Table 2.
Summary of Studies Conducted in Humans.
| Author | Characteristics of Patients | Acupuncture Treatment ① Acupuncture Types ② Acupoints ③ Retention Time ④ Treatment Duration (Sessions) ⑤ Conventional Treatment ⑥ Control to Acupuncture |
Outcomes | ||
|---|---|---|---|---|---|
| Patients-Related Outcomes | Nerve-Function Outcomes | ||||
| Abuaisha et al., 1998 [67] |
Participants: n = 44 |
① | Manual acupuncture | Improved in primary (74.9 ± 2.4 to 44.5 ± 4.3) and secondary (70.3 ± 2.9 to 43.5 ± 4.2) symptoms: 34/44 (77%) Complete symptoms relief after treatment: 7/34 (21%) No significant change in NDS (7.3 ± 0.5 to 7.2 ± 0.7) |
No significant change in VPT (30.4 ± 1.9 to 31.1 ± 2.2 volts) |
| ② | LI3, SP6, SP9, ST36 | ||||
| ③ | 20 min (first week: 5 min) | ||||
| ④ | 10 weeks (6) | ||||
| ⑤ | Analgesics, tricyclic drugs, anticonvulsants (63%) | ||||
| ⑥ | - | ||||
| Jiang et al., 2006 [70] |
Participants: n = 90 Wrist-ankle acupuncture: n = 30 Body acupuncture: n = 30 Control: n = 30 |
① | Manual acupuncture | Wrist-ankle acupuncture: 56.67% markedly relieved and 36.67% improved Body acupuncture: 56.67% markedly relieved and 33.33% improved Control: 23.33% markedly relieved and 40.00% improved |
Wrist-ankle acupuncture: Improved CV of median (42.12 ± 3.80 → 46.87 ± 5.57 m/s) & common peroneal nerve (41.42 ± 4.47 → 45.45 ± 4.82 m/s) Body acupuncture: Improved CV of median (42.17 ± 4.51 → 45.48 ± 4.92 m/s) & common peroneal nerve (42.12 ± 4.63 → 45.37 ± 4.90 m/s) Control: No change in CV of median (42.22 ± 4.90 → 43.15 ± 5.24 m/s) & common peroneal nerve (42.04 ± 4.53 → 43.91 ± 5.51 m/s) |
| ② | Wrist-ankle acupuncture: upper 2 and lower 2 Body acupuncture: SP6, SP10, KI3, LI11, GB34 Additional acupoints regarding to symptoms applied to both groups |
||||
| ③ | 15–30 min | ||||
| ④ | 25 days (21) | ||||
| ⑤ | - | ||||
| ⑥ | VB1 and VB12, i.m. | ||||
| Zhang et al., 2010 [71] |
Participants: n = 65 Acupuncture: n = 32 Control: n = 33 |
① | Manual acupuncture | Acupuncture: 16 markedly relieved, 12 improved, 4 failed Control: 7 markedly relieved, 14 improved, 12 failed |
- |
| ② | BL18, BL20, BL23, BL58, ST36, SP6, SP3, CV6, CV4, ST40, GB34, Ex-B3 + acupoints regarding to symptoms | ||||
| ③ | 25 min | ||||
| ④ | 3 months (70) | ||||
| ⑤ | - | ||||
| ⑥ | Inositol, p.o., 2 g/day | ||||
| Tong et al., 2010 [72] |
Participants: n = 63 Acupuncture: n = 42 Control: n = 21 |
① | Manual acupuncture | Improved numbness of lower extremities Improved spontaneous pain of lower extremities Improved rigidity in upper extremities Improved alterations in temperature perception in lower extremities |
Improved F-wave minimum latency in tibial nerve (52.6 ± 0.5 → 53.0 ± 0.3 m/s) Improved MNCV in tibial nerve (39.5 ± 0.5 → 40.2 ± 3.9 m/s) Improved FCV in median nerve (55.6 ± 0.4 → 56.5 ± 0.5 m/s) Improved SNCV of forearm (47.8 ± 0.5 → 48.3 ± 0.7 m/s) Improved VPT (8.05 ± 3.22 → 8.56 ± 3.43 s) |
| ② | LI4, ST40, LI11, ST36, SP6 | ||||
| ③ | 30 min | ||||
| ④ | 15 days (15) | ||||
| ⑤ | - | ||||
| ⑥ | 0.3 cm (vs. 1.2–2.3 cm) needles insertion without stimulation | ||||
| Garrow et al., 2014 [74] |
Participants: n = 45 Acupuncture: n = 24 Control: n = 21 |
① | Manual acupuncture | Improved LANSS score (14.3 ± 6.4 → 13.6 ± 7.2) Improved VAS pain intensity (73 ± 24 → 58 ± 26) Improved MYMOP score (4.3 ± 1.2 → 3.4 ± 1.3) Improved SF-36 physical component score (40.7 ± 13.2 → 39.2 ± 14.0) No change in SF-36 bodily pain score (37.7 ± 27.4 → 40.2 ± 20.2) |
- |
| ② | LR3, KI3, SP6, ST36 | ||||
| ③ | 30 min | ||||
| ④ | 10 weeks (10) | ||||
| ⑤ | - | ||||
| ⑥ | Sham acupuncture (blunt and slides into the handle) | ||||
| Jeon et al., 2015 [75] |
Participants: n = 9 |
