Mapping Acupoint Networks for Chronic Pelvic Pain: A Review-Based Network Analysis of Randomized Trials

Background: Chronic pelvic pain (CPP) is a heterogeneous clinical condition affecting both women and men, but acupoint selection patterns across CPP-related randomized trials have not been systematically characterized. Objective: To identify common acupoint networks used for CPP and to examine sex-stratified differences in acupoint co-occurrence patterns. Methods: This study was a review-based secondary network analysis of randomized controlled trials included in a previously published systematic review and meta-analysis of acupuncture for CPP-related conditions. Among 17 eligible trials identified in the source review, 15 provided sufficient acupoint prescription information for network reconstruction and were included in the present analysis. The dataset comprised 8 female studies and 7 male studies. Acupoint co-occurrence networks were constructed, and eigenvector centrality was used to identify major acupoints and compare overall and sex-stratified network structures. Results: In the overall network, BL32, LI4, CV4, GV20, and BL33 showed the highest eigenvector centrality values. Spatial mapping demonstrated a multiregional configuration integrating abdominal, lumbosacral, and distal limb acupoints. In female and male CPP networks, LI4 and lumbosacral back-region acupoints such as BL32, BL25, and BL33 were more central in females, whereas CV4, CV3, and lower abdominal acupoints were more central in males. Conclusion: This review-based network analysis identified both common and sex-stratified acupoint prescription patterns for CPP and visualized their anatomical distribution. These findings provide a structured overview of acupoint network organization in CPP and support future outcome-oriented and disease-specific acupuncture research.