Acupuncture for benign prostatic hyperplasia in the elderly: A systematic review of acupoints

Abstract

Background: Benign prostatic hyperplasia (BPH) affects >50% of males aged ≥50 years, causing lower urinary tract symptoms that significantly impair quality of life. While acupuncture is increasingly used for BPH management, its acupoint selection patterns remain unstandardized.

Methods: Clinical studies on acupuncture/moxibustion for BPH published before September 30, 2024, were retrieved from CNKI, WANFANG, VIP, PubMed, and ScienceDirect. Acupoint patterns were analyzed using the Traditional Chinese Medicine Inheritance Assistance Platform (TCMISS).

Results: Among 270 articles, 85 met the inclusion criteria. Sixty-one acupoints were identified, with high-frequency selections including Guanyuan (CV4), Zhongji (CV3), Sanyinjiao (SP6), Qihai (CV6), Shenshu (BL23), Shuidao (ST28), Pangguangshu (BL28), Yinlingquan (SP9), Qugu (CV2), and Ciliao (BL32). The Conception Vessel (CV), Bladder (BL), and Spleen (SP) meridians were predominantly used, primarily distributed in the chest/abdomen (EX-CA) and back/waist (EX-BW) regions. Association rule analysis revealed strong correlations among acupoints, with key combinations being Zhongji (CV3)-Sanyinjiao (SP6), Guanyuan (CV4)-Qihai (CV6), and Guanyuan (CV4)-Sanyinjiao (SP6). Core therapeutic clusters centered on Zhongji (CV3), Guanyuan (CV4), and Shenshu (BL23), integrated with Sanyinjiao (SP6), Shuidao (ST28), and Yinlingquan (SP9).

Conclusions: Acupuncture for BPH primarily targets CV4, CV3, SP6, CV6, BL23, ST28, BL28, SP9, CV2, and BL32, reflecting their strong therapeutic relevance. These findings highlight meridians and acupoints potentially critical for symptom alleviation. However, rigorous clinical trials are warranted to validate efficacy and optimize protocols. This review provides a foundation for advancing evidence-based acupuncture interventions in BPH management.

Keywords: acupoints statistical; acupuncture; benign prostatic hyperplasia in the elderly; clustering analysis.

Figure 1.

Flow chart of literature screening. A total of 270 articles were retrieved from CNKI, WANFANG, and VIP databases. After removing duplicates and applying inclusion/exclusion criteria, 85 articles were included for analysis. Boxes represent stages of screening (identification, screening, eligibility, inclusion). Arrows indicate the flow of study selection, with exclusion reasons noted (e.g., nonrelevant interventions, unavailable full texts). CNKI = China National Knowledge Infrastructure, VIP = VIP database, WANFANG = WANFANG data.

Figure 2.

Bar chart of the frequency of meridian application. The CV, BL, and SP were the most frequently used meridians, with frequencies of 173, 120, and 55, respectively. Y-axis: frequency; X-axis: meridians. Error bars represent 95% confidence intervals (Wilson Score method). BL = bladder meridian, CV = conception vessel, SP = spleen meridian.

Figure 3.

Analysis of the usage of specific acupoints. Bar chart showing the frequency of specific acupoint categories (crossing points, alarm points, 5 transport points, etc) in BPH treatment. The crossing point category (179 occurrences) was most prevalent. Colors denote different acupoint types (e.g., blue for crossing points, red for alarm points). BPH = benign prostatic hyperplasia, CV = conception vessel.

Figure 4.

Demonstration of the acupoint combination network. Nodes represent acupoints (labeled by code, e.g., CV3, SP6), and edges indicate strong associations (support ≥12, confidence ≥0.6). Node size reflects frequency of use; line thickness corresponds to association strength. Core acupoints include Zhongji (CV3), Guanyuan (CV4), and Sanyinjiao (SP6). CV = conception vessel, SP = spleen meridian

Figure 5.

Clustering analysis of acupoints (K-means algorithm + cluster). 5 core clusters are color-coded (Group 1: red; Group 2: blue; Group 3: green; Group 4: purple; Group 5: orange). Cluster proximity to the regression curve (black line) indicates centrality of acupoints. Group 1 (red) aligns closely with core therapeutic combinations.

Figure 6.

Clustering analysis of acupoints (K-means algorithm + Simulation of regression). Scatter plot with regression lines and confidence bands. Groups 2, 3, and 4 show dispersed distributions, while Group 5 (orange) contains the most prescriptions. Symbols (circles, triangles) denote cluster membership.