The randomized controlled trials (RCTs) regarding acupuncture direction published from January 1st

2013

to November 7th

2023 were searched in China National Knowledge Infrastructure (CNKI)

Wanfang Data Knowledge Service Platform

and VIP Chinese Journal Database. As a result

21 RCTs were included. The problems identified included conceptual misunderstandings regarding acupuncture direction

incomplete selection strategies

confounding research factors

and inaccuracies in reporting. Based on the findings

four strategic approaches for enhancing therapeutic efficacy through acupuncture direction were summarized: aligning needle direction with the meridian pathway

directing the needle toward the lesion site

orienting the needle toward adjacent acupoints

and targeting special anatomical structures. Two additional strategies were proposed for optimizing the procedure: simplifying acupuncture operations and directing the needle toward safe anatomical sites. Recommendations were made to improve the rationality of research factor settings and the completeness of acupuncture operation reporting. Furthermore

three methods for reporting acupuncture direction were discussed: reporting the tip-pointed position

reporting the insertion angle and orientation

and reporting azimuth and polar angles

aiming to promote greater standardization and completeness in acupuncture practice and reporting.