Abstract：
OBJECTIVE: 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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
目的：越来越多的研究探讨针灸治疗痛性糖尿病周围神经病变(PDPN)的疗效,但是这些研究的发现产生了相互矛盾的结果。因此，本研究旨在评估针灸治疗PDPN的疗效，从而提供更有说服力的结果。
方法：系统搜索了7个数据库中直到2023年12月1日发表的研究。纳入所有针刺治疗PDPN的随机对照试验（RCT），疼痛视觉模拟评分（VAS）。研究选择，数据提取,和评估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。从这个样本中,平均差(MD)，95%置信区间(CI)，出版偏见，然后计算异质性。
结果：与常规护理组相比，手动针刺组的疼痛VAS评分显着降低（p<0.0001；MD=-1.45[95％CI，-1.97至-0.93]，I2=84%）。与假针刺组相比，真实针刺组的VAS评分降低更大（p=0.004；MD=-0.97[95％CI，-1.63至-0.31]，I2=65%)。此外,针刺组感觉神经传导速度改善(SNCV，p<0.0001；MD=2.29[95%CI，1.79至2.78]，I2=14%)以及运动神经传导速度(MNCV，p<0.0001；MD=2.87[95%CI，2.46至3.27]，I2=0)。不同持续时间的针灸治疗，包括6-10周和3-4周，与常规护理组相比，VAS评分显着降低。
结论：这项荟萃分析为针灸有可能缓解PDPN症状并改善SNCV和MNCV提供了初步证据。然而,需要高质量的随机对照试验来提供进一步的证据,从而更好地证实这一论点.
方法：系统搜索了7个数据库中直到2023年12月1日发表的研究。纳入所有针刺治疗PDPN的随机对照试验（RCT），疼痛视觉模拟评分（VAS）。研究选择，数据提取,和评估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。从这个样本中,平均差(MD)，95%置信区间(CI)，出版偏见，然后计算异质性。
结果：与常规护理组相比，手动针刺组的疼痛VAS评分显着降低（p<0.0001；MD=-1.45[95％CI，-1.97至-0.93]，I2=84%）。与假针刺组相比，真实针刺组的VAS评分降低更大（p=0.004；MD=-0.97[95％CI，-1.63至-0.31]，I2=65%)。此外,针刺组感觉神经传导速度改善(SNCV，p<0.0001；MD=2.29[95%CI，1.79至2.78]，I2=14%)以及运动神经传导速度(MNCV，p<0.0001；MD=2.87[95%CI，2.46至3.27]，I2=0)。不同持续时间的针灸治疗，包括6-10周和3-4周，与常规护理组相比，VAS评分显着降低。
结论：这项荟萃分析为针灸有可能缓解PDPN症状并改善SNCV和MNCV提供了初步证据。然而,需要高质量的随机对照试验来提供进一步的证据,从而更好地证实这一论点.
