Different Acupuncture Therapies Combined with Sulfasalazine for the Treatment of Ankylosing Spondylitis: Bayesian Network Meta-Analysis.

BACKGROUND: Ankylosing Spondylitis (AS) is a serious challenge to public health. Acupuncture can effectively improve pain symptoms, activity function and quality of life in patients with AS. However, there is still significant heterogeneity in the evidence of its efficacy. Therefore, by conducting a Bayesian network meta-analysis, the efficacy of different acupuncture methods can be evaluated more systematically, providing a scientific basis for the optimization of treatment strategies for AS. METHODS: Randomized controlled trials of acupuncture combined with Sulfasalazine (SASP) for AS published in commonly used databases. Time up to July 8, 2025. Analysis was conducted using R4.2.0 and Stata16.0. RESULTS: 31 studies included 9 acupuncture methods. Network meta-analysis results: On the BASDAI indicator: Acupuncture combined with SASP did not have a significant advantage over SASP. In terms of BASFI, SASP and Acupotomy and Tuina or Fu's Subcutaneous needling and Traditional Chinese medicine had a significant advantage over SASP. In terms of Efficacy, compared with SASP, Acupotomy and SASP, Warm Needling and Tuina and SASP, Du Meridian Moxibustion and SASP Du Meridian Moxibustion and Traditional Chinese medicine and SASP, Du Meridian Moxibustion and Acupuncture and SASP Bowl moxibustio and SASP, Fu's Subcutaneous needling and Traditional Chinese medicine and SASP Acupuncture and SASP, Acupuncture and Traditional Chinese medicine and SASP have significant advantages. Du Meridian Moxibustion and Acupuncture and SASP are more effective than Du Meridian Moxibustion and SASP. CONCLUSION: Based on the results of this study, Acupotomy, Du Meridian Moxibustion and Cupping and SASP combined with SASP have the best effects.