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Acupuncture for Chemotherapy-Induced Peripheral Neuropathy (Cipn): A Pilot Study Using Neurography

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Chemotherapy-induced peripheral neuropathy (CIPN) can produce severe neurological deficits and neuropathic pain and is a potential reason for terminating or suspending chemotherapy treatments. Specific and effective curative treatments are lacking. A pilot study was conducted to evaluate the therapeutic effect of acupuncture on CIPN as measured by changes in nerve conduction studies (NCS) in six patients treated with acupuncture for 10 weeks in addition to best medical care and five control patients who received the best medical care but no specific treatment for CIPN. In five of the six patients treated with acupuncture, NCS improved after treatment. In the control group, three of five patients did not show any difference in NCS, one patient improved and one showed impaired NCS. The data suggest that acupuncture has a positive effect on CIPN. The encouraging results of this pilot study justify a randomised controlled trial of acupuncture in CIPN on the basis of NCS.
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Original paper
Schroeder S, Meyer-Hamme G, Epplée S. Acupunct Med (2011). doi:10.1136/acupmed-2011-010034 1 of 4
ABSTRACT
Objectives Chemotherapy-induced peripheral
neuropathy (CIPN) can produce severe neurological
defi cits and neuropathic pain and is a potential
reason for terminating or suspending chemotherapy
treatments. Specifi c and effective curative
treatments are lacking.
Methods A pilot study was conducted to evaluate
the therapeutic effect of acupuncture on CIPN as
measured by changes in nerve conduction studies
(NCS) in six patients treated with acupuncture for
10 weeks in addition to best medical care and fi ve
control patients who received the best medical
care but no specifi c treatment for CIPN.
Results In fi ve of the six patients treated with
acupuncture, NCS improved after treatment. In the
control group, three of fi ve patients did not show any
difference in NCS, one patient improved and one
showed impaired NCS.
Conclusion The data suggest that acupuncture has
a positive effect on CIPN. The encouraging results of
this pilot study justify a randomised controlled trial of
acupuncture in CIPN on the basis of NCS.
INTRODUCTION
Chemotherapy-induced peripheral neuropa-
thy (CIPN) involves damage to the peripheral
nervous system and can produce severe neu-
ropathic pain or gait impairment and may be
a reason to terminate or suspend chemother-
apy treatments. Specifi c and effective curative
treatments are lacking. The major groups of
drugs that induce CIPN include the taxanes,
vinca alkaloids and platinum compounds. The
incidence of CIPN is high and can reach levels
of up to 92%.1
Publications in English language journals on
acupuncture as a symptomatic treatment for
CIPN have been limited to only a few case
studies, all of which report an improvement
in symptoms.2 3 A Chinese study described
acupuncture as more effective than cobama-
mide for the treatment of sensory symptoms
in paclitaxel-induced CIPN.4
We conducted a pilot study in 2006 in 192
patients with peripheral neuropathy diag-
nosed on the basis of nerve conduction studies
(NCS). Patients were evaluated over a period
of 1 year, measured by NCS. The aim of this
Acupuncture for chemotherapy-induced peripheral
neuropathy (CIPN): a pilot study using neurography
Sven Schroeder1,2,, Gesa Meyer-Hamme1, Susanne Epplée1
1HanseMerkur Center for TCM
at the University Medical
Centre, Hamburg, Germany
2Department of
Neurophysiology, Instituto de
Ciências Biomédicas, Abel
Salazar, University of Porto,
Porto, Portugal
Correspondence to
Sven Schroeder, HanseMerkur
Centre for TCM at the University
Medical Center, UKE-Campus,
House O55, Martinistrasse 52,
20246, Hamburg, Germany;
schroeder@tcm-am-uke.de
Received 22 May 2011
Accepted 11 October 2011
non-randomised non-blinded study was to
determine whether there is evidence of effec-
tive treatment of peripheral neuropathy (PN)
with acupuncture assessed by objective mea-
surements and whether further prospective
studies on the basis of the above criteria are
warranted. We have previously published
data on the treatment of PN of unknown aeti-
ology and diabetic neuropathy with acupunc-
ture, and found an improvement in NCS in
76% of patients after a treatment period of
10 weeks, one treatment per week.5 6 In this
paper we report our results in patients with
CIPN.
