performance measures to compare the effects of different interventions and rank them. The above data were statistically analyzed using STATA 17.0 software. RESULTS: Electroacupuncture has the highest cumulative probability of increasing FSH levels (surface under the cumulative ranking curve [SUCRA]: 86%) and is considered the best intervention to improve FSH in patients with PCOS. Regulating the conception-governor vessel had the highest cumulative probability of reducing LH levels (SUCRA: 76.6%), making it the best choice for improving LH in PCOS patients. Abdominal acupuncture has the highest cumulative probability (SUCRA: 58.6%) and is therefore the best intervention to improve LH/FSH in patients with PCOS. It also showed the best intervention effect with the highest cumulative probability of reducing testosterone levels (SUCRA: 98.2%). Acupuncture + medication had the highest cumulative probability of reducing body mass index (SUCRA: 98.2%) and was considered the most effective intervention. At the same time, abdominal acupuncture had the highest cumulative probability of adverse effects (SUCRA: 58.6%), indicating that it may be associated with adverse events. CONCLUSION: Different TCM external treatments benefit various PCOS-related indicators. Electroacupuncture, regulating conception-governor vessel, abdominal acupuncture, and acupuncture combined with drugs each excel in specific outcomes. However, abdominal acupuncture may carry a higher risk of adverse events.