Publication Trends in Acupuncture Research: A 20-Year Bibliometric Analysis Based on PubMed

This comprehensive bibliometric study analyzed 20 years of scientific publications on acupuncture (1995–2014) through the PubMed database, revealing important trends in the development of research in this field. The investigators identified 13,320 acupuncture-related publications from 60 different countries, demonstrating the global reach of this therapeutic modality. The exponential growth observed was notable: the average annual growth rate of acupuncture publications was 10.7%, compared with only 4.5% for biomedicine in general. This means that while biomedical publications doubled over 20 years, acupuncture publications increased more than fourfold.

A particularly significant finding was the increase in the proportion of randomized controlled trials (RCTs), considered the gold standard of scientific evidence. The proportion of RCTs grew from 7.4% in 1995 to 20.3% in 2014, exceeding the 4.5% proportional growth of RCTs in general biomedicine. This increase reflects greater methodological rigor and scientific quality in acupuncture research. The study also revealed that pain consistently remained the most common focus of acupuncture research, accounting for 37.9% of all publications.

Within this category, low back pain, headache, migraine, and neuralgias were the most studied topics. Interestingly, although pain maintained its dominant position, other areas gained greater attention during the analyzed period, including arthritis, cancer, pregnancy and labor, mood disorders, stroke, nausea and vomiting, sleep disorders, and paralysis. In terms of geographic origin, China led with 47.4% of the publications, followed by the United States (17.5%) and the United Kingdom (8.2%). A notable aspect was that, although China had no RCTs registered in the first 10 years of the study, it showed significant growth in research quality during the last 10 years, with an annual RCT growth rate of 56.2%, exceeding that of the United States (17.9%) and the United Kingdom (21.2%).

Regarding journals, the publications were distributed across 1,618 different journals in 25 languages. Among the top 20 journals by number of publications, 12 specialized in complementary and alternative medicine or traditional Chinese medicine, with impact factors ranging from 0.7 to 2.8. The other 8 journals were general or specialized biomedical publications, with higher impact factors (2.2 to 16.8), indicating growing acceptance of acupuncture research in mainstream medical journals. The study also analyzed the populations studied, revealing that adults (19–44 years) and middle-aged people (45–64 years) were the most researched groups, followed by older adults, adolescents, and children.

This distribution reflects both the prevalence of the conditions studied and the clinical applicability of acupuncture across different age groups. The results have important implications for the future of acupuncture research. The exponential growth and improvement in methodological quality suggest a maturation of the scientific field. The diversification of research topics beyond pain indicates an expansion of scientific recognition of acupuncture's potential applications.

Limitations of the study include exclusive reliance on PubMed, which may not capture all relevant publications, especially from countries with their own medical traditions. Additionally, bibliometric analysis does not assess the individual quality of studies or their clinical outcomes, only quantitative trends. The study concludes that acupuncture research has experienced marked growth over the past two decades, with evidence of improvement in scientific quality and diversification of topics studied, providing valuable context for analyzing strengths and gaps in the current state of acupuncture evidence.