METHODS
A total of 192 consecutive patients with PN of
the lower extremities were diagnosed by NCS
and treated in a neurologist’s outpatient clinic
for a period of 1 year. Patients with PN con-
rmed by neurological examination and NCS
were included in the study. Patients with alco-
hol abuse, drug usage, a history of diabetes,
toxic drugs (except a history of chemother-
apy) or infl ammatory disease documented as
underlying causes for PN were excluded from
the study. This was confi rmed by standard
screening.5
Of this group, 11 patients had developed
symptoms of PN during the course of chemo-
therapy and were identifi ed as having CIPN.
Chemotherapy had been given for different
types of cancer (table 1).
Acupuncture treatment was offered to all
the patients with CIPN. Six patients agreed
to receive acupuncture treatment and ve
refused owing to personal inconvenience of
the appointments offered. These ve patients
(four men, one woman) of mean age 65 years
who received the best medical care but no spe-
cifi c treatment for PN thus served as a control
group. Six patients (three men, three women)
of mean age 64 years received the best medi-
cal care and additionally were treated with
acupuncture for PN of the lower extremities.
Patients in both groups did not receive any
other treatment for PN except stable doses
of carbamazepine or pregabalin during the
observation period. The characteristics of the
acupuncture and control groups are shown in
table 1.
Copyright 2011 by British Medical Journal Publishing Group.
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Original paper
Schroeder S, Meyer-Hamme G, Epplée S. Acupunct Med (2011). doi:10.1136/acupmed-2011-0100342 of 4
Measurements of nerve conduction velocity (NCV)
were performed with a Neuropack-Sigma, MEB-9400,
EMG/NCV/EP-System (Nihon-Khoden, Tokyo, Japan).
The amplitudes of the motor and sensory responses were
measured to the rst negative peak. All studies of NCV
were done at room temperature (22–24°C). Skin tempera-
ture was measured at the sites of sensory nerve measure-
ments and values were analysed, adjusting for the effects
of temperature. Follow-up NCS data were collected after a
period of 6 months (±2 weeks) by examination of the sural
and tibial nerves in the same calf as in the initial assess-
ment. Standard orthodromic needle recording methods
were used for sural nerve assessment while standard sur-
face recording methods were used for tibial nerve record-
ings.7 8 A change in NCV in the sural nerve of 2 m/s slower
or faster than the initial measurement was considered sig-
nifi cant. A change in the amplitude of the sensory nerve
action potential of more than 2 µV was defi ned as a signifi -
cant impairment or improvement in the sural nerve.
The patients were asked at the time of the second
NCS to tick one box to indicate whether their condition
had improved, worsened or remained unchanged.
Acupuncture treatment was based on a neurophysi-
ologcial approach to traditional Chinese medicine (TCM)
theory.9 Point selection followed the training curriculum
at the TCM-Master Education at the Instituto de Ciências
Biomédicas Abel Salazar, University of Porto, Portugal.
The specifi c acupuncture protocols employed in this
study are described below, point location and depth of
insertion were as described in standard textbooks10 and
disposable sterile steel needles of 0.30×30 mm were used
and left in place for 20 min to a depth of 10–30 mm. Each
patient received a standard 10-week treatment of the
ST34 (Liangqiu) as well as the ve extra points EX–LE12
(Qiduan) and the four extra points EX–LE8 (Bafeng). The
needles were inserted bilaterally. Twenty needles were
inserted per session. Needle stimulation techniques were
not used. We did not employ manipulation in order to
elicit a de qi sensation. Acupuncture was performed in
all cases by the same senior physician who had received
>1000 h of acupuncture training before participating in
the trial and had used acupuncture for 20 years. The six
patients in the acupuncture group were examined by NCS
2–21 months (mean 10.3) after chemotherapy. NCS was
performed before treatment and again 6 months later (ie,
3 months (±2 weeks) after the end of treatment).
