针刺治疗周围神经病变系统文献评价

目的:总结现有的针刺治疗周围神经病变资料,通过系统综述进行荟萃分析.方法:文献查找范围涉及11个数据库.以针刺或电针治疗的由糖尿病、化学疗法、人体免疫缺损病毒及其他不明原因引起的周围神经病变的临床研究文献均被纳入.以样本量、随机方法、对照组、盲法、针刺方法及结果评价方法作为荟萃分析的指标.结果:纳入的26个临床文献中,无高质量的随机临床试验.所有研究都存在方法缺陷.9个研究的样本量偏小,25个研究未使用随机方法,8个研究缺少对照组,11个研究的对照不完善,24个研究缺少盲法,并且针刺和结果评价的方法过于多样化.结论:所有针刺治疗周围神经病变的研究都给出了有效的结果,然而目前的数据并不足以做出荟萃分析,期待设计完备的随机对照盲法试验.

Structured literature review of acupuncture treatment for peripheral neuropathy

Objective

To summarize existing evidence on acupuncture treatment for peripheral neuropathy (PN) and potentially generate a meta-analysis by performing a structured literature review.

Methods

Literature searches were conducted on 11 databases. All identified clinical studies of acupuncture and electroacupuncture for peripheral neuropathy due to diabetes, chemotherapy, human immunodeficiency virus (HIV) and unknown cause were included. Study criteria such as sample size, randomization, controls, blinding, acupuncture patterns and outcome measurements were examined for the requirements of the meta-analysis.

Results

Among the 26 studies included, no high quality randomized clinical trial was found. There were methodical limitations in all studies. Small sample size was found in 9 studies, lack of randomization in 25, lack of controls in 8, inadequate controls in 11, and lack of blinding in 24 studies, as well as a high variability of acupuncture patterns and outcome measurements.

Conclusion

Nearly all acupuncture pilot studies on peripheral neuropathy give positive results encouraging further investigation, but a meta-analysis is not possible on the existent data. Randomized, controlled, blinded clinical trials with adequate design and significance still have to be performed.