Acupuncture Treatment of Diabetic Peripheral Neuropathy in an American Indian Community

다국어 초록 (Multilingual Abstract)

Diabetic peripheral neuropathy (DPN) develops in 30% of type 2 diabetes patients, increases the risk for foot ulcers and amputation, and is a significant source of disability and medical costs. Treatment remains challenging, propelling research to focus on therapeutic methods that aim to improve blood circulation or ameliorate oxidative stress that drives development of DPN. The aim of this study was to assess the effectiveness of acupuncture treatment for DPN symptoms and lower extremity arterial circulation in people with type 2 diabetes. Twenty-five patients seen at a Southern California Tribal Health Center who reported a threshold level of diabetic neuropathy symptoms in the lower extremities during the previous 4 weeks received acupuncture treatment once per week over a 10-week period between 2011 and 2013. The Neuropathy Total Symptom Scale (NTSS-6), Neuropathy Disability Score (NDS), and laser Doppler fluxmetry (LDF) were used for assessment at baseline and 10 weeks. A total of 19 of 25 study participants completed the study and reported a significant reduction in the NTSS symptoms of aching pain, burning pain, prickling sensation, numbness, and allodynia. Lancinating pain did not decrease significantly. LDF measures improved but not significantly. Acupuncture may effectively ameliorate selected DPN symptoms in these American Indian patients.

참고문헌 (Reference)

1 Brunelli B, "The use of complementary and alternative medicines by patients with peripheral neuropathy" 218 : 5-66, 2004

2 Kolka C, "The endothelium in diabetes : its role in insulin access and diabetic complication" 14 : 13-19, 2013

3 Sharma A, "Targeting endothelial dysfunction in vascular complications associated with diabetes" 2012 : 750126-, 2012

4 Garrow AP, "Role of acupuncture in the management of diabetic painful neuropathy(DPN) : a pilot RCT" 32 : 242-249, 2014

5 Rith-Najarian S, "Preventing amputations from diabetes : the Indian Health Service experience" 50 : 41-44, 2001

6 A. Peltier, "Painful diabetic neuropathy" BMJ 348 : g1799-g1799, 2014

7 Giacco F, "Oxidative stress and diabetic complications" 107 : 1058-1070, 2010

8 Fronek A, "Noninvasive assessment of endothelial activity in patients with coronary heart disease and cardiovascular risk factors" 37 : 137-142, 2008

9 Sandireddy R, "Neuroinflammation and oxidative stress in diabetic neuropathy : futuristic strategies based on these targets" 2014 : 674987-, 2014

10 "National Diabetes Fact Sheet"

11 Kann O, "Mitochondria and neuronal activity" 292 : C641-C657, 2007

12 Hsiu J, "Microcirculatory characteristics of acupuncture points obtained by laser Doppler flowmetry" 28 : N77-N86, 2007

13 Miranda-Massari J, "Metabolic correction in the management of diabetic peripheral neuropathy : improving clinical results beyond symptom control" 6 : 260-273, 2011

14 Singleton JR, "Increased prevalence of impaired glucose tolerance in patients with painful sensory neuropathy" 24 : 1448-1453, 2001

15 Quattrini C, "Impaired skin microsvascular reactivity in painful diabetic neuropathy" 30 : 655-659, 2007

16 Zimmet P, "Global and societal implication of the diabetes epidemic" 414 : 782-787, 2001

17 Yanqing Tong, "Fifteen-day Acupuncture Treatment Relieves Diabetic Peripheral Neuropathy" 사단법인약침학회 3 (3): 95-103, 2010

18 Su L, "Effects of warm needling at Zusanli on NO and IL-2 levels in the middle-aged and old people" 23 : 127-128, 2003

19 Sandberg M, "Effects of acupuncture on skin and muscle blood flow in health subjects" 90 : 114-119, 2003

20 Witt CM, "Effectiveness guidance document(EGD)for acupuncture research d a consensus document for conduction trials" 12 : 148-, 2012

21 Tomesova J, "Differences in skin microcirculation on the upper and lower extremities in patients with diabetes mellitus : relationship of diabetic neuropathy and skin microcirculation" 15 : 968-975, 2013

22 Hosseini A, "Diabetic neuropathy and oxidative stress : therapeutic perspectives" 2013 : 168039-, 2013

23 Bastyr EJ, "Development and validity testing of the neuropathy total symptoms score-6 : questionnaire for the study of sensory symptoms of diabetic peripheral neuropathy" 27 : 12278-12294, 2005

24 Gore M, "Burden of illness in painful diabetic peripheral neuropathy" 7 : 892-900, 2006

25 Sadosky A, "Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US : results from a retrospective chart review and crosssectional survey" 6 : 79-92, 2013

26 Klonizakis M, "Assessment of lower limb microcirculation : exploring the reproducibility and clinical application of laser Doppler techniques" 24 : 136-143, 2011

27 Vallianou N, "Alpha-lipoic acid and diabetic neuropathy" 6 : 230-236, 2009

28 Abuaisha BB, "Acupuncture of the treatment of chronic painful peripheral diabetic neuropathy : a long-term study" 39 : 115-121, 1998

29 Tsuchiya M, "Acupuncture enhances geration of nitric oxide and increases local circulation" 104 : 301-307, 2007

30 Sheng-Hsiung Hsiao, "A Neurovascular Transmission Model for Acupuncture-induced Nitric Oxide" 사단법인약침학회 1 (1): 42-50, 2008