With the change of modern lifestyle and the aggravation of social aging, the incidence of benign prostatic hyperplasia (BPH) is increasing year by year, which has become a major problem threatening the health of middle-aged and elderly men. At present, western medicine is mainly based on surgery and oral drugs treatment, which has certain adverse reactions and complications. However, the clinical application of filiform acupuncture in the treatment of BPH has a significant effect, but there is a lack of evidence-based evidence.

To systematically review the clinical efficacy of acupuncture therapy in treating BPH.

The randomized controlled trials (RCTs) on acupuncture for BPH were retrieved from CNKI, VIP, Wanfang Data, SinoMed, PubMed and Cochrane Library by computer from inception to October1, 2021, including the experimental group treated by acupuncture, with or without the drugs used in the control group and the control group treated by conventional western medicine. According to inclusion and exclusion criteria, the literature was extracted and evaluated by using RevMan 5.3 software.

A total of 17 articles and 1 547 patients were included. Meta-analysis results showed that the clinical effective rate and maximum urinary flow rate (Qmax) of the experimental group were higher than those of the control group〔OR=3.21, 95%CI (2.25, 4.57) , P<0.000 01; MD=2.48, 95%CI (1.26, 3.70) , P<0.000 1〕. The international prostate symptom score (IPSS) , residual urine volume (PVR) , prostate volume (PV) , and quality of life (QOL) score in the experimental group were lower than those in the control group〔MD=-2.39, 95%CI (-3.84, -0.94) , P=0.001; MD=-10.59, 95%CI (-15.20, -5.98) , P<0.000 01; MD=-3.50, 95%CI (-5.07, -1.93) , P<0.000 1; MD=-0.68, 95%CI (-0.99, -0.37) , P<0.000 1〕. The clinical effective rate and Qmax of acupuncture alone in treating BPH were higher than those of western medicine〔OR=3.53, 95%CI (2.20, 5.68) , P<0.000 01; MD=2.75, 95%CI (1.62, 3.88) , P<0.000 01〕. The PVR, PV and QOL of acupuncture alone in treating BPH were lower than those of western medicine〔MD=-9.41, 95%CI (-15.87, -2.94) , P=0.004; MD=-2.99, 95%CI (-4.86, -1.12) , P=0.002; MD=-0.74, 95%CI (-1.33, -0.15) , P=0.01〕. The clinical effective rate of acupuncture+western medicine for BPH was higher than that of western medicine〔OR=2.84, 95%CI (1.67, 4.82) , P=0.000 1〕; IPSS, PVR, PV and QOL of acupuncture+western medicine for BPH were lower than that of western medicine〔MD=-2.88, 95%CI (-3.43, -2.32) , P<0.000 01; MD=-12.25, 95%CI (-16.92, -7.57) , P<0.000 01; MD=-4.41, 95%CI (-8.03, -0.79) , P=0.02; MD=-0.59, 95%CI (-1.03, -0.15) , P=0.008〕. There were no obvious adverse reactions in both groups. The sensitivity analysis of IPSS, Qmax, PVR, PV and QOL results showed that the change effect model had no significant effect on the combined results. Funnel plot analysis was performed on RCTs of clinical response rate, IPSS, Qmax, PVR, and QOL, and the results showed that the funnel diagram of clinical response rate was basically symmetrical on both sides. The funnel plots of IPSS, Qmax, PVR, and QOL were scattered, and there was publication bias.

Based on the current clinical evidence, the clinical efficacy and Qmax of acupuncture therapy for BPH were higher than those of the control group, and the IPSS, PVR, PV, and QOL were lower than those of the control group. Since funnel plots of IPSS, Qmax, PVR and QOL are scattered and have publication bias, the results of this study need further verification.

随着现代生活方式的改变及社会老龄化的加剧，良性前列腺增生（BPH）的发病率逐年增高，已成为威胁中老年男性健康的主要问题，目前西医多以手术及口服药物治疗，存在一定的不良反应及并发症，而临床应用毫针针刺治疗BPH疗效显著，但缺乏循证依据。

系统评价针刺疗法治疗BPH的临床疗效。

计算机检索中国知网、维普网、万方数据知识服务平台、中国生物医学文献服务系统、PubMed、Cochrane Library数据库，搜集关于针刺疗法治疗BPH的随机对照试验（RCT）：试验组为针刺疗法，配合或不配合对照组所用药物；对照组为常规西药治疗。检索时间为建库至2021-10-01。由2名研究者依据纳入与排除标准，独立筛选文献，提取评估，采用RevMan 5.3软件进行Meta分析。

共纳入17篇文献，1 547例患者。Meta分析结果显示，试验组临床有效率、最大尿流率（Qmax）高于对照组〔OR=3.21，95%CI（2.25，4.57），P<0.000 01；MD=2.48，95%CI（1.26，3.70），P<0.000 01〕；试验组国际前列腺症状评分（IPSS）、残余尿量（PVR）、前列腺体积（PV）、生活质量指数评分（QOL）低于对照组〔MD=-2.39，95%CI（-3.84，-0.94），P=0.001；MD=-10.59，95%CI（-15.20，-5.98），P<0.000 01；MD=-3.50，95%CI（-5.07，-1.93），P<0.000 1；MD=-0.68，95%CI（-0.99，-0.37），P<0.000 1〕。单纯针刺疗法治疗BPH的临床有效率、Qmax高于常规西药治疗〔OR=3.53，95%CI（2.20，5.68），P<0.000 01；MD=2.75，95%CI（1.62，3.88），P<0.000 01〕；单纯针刺疗法治疗BPH的PVR、PV、QOL低于常规西药治疗〔MD=-9.41，95%CI（-15.87，-2.94），P=0.004；MD=-2.99，95%CI（-4.86，-1.12），P=0.002；MD=-0.74，95%CI（-1.33，-0.15），P=0.01〕。针刺疗法+常规西药治疗BPH的临床有效率高于常规西药治疗〔OR=2.84，95%CI（1.67，4.82），P=0.000 1〕；针刺疗法+常规西药治疗BPH的IPSS、PVR、PV、QOL低于常规西药治疗〔MD=-2.88，95%CI（-3.43，-2.32），P<0.000 01；MD=-12.25，95%CI（-16.92，-7.57），P<0.000 01；MD=-4.41，95%CI（-8.03，-0.79），P=0.02；MD=-0.59，95%CI（-1.03，-0.15），P=0.008〕。两组均无明显不良反应发生。对IPSS、Qmax、PVR、PV、QOL 5个结局指标分别进行敏感性分析，发现改变效应模型对合并结果影响不明显。对临床有效率、IPSS、Qmax、PVR、QOL的RCT进行漏斗图分析，结果显示，临床有效率的漏斗图双侧基本对称；IPSS、Qmax、PVR、QOL的漏斗图较为分散，存在发表偏倚。

基于当前临床证据，针刺疗法治疗BPH的临床有效率和Qmax高于对照组，IPSS、PVR、PV、QOL低于对照组。因IPSS、Qmax、PVR、QOL的漏斗图提示存在发表偏倚，本研究的结果还需进一步验证。