Acupuncture for the treatment of painful diabetic peripheral neuropathy: A systematic review and meta-analysis

IF 2.2 3区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary Therapies in Clinical Practice Pub Date : 2024-07-29 DOI:10.1016/j.ctcp.2024.101889

Chunliang Wang , Yuzhu Fan , Guiting Liang , Qiang Wang , Hui Gao , Junhong Duan

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引用次数: 0

Abstract

Background and purpose

A growing number of studies have investigated the efficacy of acupuncture in the treatment of painful diabetic peripheral neuropathy (PDPN), but the findings of these studies have generated conflicting results. This study therefore aimed to assess the efficacy of acupuncture for treating PDPN so as to offer more conclusive results.

Methods

Seven databases were systematically searched for studies published up until December 1, 2023. All randomized controlled trials (RCTs) of acupuncture for PDPN with visual analog scale (VAS) for pain score were included. Study selection, data extraction, and evaluation were conducted independently by researchers. The Risk of Bias 2 (RoB2) tool was employed to assess the risk of bias. From this sample, the mean difference (MD), 95 % confidence intervals (CI), publication bias, and heterogeneity were then computed.

Results

The manual acupuncture group exhibited a significant decrease in the VAS for pain score compared with the routine care group (p < 0.0001; MD = −1.45 [95 % CI, −1.97 to −0.93], I² = 84 %). The real acupuncture group demonstrated a greater reduction in VAS scores than the sham acupuncture group (p = 0.004; MD = −0.97 [95 % CI, −1.63 to −0.31], I² = 65 %). Additionally, the acupuncture group showed improvements in sensory nerve conduction velocity (SNCV, p < 0.0001; MD = 2.29 [95 % CI, 1.79 to 2.78], I² = 14 %) as well as motor nerve conduction velocity (MNCV, p < 0.0001; MD = 2.87 [95 % CI, 2.46 to 3.27], I² = 0). Different durations of acupuncture treatment, including 6–10 weeks and 3–4 weeks, demonstrated a significant reduction in VAS scores compared with the routine care group.

Conclusion

This meta-analysis provides preliminary evidence for the claim that acupuncture has the potential to alleviate PDPN symptoms and improve SNCV and MNCV. However, high-quality RCTs are needed to offer further evidence and thus better substantiate such a contention.

查看原文本刊更多论文

针灸治疗疼痛性糖尿病周围神经病变：系统综述与荟萃分析。

背景和目的：越来越多的研究调查了针灸治疗糖尿病周围神经病变（PDPN）的疗效，但这些研究的结果相互矛盾。因此，本研究旨在评估针灸治疗糖尿病周围神经病变的疗效，以提供更具结论性的结果：系统检索了七个数据库中截至 2023 年 12 月 1 日发表的研究。所有针灸治疗 PDPN 的随机对照试验（RCT）均以视觉模拟量表（VAS）作为疼痛评分标准。研究人员独立完成了研究选择、数据提取和评估工作。采用偏倚风险2（RoB2）工具评估偏倚风险。然后从样本中计算出平均差（MD）、95% 置信区间（CI）、发表偏倚和异质性：与常规护理组相比，手法针灸组的 VAS 疼痛评分明显下降（P 2 = 84%）。与假针灸组相比，真针灸组的 VAS 评分下降幅度更大（p = 0.004；MD = -0.97 [95 % CI, -1.63 to -0.31]，I2 = 65 %）。此外，针灸组的感觉神经传导速度（SNCV，p 2 = 14 %）和运动神经传导速度（MNCV，p 2 = 0）均有改善。与常规护理组相比，针灸治疗的不同持续时间（包括 6-10 周和 3-4 周）均显著降低了 VAS 评分：这项荟萃分析为针灸有可能缓解 PDPN 症状并改善 SNCV 和 MNCV 的说法提供了初步证据。然而，还需要高质量的研究性临床试验来提供进一步的证据，从而更好地证实这一论点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Complementary Therapies in Clinical Practice INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

6.30

自引率

6.70%

发文量

157

审稿时长

40 days

期刊介绍： Complementary Therapies in Clinical Practice is an internationally refereed journal published to meet the broad ranging needs of the healthcare profession in the effective and professional integration of complementary therapies within clinical practice. Complementary Therapies in Clinical Practice aims to provide rigorous peer reviewed papers addressing research, implementation of complementary therapies (CTs) in the clinical setting, legal and ethical concerns, evaluative accounts of therapy in practice, philosophical analysis of emergent social trends in CTs, excellence in clinical judgement, best practice, problem management, therapy information, policy development and management of change in order to promote safe and efficacious clinical practice. Complementary Therapies in Clinical Practice welcomes and considers accounts of reflective practice.