Meta-analysis Of Acupuncture On Peripheral Neuropathy In Diabetes Mellitus

Objective To evaluate the efficacy of evidence-based medicine in the treatment of DPN.Methods Based on the system evaluation principle of Cochrane collaborative network,a search strategy was developed to fully retrieve the randomized controlled trials of acupuncture treatment in DPN.The computer searches the database of CNKI,PubMed and CBM.Establish inclusion criteria and strictly follow the criteria for literature screening.The data was extracted and the quality rating of qualified literature was carried out according to the "bias risk assessment criteria" of Cochrane collaboration.The data were meta-analyzed with RevMan5.3 software,and the quality evaluation was performed using GradePro3.6 software for the analysis results.Results The result was included in 23 studies with a total of 1,900 subjects.In the study of total effective rate.There were six studies(n = 444)that reported the total effective contrast between acupuncture and the drug used to apply nutritional neurologic,after eliminating the literature of lead to heterogeneity,meta-analysis RR and 95%CI were 1.36 and[1.18,1.56],respectively.Eight studies(n = 568)reported the acupuncture + nutrition nerve VS the efficient of nerve nutrition drugs,combined effect and its 95%confidence interval were 1.34 and[1.23,1.46],respectively.Five studies(n = 347)reported the effectiveness of acupuncture + conventional treatment VS conventional treatment.The results of meta-analysis showed that RR and 95%Cl were11.33 and[1.19,1.48],respectively.In the study of nerve conduction velocity,2 study(n = 120)reported the acupuncture and moxibustion improve nerve conduction velocity compared with drugs of trophic nerve,median nerve SNCV combination and effect size SMD and 95%CI were 0.73 and[0.36,1.10],respectively.Median nerve MNCV combination and effect size SMD and 95%Cl were 1.00[0.61,1.38],respectively.Phil always nervous SMD SNCV group and 95%CI were 1.35[0.95,1.75],respectively.Phil is always nervous SMD MNCV group and 95%CI were 1.05[0.67,1.44],respectively.Four studies(n = 315)reported the acupuncture combined neural nutrition medicine to improve nerve conduction velocity and nerve nutrition drug contrast,there is heterogeneity between groups,eliminate lead to heterogeneity research,median nerve SNCV combination and effect size SMD and 95%CI were[0.17,0.80],respectively.median nerve MNCV set of SMD and 95%CI were 0.60 and[0.29,0.92],respectively.Phil always nervous SMD SNCV group and 95%Cl were 0.72 and[0.45,1.00],respectively.Phil total nerve MNCV combination and effect size SMD and 95%CI were 0.63 and[0.36,0.90],respectively.3 research(n=311),the group research observation acupuncture plus routine therapy and conventional therapy of median nerve,tibial nerve conduction velocity,the effect of median nerve SNCV combination and effect size SMD and 95%Cl were 0.78 and[0.55,1.02],respectively.Median nerve MNCV set of SMD and 95%Cl were 1.37[0.96,1.78],respectively.Tibial SNCV combination and effect size SMD and 95%CI were 1.07 and[0.79,1.35],respectively.tibial MNCV set of SMD and 95%Cl were 1.73 and[1.42,2.03],respectively.2 study(160)observation acupuncture + nutrition on the TCSS score of patients with DPN nerve medicine,SMD and 95%Cl were 1.03 and[1.36,0.70],respectively.All the above results are evidence GRADE rating,ending the GRADE of quality of evidence are very low(D),as a result,the system evaluation of the effectiveness of acupuncture in the treatment of DPN should be treated with caution,still need a higher quality of research,to provide more reliable evidence.None of the studies reported adverse reactions to acupoint injection therapy.Conclusion The literature quality of this study is low,and the quality of data GRADE is very low.Therefore,the effectiveness of acupuncture to treat DPN remains to be studied to provide more reliable evidence.The records of the non-adverse reactions included in the evaluation of the system are not excluded from the selective report of the researchers.In future research,the adverse reaction of acupuncture to DPN is also needed to provide the basis for its safety.