OBJECTIVE: To assess the efficacy of acupoint therapy combined with spine pinching in patients with menopausal syndrome.METHODS: This is a parallel,randomized,controlled,investigator-blinded trial.A total of 132 participants were randomly assigned to receive either acupoint therapy combined with spine pinching (intervention group) or tibolone therapy alone (control group).The intervention group received acupoint therapy combined with spine pinching three times per week for 4 weeks.The control group received 2.5 mg of tibolone once daily for 4 weeks.The primary outcome was the improved Kupperman score.The WHO quality of life scale was also used.The secondary aim was to identify those who would benefit from acupoint therapy combined with spine pinching based on the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH).RESULTS: In the intervention group,the improved Kupperman score was significantly decreased after treatment compared with before treatment.However,there were no differences between the intervention and control groups for any outcome.Changes in the physiology score presented negative outcomes in patients with a low FSH level with increasing body mass index (BMI) (P =0.0).In contrast,changes in the physiology score presented positive outcomes in patients with a moderate LH level with increasing BMI (P =0.0).The mean change in the physiology score of patients with a low FSH level and a BMI of ≥ 25.7 kg/m2 was-7.17 (range-10.94 to-3.40) after adjustments for age and disease duration.CONCLUSION: Acupoint therapy combined with spine pinching is effective in treating menopausal syndrome,especially in women with a moderate LH level.However,patients with a low FSH level had a negative outcome after acupoint therapy combined with spine pinching.In addition,patients with a BMI of ＞ 25.7 kg/m2 had a negative outcome after the intervention,regardless of hormone levels.