Lan Lei, Wang Li, Sadeghirad Behnam, Tang Juan, Liu Yunyu, Couban Rachel J, Ma Wenbin, Busse Jason W
Acupuncture and Tuina College, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Canada.
Curr Pain Headache Rep. 2025 Apr 12;29(1):74. doi: 10.1007/s11916-025-01386-z.
Diabetic peripheral neuropathy (DPN) affects up to half of all patients with diabetes mellitus. Acupuncture is often used to manage chronic pain, but its' effects on DPN are uncertain. We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) to assess the effectiveness of acupuncture for DPN.
We searched databases from inception to September 30, 2024. Paired reviewers independently extracted data and assessed risk of bias. We used random effects models for all meta-analyses and the GRADE approach to assess the certainty of evidence.
We included 14 RCTs (1,169 participants, 45% female). Low certainty evidence suggests that, compared to sham, acupuncture may reduce pain (weighted mean difference [WMD] -1.44 cm on a 10 cm VAS, 95%CI -1.72 to -1.15; modelled risk difference [RD] for achieving the minimally important difference [MID] of 1.5 cm: 45%, 95%CI 35-54%). Comparted to sham or usual care, low certainty evidence suggests that acupuncture may reduce overall neurological symptom severity (WMD - 1.22 [95%CI -1.85, -0.59] on the 19-point Toronto Clinical Scoring System [TCSS]), and provide little to no difference in physical functioning, mental functioning, or adverse events. Low certainty evidence suggests that, compared to amitriptyline or pregabalin, acupuncture may reduce pain associated with DPN.
Acupuncture for DPN may reduce pain when compared to sham acupuncture and may reduce neurologic symptom severity and result in little to no difference in physical functioning, mental functioning or adverse events, when compared with sham acupuncture or usual care.
糖尿病周围神经病变（DPN）影响多达一半的糖尿病患者。针灸常用于管理慢性疼痛，但其对DPN的影响尚不确定。我们进行了一项随机临床试验（RCT）的系统评价和荟萃分析，以评估针灸治疗DPN的有效性。
我们检索了从数据库创建至2024年9月30日的资料。两名评价员独立提取数据并评估偏倚风险。所有荟萃分析均采用随机效应模型，并采用GRADE方法评估证据的确定性。
我们纳入了14项RCT（1169名参与者，45%为女性）。低确定性证据表明，与假针灸相比，针灸可能减轻疼痛（在10厘米视觉模拟量表上加权平均差[WMD]为-1.44厘米，95%可信区间为-1.72至-1.15；实现最小重要差异[MID]为1.5厘米的模拟风险差[RD]：45%，95%可信区间为35-54%）。与假针灸或常规护理相比，低确定性证据表明，针灸可能降低整体神经症状严重程度（在19分的多伦多临床评分系统[TCSS]上WMD为-1.22[95%可信区间为-1.85，-0.59]），并且在身体功能、心理功能或不良事件方面几乎没有差异。低确定性证据表明，与阿米替林或普瑞巴林相比，针灸可能减轻与DPN相关的疼痛。
与假针灸相比，针灸治疗DPN可能减轻疼痛，与假针灸或常规护理相比，针灸可能降低神经症状严重程度，并且在身体功能、心理功能或不良事件方面几乎没有差异。