The ve patients in the control group were examined
by NCS 1–14 months (mean 10.8) after chemotherapy and
routinely again at 6 months.
RESULTS
All six patients in the acupuncture group had hypoesthesia
in a stocking distribution; three had additional neuropathic
pain. There was no clinical motor involvement and no
motor involvement in NCS. NCS showed mixed damage of
the axon and the myelin sheath of the sensory sural nerve
in all six acupuncture-treated patients. All fi ve patients in
the control group had hypoesthesia in a stocking contri-
bution; three had additional neuropathic pain. There was
no clinical motor involvement and no motor involvement
in NCS. NCS revealed mixed damage to the axon and
myelin sheath of the sensitive sural nerve in two patients
in the control group while three had pure axonopathy. The
results of the NCS of the sural nerve as well as the subjec-
tive outcomes are shown in table 2. A comparison of the
mean values for the two groups is shown in table 3.
DISCUSSION
This pilot study shows improvement in NCS after acu-
puncture treatment in CIPN. The use of NCS as an
Table 1 Cancer types and chemotherapy of patients with
chemotherapy-induced peripheral neuropathy
Patient groups Chemotherapy
Acupunture group
Breast Docetaxel/doxorubicin/cyclophosphamide
Colon Oxaliplatin
Colon (sigmoid) Cisplatin
Bronchial Cisplatin
Lymphoma Rituximab/fl udarabin/cyclophosphamide
Lymphoma Rituximab/fl udarabin/cyclophosphamide
Control group
Breast Docetaxel/doxorubicin/cyclophosphamide
Colon (sigmoid) Oxaliplatin
Colon 5-fl uorouracil/oxaliplatin
Pleura mesothelioma Alimta/cisplatin
Lymphoma Rituximab/fl udarabin/cyclophosphamide
Table 2 Nerve conduction studies of the sural nerve and subjective outcome in acupuncture-treated and control groups
Acupuncture (10 treatments over 3 months) Control (no specifi c treatment)
Patient no NCV (m/s) Amplitude (µV)
Patients’
evaluation Patient no NCV (m/s) Amplitude (µV)
Patients’
evaluation
Initial After 6 months Initial After 6 months After 6 months Initial After 6 months Initial After 6 months After 6 months
1 0 30.6 0 0.8 Improvement 1 42 42 3.9 3.9 No change
200 00 No change 2 42 42 3.6 3.8 No change
3 36 45 0.2 1.7 Improvement 3 36 42 3.2 3.1 No change
4 0 42 0 1.2 Improvement 4 42 42 2.3 5 Improvement
5 0 42 0 2.2 Improvement 5 37 0 20 Impairment
6 34 45 1.5 2 Improvement
NCV, nerve conduction velocity.
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Original paper
Schroeder S, Meyer-Hamme G, Epplée S. Acupunct Med (2011). doi:10.1136/acupmed-2011-010034 3 of 4
objective parameter is promising for future acupunc-
ture studies, although the number of cases is limited.
Interestingly, an improvement in NCS after acupuncture
was shown in CIPN as well as in previous studies on PN
of undefi ned aetiology and diabetic neuropathy.5 6 The
results are consistent with previously published case
studies on acupuncture treatment of CIPN.4
Although PN has numerous causes including genetic,
toxic, metabolic, infectious, infl ammatory, ischaemic and
paraneoplastic disorders, the nerve can be destroyed in
a limited number of ways because the damage can only
occur at the level of the axon or the myelin sheaths.11 12
Differentiating whether neuropathy is axonal, demyelinat-
ing or both is achieved by NCS.11–14 It is generally accepted
that compromised nerve conduction in PN mainly depends
on structural changes of the myelin sheaths, while the
amplitude is correlated with the number of functional
axons.7 8 Consequently, one may speculate that repeated
therapeutic interventions with acupuncture over a period
of 10 weeks improves the symptomatic state of PN and
also induces a normalisation of histological morphology.
