Acupuncture treatment of diabetic peripheral neuropathy: An overview of systematic reviews

Bin Yu, MengYuan Li, HaiPeng Huang, ShiQi Ma, Ke Huang, Zhen Zhong, Shuo Yu, LiYing Zhang, Bin Yu, MengYuan Li, HaiPeng Huang, ShiQi Ma, Ke Huang, Zhen Zhong, Shuo Yu, LiYing Zhang

Abstract

What is known and objective: To evaluate the clinical efficacy of acupuncture through a review and analysis of systematic reviews of acupuncture for the treatment of diabetic peripheral neuropathy.

Methods: Systematic reviews of acupuncture treatment for diabetic peripheral neuropathy were collected by searching CNKI, VIP, Wanfang database, Chinese Biomedical Literature Database (CBM), PubMed, Web of Science and the Cochrane Library. The retrieval period was from the establishment of the database to February 14, 2020. After literature selection and extraction, included reports were evaluated in terms of the quality of the methodology and of the report using criteria from the AMSTAR2 scale and the PRISMA statement.

Results and discussion: Eighty eight reviews were retrieved. The inclusion criteria were a published systematic evaluation/meta-analysis/systematic review of acupuncture treatment for diabetic peripheral neuropathy, which included subjects meeting the diagnostic criteria for diabetic peripheral neuropathy, and which compared acupuncture treatment with non-acupuncture treatment. After the inclusion criteria had been applied, 18 reviews were finally included. According to the PRISMA statement, 3 reports were relatively complete, 12 reports had certain defects, 3 reports had considerable information missing, and 18 reports had extremely low methodological quality according to the AMSTAR2 scale. Current evidence shows that acupuncture improves diabetic peripheral neuropathy and increases nerve conduction velocity. However, the methodological quality of the reviews is generally extremely low, and most of the reviews had certain defects, showing that there is still much room for improvement in terms of the methodology and quality of the research reports.

What is new and conclusion: Acupuncture appears to have an effect on DPN, effectively improving nerve conduction and clinical symptoms. Although the methodological quality of the included studies was generally very low and defects were frequent, our study highlights areas where improvement in methodology is required. There is a need for further study of the pathogenesis of DPN, and for developing a unified standard for methods of acupuncture treatment, acupoint selection, and adverse reactions reporting. Traditional Chinese medical practices such as acupuncture should adopt an evidence-based approach to provide greater confidence in their use.

Keywords: acupuncture; an overview of systematic reviews; diabetic peripheral neuropathy.

Conflict of interest statement

All authors report that they have no conflicts of interests.

© 2021 The Authors. Journal of Clinical Pharmacy and Therapeutics published by John Wiley & Sons Ltd.

Figures

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FIGURE 1
Literature selection process

