Review of systematic reviews of acupuncture for diabetic peripheral neuropathy

Objective To review the systematic reviews of acupuncture for diabetic peripheral neuropathy (DPN) and to provide evidence for clinical decisions. Methods Published systematic reviews targeting acupuncture treatment of DPN were searched using computer through both Chinese and English databases till...

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Bibliographic Details
Published in:Journal of acupuncture and tuina science 2021-04, Vol.19 (2), p.95-103
Main Authors: Wei-jing, Fan, Shi-bing, Liang, Qiang, Han, Ren-yan, Huang, Feng, Xu, Guo-bin, Liu
Format: Article
Language:English
Subjects:
Acupuncture
Diabetes
Medicine
Medicine & Public Health
Peripheral neuropathy
Systematic Review
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Summary:Objective To review the systematic reviews of acupuncture for diabetic peripheral neuropathy (DPN) and to provide evidence for clinical decisions. Methods Published systematic reviews targeting acupuncture treatment of DPN were searched using computer through both Chinese and English databases till July 1, 2019. Two researchers screened the papers based on inclusion and exclusion criteria and conducted report quality evaluation, methodological quality assessment and evidence quality grading using the preferred reporting items for systematic reviews and meta-analyses (PRISMA), assessment of multiple systematic review 2 (AMSTAR 2) and grading of recommendations assessment, development and evaluation (GRADE). Results Ten systematic reviews were included, involving 11 outcome measures. According to PRISMA, 6 items were sufficiently reported while 1 item was not; AMSTAR 2 appraised that all the included systematic reviews were of low quality in the methodological evaluation; according to GRADE, of the 30 clinical evidences, only 5 were graded moderate while the remained were graded low or extremely low. Descriptive analysis showed that acupuncture can significantly improve DPN symptoms, accelerate the conduction velocities of sensory and motor nerves, and up-regulate the content of plasma nitric oxide (NO), while the adverse reaction rate was low. Conclusion Acupuncture can produce satisfactory clinical efficacy in treating DPN, but the existing problems, such as low-quality evidence, unitary outcome measures, poor methodological quality of systematic reviews and nonstandard reporting, need to be treated cautiously; meanwhile, more high-quality clinical trials are required to elevate the level of evidence.
ISSN:1672-3597
1993-0399
DOI:10.1007/s11726-021-1231-2