It has been shown by Litscher et al15 that acupuncture may
increase the blood fl ow in the limbs. Increased blood ow
to the vasa nervorum and dependent capillary beds sup-
plying the neurons16 may contribute to nerve repair with
measurable improvement of axons or myelin sheaths.
Peripheral mechanisms possibly involved may include
other types of bres, such as the small unmyelinised or
thinly myelinised fi bres commonly believed to be unde-
tected by NCS.
In addition, the symptomatic effect of acupuncture may
refl ect morphological changes in the anatomy of periph-
eral nerves and also complex derangements of central and
peripheral regulation.17 18 One hypothesis relates to the
enhancement of conduction by the dorsal column19–21 or
higher centres.22 23
CONCLUSION
The data suggest that acupuncture has a positive effect
on CIPN as measured by objective parameters (NCS).
The results are comparable to previous studies in dia-
betic neuropathy and PN of undefi ned aetiology. These
ndings are of special signifi cance since PN is otherwise
almost untreatable but seems to respond to treatment by
acupuncture. This pilot study shows encouraging results
for the application of acupuncture in CIPN, justifying a
randomised controlled trial.
Contributors SS designed data collection tools, monitored data collection for the
whole trial, wrote the statistical analysis plan, cleaned and analysed the data and
drafted and revised the paper. MH-G analysed the data and drafted and revised the
paper. ES monitored data collection and revised the draft paper.
Competing interests None
Patient consent Obtained
Ethics approval Ethical approval was obtained from the Ethik Kommission der
Hamburger Ärztekammer
Provenance and peer review Not commissioned; externally peer reviewed
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Table 3 Mean (SD) differences in nerve conduction studies of the sural nerve in acupuncture-treated and control groups
Acupuncture (10 treatments over 3 months) Control (no specifi c treatment)
Initial After 6 months Paired t test p Value Mean difference Initial After 6 months Paired t test p Value Mean difference
Mean NCV (m/s)
11.67 (18.09) 34.1 (17.54) t=3.0278 df=5 0.03 +22.43 (18.15) 39.8 (3.03) 33.6 (18.78) t=0.7962 df=4 NS 6.20 (17.41)
Mean amplitude (µV)
0.28 (0.60) 1.32 (0.83) t=3.2604 df=5 0.02 +1.03 (0.77) 3.0 (0.88) 3.16 (1.89) t=0.214 df=4 NS +0.06 (1.49)
Product of NCV
and amplitude
9.70 (20.44) 55.55 (37.66) t=3.4289 df=5 0.02 +45.85 (32.75) 120.29 (37.32) 132.72 (79.5) t=0.4163 df=4 NS +12.43 (66.78)
NCV, nerve conduction velocity.
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doi: 10.1136/acupmed-2011-010034
published online December 5, 2011Acupunct Med
Sven Schroeder, Gesa Meyer-Hamme and Susanne Epplée
using neurography
peripheral neuropathy (CIPN): a pilot study
Acupuncture for chemotherapy-induced
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... The principle of acupuncture treatment involves activating meridians and collaterals, benefiting qi, and promoting blood circulation to remove blood stasis, which makes our treatment of CIPN patients more targeted and effective. Based on clinical findings in existence (27,(46)(47)(48)(49)(50)(51), acupuncture is estimated to have potential therapeutic effect in treating symptoms of CIPN with particular advantages of relieving pain and improving the quality of life. Some studies are single-arm trials and deficient in randomization and control (49-51). ...
