The efficacy and safety of acupuncture compared to Western medicine in patients with nonalcoholic fatty liver disease: A systematic review and meta‐analysis

Abstract The comparative role of acupuncture versus Western medicine in the treatment of nonalcoholic fatty liver disease (NAFLD) remains controversial due to insufficient evidence. This study synthesizes data from randomized controlled trials (RCTs) to compare the efficacy of the two interventions. A systematic literature search was conducted in CNKI, VIP, Wanfang, CBM, PubMed, Web of Science, and the Cochrane Library for RCTs published up to April 8, 2025. Six RCTs involving 756 patients were included. Meta‐analysis revealed that acupuncture significantly outperformed Western medicine in terms of overall clinical efficacy (odds ratio OR = 2.80, 95% confidence interval CI 1.57, 5.01). Significant improvements were also observed in key biomarkers: liver enzymes (mean difference MD = −21.93, 95% CI −24.81, −19.05) and blood lipids (MD = −0.78, 95% CI −1.00, −0.56). Furthermore, acupuncture demonstrated superior efficacy in ameliorating Traditional Chinese Medicine syndromes (MD = −2.05, 95% CI −2.10, −2.00). Although this analysis suggests that acupuncture may provide superior benefits for NAFLD compared with Western medicine, the conclusions are limited by the small sample sizes, methodological flaws, and substantial heterogeneity observed across the included studies. Therefore, the results should be regarded as preliminary and interpreted with caution.