Behandlung der Polyneuropathie mit Akupunktur – Teil 2 – Grundkonzepte und Studienlage

Peripheral Neuropathy (PNP) is caused by diabetes mellitus or chemotherapeutic agents, amongst others. Typical symptoms are distal paresthesia, pain, and the loss of sensitivity and function of the extremities. There is no pharmacological therapy except for the palliation of neuropathic pain and paresthesia. Acupuncture meets the need for new therapies for PNP. Nerve damage can be quantified by nerve conduction studies. This also enables an objectively measurable investigation of acupuncture effects.

According to criteria of TCM, PNP is a damage to the Yin. Diabetes mellitus corresponds to Xiaoke syndrome, diabetic PNP as a complication corresponds to Wei Zheng atrophy syndrome and chemotherapy-induced PNP (CIPN) largely corresponds to Bi Zheng painful obstruction syndrome.

Since the 1980s, at least 600 clinical studies, 26 reviews and three overviews of acupuncture for diabetic PNP and about 800 clinical trials, 39 reviews and three overviews of CIPN have been conducted. However, the evidence is still limited. The most common acupuncture points for PNP are located on the stomach, large intestine, liver, kidney, bladder, spleen and gallbladder meridians. In addition, the extra points Bafeng (ex-LE10) and Baxie (ex-UE9) have been used frequently. Treatment of distal points showed superior effects compared to the exclusive treatment of proximal points. Our own clinical studies have shown significant positive effects on nerve conduction studies as well as on clinical and symptom-related endpoints in diabetic PNP and CIPN. Further high-quality studies are necessary to establish a consensus for optimal treatment concepts and to clarify mechanisms of action and potential regenerative effects of acupuncture on peripheral nerves.