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Introduction Effective treatments for preventing and treating chemotherapy-induced peripheral neuropathy (CIPN) are still under exploration. Acupuncture in the treatment of CIPN requires more clinical trial data. This study aimed to evaluate the therapeutic effect of acupuncture on CIPN and explore its efficacy and safety in improving peripheral neuropathy. Methods A randomized controlled trial was conducted from May 2021 to June 2023. Eligible patients were randomly divided into a verum acupuncture group and a sham acupuncture group at a 1:1 ratio with sealed opaque envelopes. The patients of both the two groups took oral mecobalamin tablets, 0.5 mg, three times a day for 2 weeks. Participants received acupuncture treatment three times a week for 2 weeks. The primary outcome was evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) 3.0. The secondary outcomes were assessed using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-CIPN twenty-item subscale (QLQ-CIPN20), Numerical Rating Scale (NRS), Traditional Chinese Medicine (TCM) syndrome score, and nerve conduction study (NCS) testing. Assessments were conducted at baseline, 1 week, and 2 weeks. Results All 70 participants were recruited and randomized. In the end, 68 patients were included in the datasets and received verum acupuncture (n = 34) or sham acupuncture (n = 34). After 2 weeks of treatment and follow-up, a statistically significant difference was found in the NCI-CTCAE scores between the two groups (p = 0.02). Baseline-to-2-week assessment scores improved significantly in the intervention group (vs. controls) on EORTC QLQ-CIPN20 (p = 0.02), NRS scores (p = 0.03), TCM syndrome scores (p = 0.04), and sensory nerve action potential (SNAP) of median and peroneal nerves, sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) of peroneal nerves (p < 0.05). No serious adverse events were reported. Conclusion This study supports the feasibility of acupuncture combined with medication as an intervention for patients with CIPN and confirms its efficacy and safety in improving peripheral neuropathy. Clinical Trial Registration The Chinese Clinical Trial Registry, identifier ChiCTR2100045762.
... Figure 7A displays the five most prominent references exhibiting strong citation bursts, two of which are also among the most frequently co-cited works. Notably, Sven Schroeder et al. (77) had recorded the highest burst strength at 10.63. Moreover, Lu Weidong (22) had attracted considerable attention from the academic community since 2021, a trend that remains ongoing. ...
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Background Peripheral nervous system diseases (PNSD) have represented a major global health burden, leading to significant economic impacts and diminished productivity. This bibliometric analysis was performed to summarize the current research trends and hotspots over the past two decades, aiming to provide a comprehensive perspective for future research. Methods All data were sourced from the Web of Science Core Collection (WoSCC) on March 1, 2024, for publications between January 1, 2004, and December 31, 2023. Data visualization and analyses, including descriptive statistics, co-occurrence mapping, and cluster analysis, were performed using CiteSpace (Version 6.1.R6) and Excel 2021. Results Our search yielded 678 references, with the annual publication count demonstrating an increasing trend over the past 20 years. The most productive country and institution were China and Kyung Hee University, respectively. Fang Jianqiao, was the most prolific author with the highest publications. Among journals, “ Pain ,” was the most frequently cited, while the top-cited reference was a randomized controlled pilot trial by Lu Weidong in 2020. “Acupuncture” emerged as the keyword with the highest frequency. The meta-analysis indicated that acupuncture was more effective than standard care for pain associated with Diabetic Peripheral Neuropathy [MD = −2.03, 95% CI (−2.86, −1.21), 2 RCTs, 102 participants, p < 0.0001]. Conclusion Our bibliometric review revealed key insights into the focal areas of PNSD research, underscoring the urgent need for continued and targeted high-quality investigations.
... Rising evidence has highlighted the effectiveness of acupuncture in reducing neuropathic pain [15]. However, both clinical research and practice suggest that response to acupuncture is variable among patients with persistent CIPN [16][17][18][19][20]. In this threearm placebo-controlled acupuncture study for patients with moderate-to-severe CIPN, we prospectively performed QST testing to determine somatosensory characteristic changes. ...
