Therapeutic effect of Chinese Tuina on diabetic peripheral neuropathy: systematic review and meta-analysis

Objectives: Clinical studies suggest that Chinese Tuina therapy may benefit diabetic peripheral neuropathy (DPN), but the evidence is inconclusive. This study evaluates its clinical efficacy and safety for DPN treatment. Methods: Ten databases were searched, covering the period from their inception to February 21, 2024. Relevant data were extracted from studies meetingthe inclusion criteria, and a meta-analysis was conducted using RevMan 5.3 software. Results: A total of 24 randomized controlled trials (RCTs) involving 1,989 participants were included in the study. The meta-analysis results showed that, compared to a control group, the Chinese Tuina therapy group demonstrated a higher overall clinical efficacy rate and improved Toronto Clinical Scoring System (TCSS) scores, indicating that Chinese Tuina may provide benefits beyond conventional treatment. Furthermore, improvements were observed in the motor and sensory nerve conduction velocities (MNCV and SNCV) of certain specific nerves, such as the common peroneal nerve, sural nerve, and ulnar nerve. Although the differences in MNCV and SNCV of the tibial and median nerves were not statistically significant, the overall improvement in clinical outcome supports the conclusion that Chinese Tuina is superior to conventional treatment. Conclusion: Chinese Tuina therapy is a safe and effective treatment option for DPN. It can alleviate clinical symptoms and improve the MNCV of the common peroneal nerve as well as the SNCV of the sural and ulnar nerves. Its efficacy in the tibial and median nerves remains unconfirmed, highlighting a need for future large-scale, high-quality RCTs.