SYSTEMATIC REVIEW article
Front. Med.
Sec. Pulmonary Medicine
Efficacy of acupuncture-related therapies for gastroesophageal reflux-related chronic cough: a systematic review and meta-analysis
Provisionally accepted
- Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
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Background: Gastroesophageal reflux disease (GERD) may present as chronic cough, known as GERD-related chronic cough (GERC). Conventional treatment, including proton pump inhibitors, is often suboptimal. Acupuncture has been proposed as a complementary therapy, however, its clinical effectiveness for GERC remains unclear. This study aimed to evaluate the efficacy and safety of acupuncture-related therapies for GERC. Methods: We systematically searched 11 international and regional databases up to June 2025 for randomized controlled trials (RCTs) on acupuncture for GERC. Primary outcomes were daytime and nighttime cough symptom scores; secondary outcomes included the Leicester Cough Questionnaire (LCQ) score and total effective rate (TER). A random-effects model was used for meta-analysis. Risk of bias was assessed with RoB 2, and certainty of evidence with GRADE. Results: Five RCTs involving 390 participants were identified. Compared with Western medicine alone, acupuncture significantly reduced daytime (MD = -0.41, 95% CI [-0.75, -0.07]) and nighttime cough scores (MD = -0.38, 95% CI [-0.59, -0.17]). LCQ scores improved (MD = 2.29, 95% CI [1.99, 2.60], p < 0.00001), and TER was higher in the acupuncture group (RR = 1.13, 95% CI [1.01, 1.27]). No serious adverse events were reported. The overall risk of bias was moderate, mainly due to blinding and allocation limitations. Conclusion: Acupuncture may be a safe and effective complementary therapy for GERC, improving cough symptoms and quality of life. However, the current evidence is limited; larger, high-quality RCTs with standardized protocols are warranted. Systematic review registration: This study was registered in PROSPERO (CRD42024627037)
Keywords: Acupuncture, chronic cough, Gastroesophageal reflux disease, Meta-analysis, Quality of Life, randomizedcontrolled trial
Received: 24 Sep 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 Choi, Ang and Lee. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tae-Young Choi
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