Department of Cardiology, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China.
Department of Endocrinology, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China.
Complement Ther Clin Pract. 2024 Nov;57:101889. doi: 10.1016/j.ctcp.2024.101889. Epub 2024 Jul 29.
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.
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.
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], I = 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], I = 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], I = 14 %) as well as motor nerve conduction velocity (MNCV, p < 0.0001; MD = 2.87 [95 % CI, 2.46 to 3.27], I = 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.
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.
越来越多的研究探讨了针刺治疗痛性糖尿病周围神经病变（PDPN）的疗效，但这些研究的结果存在矛盾。因此，本研究旨在评估针刺治疗 PDPN 的疗效，以期提供更具结论性的结果。
系统检索了截至 2023 年 12 月 1 日发表的 7 个数据库中关于针刺治疗 PDPN 且采用视觉模拟评分（VAS）评估疼痛评分的随机对照试验（RCT）。研究选择、数据提取和评估均由研究人员独立进行。采用偏倚风险 2（RoB2）工具评估偏倚风险。在此样本中，计算了均数差（MD）、95%置信区间（CI）、发表偏倚和异质性。
与常规护理组相比，手动针刺组的 VAS 疼痛评分显著降低（p<0.0001；MD=-1.45[95%CI，-1.97 至-0.93]，I=84%）。与假针刺组相比，真针刺组的 VAS 评分降低更明显（p=0.004；MD=-0.97[95%CI，-1.63 至-0.31]，I=65%）。此外，针刺组的感觉神经传导速度（SNCV，p<0.0001；MD=2.29[95%CI，1.79 至 2.78]，I=14%）和运动神经传导速度（MNCV，p<0.0001；MD=2.87[95%CI，2.46 至 3.27]，I=0）均有改善。6-10 周和 3-4 周的针刺治疗与常规护理组相比，VAS 评分均显著降低。
本荟萃分析初步证实了针刺治疗 PDPN 可缓解症状、改善 SNCV 和 MNCV 的假说，但仍需要高质量的 RCT 来提供更多证据，从而更好地证实这一观点。
