Search results   The initial search yielded 1 020 studies, which were reduced to 479 after removing duplicates. Through preliminary screening of titles and abstracts, 128 relevant studies were selected. After further full-text screening, a total of 62 studies were ultimately included[15-76]. Among them, 60 reports were written in Chinese, and two reports were written in English; however, all reports were published by Chinese researchers. The flow diagram of literature selection is shown in Figure 1. Information on published papers per year All the studies were published between 2007 and 2024, with an overall increasing trend in the number of publications. The peak was reached in 2019, with a total of 8 articles published. Details can be found in Figure 2.  Quality of the studies Risk of bias  The quality of the included literature was evaluated using the Cochrane Collaboration’s tool for assessing the risk of bias. The results indicated that most items were classified as “low risk of bias,” while the proportion of “high risk of bias” items was the lowest, primarily concentrated in the “Random sequence generation” and “Binding of participants and personnel” sections. Specifically, some studies mentioned randomization but did not describe the method used to generate the randomization results, thus being rated as “high risk of bias.” Moreover, although some studies reported the implementation of single blinding in their respective articles, blinding of participants and personnel was deemed impractical considering the designs of the included studies, thereby increasing the potential for performance bias. Low-quality RCTs will produce evidence and results that lack credibility and may even mislead readers and affect the implementation of clinical decision-making. A"

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CONSORT statement  We conducted a quality report on the 62 included studies according to the CONSORT statement (Table 2). Among the 37 items encompassed within the eight criteria, 15 items had a reporting rate exceeding 50%, with 1 item achieving a 100% reporting rate. Meanwhile, nine items had a reporting rate of 0%, but it is important to note that most of these items are only required to be reported when necessary and are not mandatory. Therefore, their low reporting rates do not necessarily reflect the quality of reporting. Additionally, items with a reporting rate below 50% were mainly concentrated in the following aspects: “Identification as a randomized trial in the title” (1/62, 1.61%), “How sample size was determined” (7/62, 11.29%), “Implementation” (1/62, 1.61%), “Blinding” (1/62, 1.61%) (2/62, 3.23%), “Losses and exclusions after randomization” (19/62, 30.65%), “A table showing baseline data” (21/62, 33.87%), “Reports of Harms” (16/62, 25.81%), “Reports of limitations” (20/62, 32.26%), and “Reports of funding” (4/62, 6.45%). It remains unclear what factors may reduce the credibility of the research results or even lead to misleading conclusions. In the evaluation of the 37 items by two reviewers, 31 items had kappa values greater than 0.8, and the kappa values of the remaining six items were all within the range of 0.6 to 0.8, indicating good overall consistency.  STRICTA checklist Using the STRICTA checklist, a quality assessment was conducted on the 58 included studies related to acupuncture, as shown in Table 3. Among the 17 items encompassed by the 6 Criteria, 12 items had a reporting rate exceeding 50%, with two items achieving a 100% reporting rate. There were five items with a reporting rate below 50%, among which two items had a 0% reporting rate, precisely “Needle type” (22/58, 37.93%), “Details of other interventions” (7/58, 12.07%), “Setting and context of treatment” (0/58, 0%), “Description of participating acupuncturists” (0/58, 0%), and “Rationale for the control or comparator” (21/58, 36.21%). It remains unknown what factors reduce the reproducibility and authenticity of the research. In the assessment of the 17 detailed items by two evaluators, 14 items had kappa values greater than 0.8, and 3 items ranged from 0.6 to 0.8, indicating good overall consistency."

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