Acupuncture for the Treatment of Peripheral Neuropathy: A Systematic Review and Meta-Analysis
Objectives: Neuropathy and its associated pain pose great therapeutic challenges. While there has been arecent surge in acupuncture use and research, little remains known about its effects on nerve function. Thisreview aims to assess the efﬁcacy of acupuncture in the treatment of neuropathy of various etiologies.
Methods: The Medline, AMED, Cochrane, Scopus, CINAHL, and clintrials.gov databases were systemati-cally searched from inception to July 2015. Randomized controlled trials (RCTs) assessing acupuncture’sefﬁcacy for poly- and mononeuropathy were reviewed. Parallel and crossover RCTs focused on acupuncture’sefﬁcacy were reviewed and screened for eligibility. The Scale for Assessing Scientiﬁc Quality of Investigationsin Complementary and Alternative Medicine was used to assess RCT quality. RCTs with score of >9andactive control treatments such as sham acupuncture or medical therapy were included.
Results: Fifteen studies were included: 13 original RCTs, a long-term follow-up, and a re-analysis of a priorRCT. The selected RCTs studied acupuncture for neuropathy caused by diabetes, Bell’s palsy, carpal tunnelsyndrome, human immunodeﬁciency virus (HIV), and idiopathic conditions. Acupuncture regimens, controlconditions, and outcome measures differed among studies, and various methodological issues were identiﬁed.Still, the majority of RCTs showed beneﬁt for acupuncture over control in the treatment of diabetic neuropathy,Bell’s palsy, and carpal tunnel syndrome. Acupuncture is probably effective in the treatment of HIV-relatedneuropathy, and there is insufﬁcient evidence for its beneﬁts in idiopathic neuropathy. Acupuncture appears toimprove nerve conduction study parameters in both sensory and motor nerves. Meta-analyses were conductedon all diabetic neuropathy and Bell’s palsy individual subject data (six RCTs; a total of 680 subjects) using asummary estimate random effects model, which showed combined odds ratio of 4.23 (95% conﬁdence interval2.3–7.8; p<0.001) favoring acupuncture over control for neuropathic symptoms.
Conclusions: Acupuncture is beneﬁcial in some peripheral neuropathies, but more rigorously designedstudies using sham-acupuncture control are needed to characterize its effect and optimal use better
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