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 a recent surge in acupuncture use and research, little remains known about its effects on nerve function. This review aims to assess the efficacy of acupuncture in the treatment of neuropathy of va...

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Published in:Journal of Alternative & Complementary Medicine Vol. 23; no. 3; pp. 164 - 180
Main Authors: Dimitrova, Alexandra, Murchison, Charles, Oken, Barry
Format: meta analysis research systematic review tables/charts Journal Article
Published: Mary Ann Liebert, Inc. Mar2017
Online Access:View this record in EBSCOhost
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      dt: Mar2017
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      pub: Mary Ann Liebert, Inc.
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        atl: Acupuncture for the Treatment of Peripheral Neuropathy: A Systematic Review and Meta-Analysis.
      aug:
        au:
          Dimitrova, Alexandra
          Murchison, Charles
          Oken, Barry
      sug:
        subj:
          Acupuncture Utilization
          Peripheral Nervous System Diseases Therapy
          Treatment Outcomes
          Patient Safety
          Human
          Bell Palsy
          Carpal Tunnel Syndrome
          Diabetic Neuropathies
          Facial Paralysis
          Systematic Review
          Medline
          AMED Database
          CINAHL Database
          Cochrane Library
          Randomized Controlled Trials
          HIV Infections
          Descriptive Statistics
          Confidence Intervals
          Meta Analysis
          Odds Ratio
          Fisher's Exact Test
          Data Analysis Software
          Acupuncture Points
          Funding Source
          Scales
      ab: Objectives: Neuropathy and its associated pain pose great therapeutic challenges. While there has been a recent surge in acupuncture use and research, little remains known about its effects on nerve function. This review aims to assess the efficacy of acupuncture in the treatment of neuropathy of various etiologies. Methods: The Medline, AMED, Cochrane, Scopus, CINAHL, and databases were systematically searched from inception to July 2015. Randomized controlled trials (RCTs) assessing acupuncture's efficacy for poly- and mononeuropathy were reviewed. Parallel and crossover RCTs focused on acupuncture's efficacy were reviewed and screened for eligibility. The Scale for Assessing Scientific Quality of Investigations in Complementary and Alternative Medicine was used to assess RCT quality. RCTs with score of >9 and active 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 prior RCT. The selected RCTs studied acupuncture for neuropathy caused by diabetes, Bell's palsy, carpal tunnel syndrome, human immunodeficiency virus (HIV), and idiopathic conditions. Acupuncture regimens, control conditions, 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-related neuropathy, and there is insufficient evidence for its benefits in idiopathic neuropathy. Acupuncture appears to improve nerve conduction study parameters in both sensory and motor nerves. Meta-analyses were conducted on all diabetic neuropathy and Bell's palsy individual subject data (six RCTs; a total of 680 subjects) using a summary estimate random effects model, which showed combined odds ratio of 4.23 (95% confidence interval 2.3-7.8; p < 0.001) favoring acupuncture over control for neuropathic symptoms. Conclusions: Acupuncture is beneficial in some peripheral neuropathies, but more rigorously designed studies using sham-acupuncture control are needed to characterize its effect and optimal use better.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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