Abstract:Objective To systematically evaluate the prognosis and safety of acupuncture therapy in the clinical treatment of gouty arthritis (GA).Methods The controlled clinical trials of acupuncture therapy for GA were retrieved from the databases including CNKI, Wanfang Data, VIP, PubMed, Embase and Cochrane Library. The literature search time was from the establishment of the database to June 2021. The quality of the included studies was evaluated by Cochrane collaboration bias risk assessment tool. The process of meta-analysis and Cox multivariate regression analysis were respectively performed by RevMan 5.3 software and R software, and subgroup analysis were performed based on the result of Cox multivariate regression analysis. Results A total of 23 studies involving 2 458 patients were included in the study. The results showed that compared with patients who received only drug treatment, patients who received acupuncture therapy had significantly improved blood uric acid level ［WMD=-53.98, 95%CI (-85.01, -22.95), P＜0.01］, erythrocyte sedimentation rate ［WMD=-6.01, 95%CI (-10.35, -1.67), P＜0.01］ and the incidence of total adverse reactions ［OR=0.12, 95%CI (0.08, 0.18), P＜0.01］. The recurrence rate of patients in the acupuncture treatment group was significantly lower than that of the non-acupuncture treatment group ［OR=0.20, 95%CI (0.14, 0.28), P＜0.01］. Cox multivariate regression analysis further confirmed that the recurrence rate reduced by acupuncture treatment was not affected by other factors, and treatment with/without acupuncture therapy had the significant correlation with the recurrence rate (P<0.01). Conclusion Acupuncture treatment can significantly improve the blood uric acid level of GA patients, reduce inflammation, and reduce the incidence of adverse reactions and recurrence rates.