P05.07
Purpose: Acupuncture has commonly been used in China, either alone or in combination with conventional medicine, to treat diabetic peripheral neuropathy (DPN). The objective of this study was to perform a systematic review to evaluate the potential benefits and harms of acupuncture for DPN to justify its clinical use.
Methods: We searched for published and unpublished randomized controlled trials of manual acupuncture for DPN till 31 March 2013. Revman 5.2 software was used for data analysis with effect estimate presented as relative risk (RR) and mean difference (MD) with a 95% confidence interval (CI).
Results: A total of 38 trials involving 2506 participants were included. The methodological quality of included trials was generally poor. Meta-analysis indicated that manual acupuncture had better effect on motor nerve conduction velocity in common peroneal nerve than electric acupuncture (MD 6.25 95%CI 5.53, 6.97, MD 2.59 95%CI 1.21, 3.96) when compared with mecobalamin. Acupuncture plus moxibustion did not show additional better effect on nerve conduction velocity compared with acupuncture alone. Adverse events were not reported in any trials. The asymmetric funnel plot suggested publication bias.
Conclusion: Despite the number of trials of acupuncture for DPN and their uniformly positive results, no clinically relevant conclusions can be drawn from this review due to the trials' high risks of bias and the possibility of publication bias. Clearly defined and internationally acknowledged outcome measures are required for future study. There remains an urgent need for training Chinese researchers in conducting unbiased trials as well as prospectively registering all initiated Chinese trials to avoid publication bias.
Contact: Wei Chen, chen7916@hotmail.com