References

    1. Zhu YT, Hu P, Chen J, et al. Analysis of related factors of diabetic peripheral neuropathy. Nerve Injury and Functional Reconstruction. 2019;14(12):622‐625.
    1. Sadosky A, Mardekian J, Parsons B, et al. Healthcare utilization and costs in diabetes relative to the clinical spectrum of painful diabetic peripheral neuropathy. J Diabetes Complications. 2015;29(2):212‐217.
    1. Khdour MR. Treatment of diabetic peripheral neuropathy: a review. J Pharm Pharmacol. 2020;72(7):863‐872.
    1. Zhang TJ, Gong YB, Zhou H, et al. Diagnosis and treatment of diabetic peripheral neuropathy by traditional Chinese and western medicine. Chin J Tradit Chin Med. 2014;29(08):2433‐2436.
    1. Li YL, Wu YR, Xu BX, et al. Bibliometric analysis of acupuncture therapy for diabetic peripheral neuropathy. Practical Diabetes. 2016;12(02):19‐21.
    1. Rong HB, Gao BV, Yu SG, et al. Research status and prospect of acupuncture treatment for diabetic peripheral neuropathy. Chongqing Med. 2009;38(18):2288‐2289.
    1. Xiong J, Du YZ. Thinking about the quality of domestic acupuncture system evaluation/Meta‐analysis method. Acupunct Res. 2011;36(01):72‐75.
    1. Liang FR, Wu X, Li Y et al. Evidence‐based acupuncture. Beijing, China: People’s Medical Publishing House;2009.
    1. Zhou PX, Yan YY, Zha SD. Bibliometric analysis of systematic reviews/Meta‐analysis published by domestic hospital pharmacy staff. Chin J Evid Based Med. 2017;17(05):580‐586.
    1. Tao H, Yang LT, Ping A, et al. Interpretation of AMSTAR 2, a quality evaluation tool for systematic evaluation of randomized or non‐randomized control studies. Chin J Evid Based Med. 2008;18(01):101‐108.
    1. Liu JQ, Ke ZP, Xie DD, et al. Meta‐analysis on the effect of acupuncture on peroneal nerve conduction velocity in the treatment of type 2 diabetes mellitus peripheral neuropathy. Shanghai J Acupunct. 2016;35(01):105‐110.
    1. Li J, Jin YR, Xue YM. Effect of acupuncture treatment on diabetic peripheral neuropathy—A systematic review of randomized controlled clinical studies. World Sci Technol Mod Tradit Chin Med. 2015;4:819‐828.
    1. Zhu X, Pu Jin YX, Yating C. Systematic evaluation of the clinical efficacy of acupuncture combined with basic therapy in the treatment of diabetic peripheral neuropathy. Chin Med J. 2019;18(02):54‐60.
    1. Liu MJ, Liu ZC, Xu B. A systematic review of acupuncture treatment of type 2 diabetic peripheral neuropathy. J Zhejiang Univ Trad Chin Med. 2014;11:1326‐1330.
    1. Cao P, Yang RD. A meta‐analysis of acupuncture treatment of diabetic peripheral neuropathy. J Tradit Chin Med. 2011;17(1):97‐101.
    1. Xv C, Wu TX, Song J, et al. Meta‐analysis and treatment strategy of acupuncture applied to diabetic peripheral neuropathy. China Modern Doctor. 2016;54(22):74‐77.
    1. He JB, Chen J. Meta‐analysis and sequential analysis of trials of the effect of acupuncture on diabetic peripheral neuropathy. Chin J Gerontol. 2019;39(20):4909‐4913.
    1. Yang WY, Huang FL. A systematic review of acupuncture treatment of diabetic peripheral neuropathy. J Liaoning Univ Tradit Chin Med. 2014;16(4):137‐140.
    1. Ma SQ, Huang HP, Wang HF. Meta‐analysis of the effect of acupuncture on tibial nerve in diabetic peripheral neuropathy. Jilin J Tradit Chin Med. 2019;39(11):1481‐1486.
    1. Zhong Z, Huang HP, Wang HF. Meta‐analysis of the effects of acupuncture and moxibustion on peripheral ulnar nerve conduction velocity in the treatment of diabetic peripheral neuropathy. Shizhen J Tradit Chin Med. 2019;30(4):1019‐1021.
    1. Ma K. Efficacy evaluation and meta‐analysis of combination of acupuncture and medicine on diabetic peripheral neuropathy. Hunan J Tradit Chin Med. 2018;34(10):143‐147.
    1. Guo YC. A meta‐analysis of acupuncture and moxibustion for the treatment of diabetic peripheral neuropathy. Everyone’s Health (Academic Edition). 2014;8(16):81.
    1. Sun HY. A systematic review on the treatment of diabetic peripheral neuropathy by acupuncture bloodletting method. Xinjiang J Tradit Chin Med, AK: Lu. 2019;37(1):27‐28.
    1. Nash J, Armour M, Penkala S. Acupuncture for the treatment of lower limb diabetic peripheral neuropathy: a systematic review. Acupunct Med. 2019;37(1):3‐15.
    1. Amato Nesbit S, Sharma R, Waldfogel JM, et al. Non‐pharmacologic treatments for symptoms of diabetic peripheral neuropathy: a systematic review. Curr Med Res Opin. 2019;35(1):15‐25.
    1. Wang LQ, Chen Z, Zhang K, et al. Zusanli (ST36) acupoint injection for diabetic peripheral neuropathy: a systematic review of randomized controlled trials. J Altern Complement Med. 2018;24(12):1138‐1149.
    1. Dimitrova A, Murchison C, Oken B. Acupuncture for the treatment of peripheral neuropathy: a systematic review and meta‐analysis. J Altern Complement Med. 2017;23(3):164‐179.
    1. Chen W, Yang GY, Liu B, Manheimer E, Liu JP. Manual acupuncture for treatment of diabetic peripheral neuropathy: a systematic review of randomized controlled trials. PLoS One. 2013;8(9):e73764.
    1. Manchikanti L, Benyamin RM, Helm S, Hirsch JA. Evidence‐based medicine, systematic reviews, and guidelines in interventional pain management: part 3: systematic reviews and meta‐analyses of randomized trials. Pain Physician. 2009;12(1):35‐72.
    1. An N, Xu JF, Ge L, et al. Quality evaluation of intervention systematic evaluation/meta‐analysis report published in Chinese journal of evidence‐based pediatrics. Chin J Evid Based Pediatr. 2013;8(02):110‐115.
    1. Bero L. What is in a name? Nonfinancial influences on the outcomes of systematic reviews and guidelines. J Clin Epidemiol. 2014;67(11):1239‐1241.
    1. Yang H, Li J, Li YX, et al. Systematic evaluation and reevaluation of acupuncture in the treatment of spastic paralysis after stroke. Chin J Evid Based Med. 2019;19(10):1233‐1239.
    1. Yin SL, Liu XM, He L, et al. Systematic evaluation of systematic evaluation/meta‐analysis reports. Chin J Evid Based Med. 2011;11(08):971‐977.
    1. Zhan HL, Tang QP, Tang X, et al. Effects of acupuncture prescription on nerve function and nerve conduction velocity in diabetic peripheral neuropathy patients. Acupunct Res. 2019;44(11):832‐834 + 839.
    1. Li YX, Li XL, Zhang F, et al. Improvement of diabetic peripheral neuropathy after intervention with acupuncture at primary points. Chin J Gerology. 2016;36(17):4185‐4186.
    1. Whiting P, Savović J, Higgins JPT, et al. A new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol. 2016;69:225‐234.
    1. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non‐randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008.

Source: PubMed

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