① | Manual acupuncture | No significant change in TSS score (7.99 ± 3.55 → 4.95 ± 4.41) No significant change in MNSI score (6.33 ± 1.31 → 4.33 ± 3.00) |
- |
| ② | Ex-LE10, LR3, GB34, GB39, GB41, ST36, SP6, SP9 | ||||
| ③ | 21–28 min | ||||
| ④ | 4 weeks (12) | ||||
| ⑤ | - | ||||
| ⑥ | - | ||||
| Bailey et al., 2017 [76] |
Participants: n = 25 |
① | Manual acupuncture | Improved NTSS-6 scores: aching pain (2.4 ± 0.6 → 1.6 ± 0.5) burning pain (1.7 ± 0.7 → 1.0 ± 0.6) tingling and prickling (2.2 ± 0.5 → 1.2 ± 0.6) numbness (1.7 ± 0.6 → 1.0 ± 0.6) allodynia (1.9 ± 0.6 → 1.2 ± 0.7) No significantly different NTSS-6 scores: lancinating pain (2.0 ± 0.6 → 1.6 ± 0.6) NDS (5.2 ± 3.6 → 4.9 ± 3.4) |
- |
| ② | EX-LE10, ST32, ST37, ST42, SP7, SP9, KI1, KI3, KI9, LR4, LR7, GB34, GB37 | ||||
| ③ | 30 min | ||||
| ④ | 10 weeks (10) | ||||
| ⑤ | - | ||||
| ⑥ | - | ||||
| Shin et al., 2018 [78] |
Participants: n = 126 Acupuncture: n = 63 Control: n = 63 |
① | EA (2/120 Hz) | Improved PI-NRS scores (−0.67 [95% CI−1.29 to −0.06] vs. control) at week 9 Improved short-form McGill pain questionnaire, sleep interference scores, and the EuroQol-5 dimensions at week 9 |
No significant difference in nerve conduction velocity |
| ② | ST36, GB39, SP9, SP6, LR3, GB41 + additional acupoints regarding to symptoms (Ex-LE10) | ||||
| ③ | - | ||||
| ④ | 8 weeks (16) | ||||
| ⑤ | Anti-diabetes and rescue medication allowed (acetaminophen 500 mg, max 3000 mg/day) | ||||
| ⑥ | No EA treatment | ||||
| Chao et al., 2019 [79] |
Participants: n = 40 Acupuncture (1/week): n = 14 Acupuncture (2/week): n = 12 Control: n = 14 |
① | Manual acupuncture | Improved NRS score (between-group differences): Average pain intensity (−1.86 (week 6), −2.06 (week 12)) Worst pain intensity (−1.88 (week 6), −2.34 (week 12)) Least pain intensity (−1.24 (week 6), −1.46 (week 12)) |
- |
| ② | Jing well and shu stream acupoints + acupoints regarding to symptoms (8–12 acupoints) | ||||
| ③ | 20–40 min. | ||||
| ④ | 12 weeks (12 and 24) | ||||
| ⑤ | Antidepressants, opiates, and anticonvulsants | ||||
| ⑥ | No acupuncture treatment | ||||
| Meyer-Hamme et al., 2020 [84] |
Participants n = 120 Acupuncture n = 60 Laser acupuncture n = 60 Control n = 60 |
① | Manual and laser acupuncture | Improved 12/12 items of patient-related outcomes in acupuncture group Improved 11/12 items of patient-related outcomes (exclusion: hyperesthesia) in laser acupuncture group Improved 9/12 of patient-related outcomes (exclusion: hyperesthesia, heat sensation, muscle cramps) in control |
Improved sural SNAP (μV) in all three groups Improved sural SNCV (m/s) in the manual and laser acupuncture group Improved tibial MNCV (m/s) in the manual acupuncture group No significant difference in tibial MNAP (mV) in all group |
| ② | Ex-LE10, Ex-LE12, ST34 | ||||
| ③ | 20 min | ||||
| ④ | 10 weeks (10) | ||||
| ⑤ | - | ||||
| ⑥ | Laser acupuncture without laser | ||||
Abbreviations: Ach: acetylcholine; CV: conduction velocity; FCV: F-wave conduction velocity; HbA1c: glycosylated hemoglobin; LANSS: Leeds assessment of neuropathic symptoms and signs; LDF: laser Doppler fluxmetry; LDS: neuropathy disability score; MNAP: motor nerve action potential; MNCV: motor nerve conduction velocity; MNSI: Michigan neuropathy screening instrument; MYMOP: Measure Yourself Medical Outcome Profile; NDS: neuropathy disability score; NRS: numerical rating scale; NS: non-significant; NTSS: neuropathy total symptom scale; PI-NRS: pain intensity numerical rating scale; SF-36: Short form 36; SNAP: sensory nerve action potential; SNCV: sensory nerve conduction velocity; SNP: Sodium nitroprusside; SPS: sleep problem scale; TSS: total symptom score; VAS: Visual analog scale; VB: Vitamin B; VPT: vibration perception threshold.