Yu Yunfeng, Zhou Tongyi, Li Liu, Liu Xiu, Yin Yuman, Yu Rong
School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China.
The First Hospital of Hunan University of Chinese Medicine, Changsha, China.
Eur J Clin Nutr. 2025 May 23. doi: 10.1038/s41430-025-01631-z.
This study aims to systematically evaluate the efficacy and safety of vitamin B12 acupoint injections compared to other administration routes in treating diabetic neuropathy (DN). We included 20 randomized controlled trials published before March 1, 2024, sourced from eight public databases, involving 1688 participants. Subsequently, we recorded their basic data, investigated their risk of bias, and then carried out a meta-analysis and trial sequential analysis (TSA). The meta-analysis revealed that compared to other administration routes of vitamin B12, acupoint injection significantly improved the clinical effectiveness proportion by 28% (risk ratio [RR] 1.28, 95% confidence interval [CI] 1.22-1.35), peroneal nerve motor nerve conduction velocity (MNCV) by 4.43 m/s (MD 4.43, 95% CI 2.83-6.03), peroneal nerve sensory nerve conduction velocity (SNCV) by 3.82 m/s (MD 3.82, 95% CI 3.23-4.41), median nerve MNCV by 5.48 m/s (MD 5.48, 95% CI 4.71-6.24), and median nerve SNCV by 4.62 m/s (MD 4.62, 95% CI 3.84-5.39) in patients with DN, while having no significant impact on fasting blood glucose (FBG) (MD -0.18, 95% CI -0.44 to 0.08), 2-h postprandial blood glucose (2h-PBG) (MD -0.02, 95% CI -0.36 to 0.33), and the adverse event incidence (RR 1.44, 95% CI 0.44-4.70). TSA indicated that except for FBG, 2h-PBG, and adverse event incidence, the remaining meta-analysis results were conclusive. These findings indicate that compared to other administration routes of vitamin B12, acupoint injection improves neurological function in patients with DN without increasing adverse events and economic burden, suggesting that it may be the optimal administration route for vitamin B12.
本研究旨在系统评价维生素B12穴位注射与其他给药途径相比治疗糖尿病性神经病变（DN）的疗效和安全性。我们纳入了2024年3月1日前发表的20项随机对照试验，这些试验来源于8个公共数据库，涉及1688名参与者。随后，我们记录了他们的基本数据，调查了他们的偏倚风险，然后进行了荟萃分析和试验序贯分析（TSA）。荟萃分析显示，与维生素B12的其他给药途径相比，穴位注射显著提高了临床有效率28%（风险比[RR]1.28，95%置信区间[CI]1.22 - 1.35），腓总神经运动神经传导速度（MNCV）提高了4.43m/s（平均差[MD]4.43，95%CI 2.83 - 6.03），腓总神经感觉神经传导速度（SNCV）提高了3.82m/s（MD 3.82，95%CI 3.23 - 4.41），正中神经MNCV提高了5.48m/s（MD 5.48，95%CI 4.71 - 6.24），正中神经SNCV提高了4.62m/s（MD 4.62，95%CI 3.84 - 5.39），而对空腹血糖（FBG）（MD -0.18，95%CI -0.44至0.08）、餐后2小时血糖（2h-PBG）（MD -0.02，95%CI -0.36至0.33）和不良事件发生率（RR 1.44，95%CI 0.44 - 4.70）没有显著影响。TSA表明，除FBG、2h-PBG和不良事件发生率外，其余荟萃分析结果具有结论性。这些发现表明，与维生素B12的其他给药途径相比，穴位注射可改善DN患者的神经功能，且不增加不良事件和经济负担，提示其可能是维生素B12的最佳给药途径。
