BACKGROUND: Comparative study results between the treatment efficiency of acupuncture plus other combination therapy and western medicine therapy in the treatment of knee osteoarthritis remain controversial. Currently, meta-analysis studies mainly focus on comparison of the efficacy between single acupuncture treatment, acupuncture plus western medicine combination therapy and western medicine, but there is a lack of investigation on acupuncture combined with other therapies. It is difficult to fully understand the efficacy of acupuncture. OBJECTIVE(S): To compare the effects of acupuncture therapy, conventional western medicine and Chinese medicine on osteoporosis treatment by network meta-analysis. METHOD(S): A search was performed on the CNKI, VIP, Wanfang, SinoMed, PubMed, and Cochrane Library databases to include the randomized controlled trials of different acupuncture treatments for osteoporosis. Relevant data were extracted after screening the literature according to relevant inclusion and exclusion criteria, and the quality of the included literature was evaluated. Literature data analysis and mapping were performed using Stata 14.0 software. RESULTS AND CONCLUSION(S): Thirty-four randomized controlled trials were included, involving seven interventions, such as single acupuncture treatment, single western medicine treatment, single Chinese medicine treatment, acupuncture plus western medicine combination therapy, acupuncture plus Chinese medicine combination therapy, Chinese medicine plus western medicine treatment, acupuncture plus Chinese medicine plus western medicine combined treatment. (1) In the treatment efficiency, acupuncture combined with traditional Chinese medicine is the best in the treatment of primary osteoporosis, and acupuncture combined with traditional Chinese medicine, acupuncture combined with western medicine and acupuncture combined with traditional Chinese medicine western medicine were significantly better than traditional Chinese medicine combined with western medicine (p < 0.05). (2) In increasing the bone mineral density of patients, acupuncture combined with traditional Chinese medicine, acupuncture combined with western medicine and acupuncture combined with traditional Chinese medicine western medicine increased the bone density compared with single Chinese medicine or western medicine (p < 0.05). (3) In terms of relieving pain in patients, the results of this study showed that compared with single western medicine, acupuncture combined with western medicine can relieve the pain of patients to some extent (p < 0.05), but there was no significant difference between the other treatment methods (p > 0.05). In the included studies, a very small number of patients developed acupuncture and blood stasis after acupuncture, but no fainting or unreported, and no other side effects were found. To conclude, acupuncture combined with other therapies can improve the efficiency, increase the bone mineral density and alleviate pain.

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