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Purpose Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of chemotherapy. Acupuncture is a promising non-pharmacological intervention for CIPN. However, the physiological effects of acupuncture treatment remain poorly understood. We examined the effects of acupuncture on CIPN using semi-objective quantitative sensory testing (QST). Methods We conducted a randomized controlled trial of real acupuncture (RA) and sham acupuncture (SA) compared to usual care (UC) in cancer survivors with moderate-to-severe CIPN. Treatment response was assessed with QST measures of tactile and vibration detection thresholds in hands and feet, thermal detection, and pain thresholds at weeks 0, 8, and 12. Constrained linear mixed model (cLMM) regression was used for statistical analysis. Results 63 patients completed QST testing. At week 8, vibrational detection thresholds in feet were significantly lower in RA and SA (p = 0.019 and p = 0.046) than in UC, with no difference between RA and SA (p = 0.637). Both RA and SA also showed significantly higher cool thermal detection than UC (p = 0.008 and p = 0.013, respectively), with no difference between RA and SA (p = 0.790). No differences in tactile detection, vibrational detection in hands, warm thermal detection, and thermal pain thresholds were detected among the three arms at weeks 8 and 12. Conclusion QST demonstrated different patterns in RA, SA, and UC. After eight weeks of RA, we observed significant improvements in the vibrational detection threshold in feet and cool thermal detection threshold in hands compared to UC. No significant differences were seen when compared to SA. Trial Registration: ClinicalTrials.gov (NCT03183037); June 9, 2017.
Chapter
Chemotherapy is one of the most common systemic treatments in the fight of breast cancer. It can be given for curative intent after breast surgery (adjuvant treatment) or to downstage and shrink the breast cancer prior to surgery (neoadjuvant treatment) or to delay the progression of metastatic cancer (palliative treatment). In certain types of breast cancer, chemotherapy is sometimes given in combination with immunotherapy (immune system stimulant treatment) such as in the case of triple negative breast cancer or in combination with targeted therapies (e.g. monoclonal antibodies such as trastuzumab) in the case of Her2-positive breast cancers. Chemotherapies are given either intravenously or orally and can have a number of side effects depending on their mode of action. Common side effects include fatigue, hair loss, nausea and vomiting, altered taste and bowel habits, low blood counts, pyrexia and infections, autoimmune conditions (immunotherapy) and cardiac complications (2023, Chemotherapy, England). Patients who undergo chemotherapy report that they are affected from a spectrum of complications ranging from mild (still able to carry on normal activities) to severe (patients confined to bed, at home or admitted to hospital due to complications). Integrative oncology approaches play an important role in preventing, reducing the effect of and managing chemotherapy toxicity so that patients do not feel that their lives are on a hold during treatment, which can take place for a number of weeks, months and sometimes years.
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As radiation therapy is increasingly utilized in the treatment of cancer, neuropathic pain (NP) is a common radiotherapy-related adverse effect and has a significant impact on clinical outcomes negatively. However, despite an improved understanding of neuropathic pain management, pain is often undertreated in patients with cancer. Herein, we reported two cases with radiotherapy-related neuropathic pain (RRNP) who presented a positive reaction to acupuncture. Patient 1 (a 73-year-old woman) with gynecologic cancer complained of burning and electric shock-like pain in the lower limb after radiotherapy. With the accepted combination of acupuncture and drugs, the pain was alleviated completely in 8 weeks. Patient 2 (a 64-year-old woman) accepted acupuncture in the absence of medication because of her inability to tolerate the adverse events of anticonvulsant drugs. She achieved remission of pain 4 weeks later. The results of this study showed that acupuncture might be promising for controlling the RRNP in patients with cancer, especially who were intolerant or unresponsive to medications.
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Purpose of Review Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and often painful condition that occurs after administration of chemotherapeutic agents. The primary objective of this systematic review was to appraise the literature on conservative, pharmacological, and interventional treatment options for CIPN pain. Recent Findings There is level I evidence supporting modest to moderate improvement in CIPN pain from duloxetine treatment, as well as short-term modest improvement from physical therapy and acupuncture. Although opioid and cannabis administration may provide short-term modest improvement, administration is commonly limited by side effects. Generally, most studies reported no clinical benefit from yoga, topical neuropathic agents, gabapentinoids, and tricyclic antidepressants. Evidence is currently equivocal for scrambler therapy and transcutaneous electrical nerve stimulation. Finally, evidence on neuromodulation options is limited to mostly case reports/series and one observational study highlighting moderate improvement with auricular nerve stimulation. Summary This systematic review provides an overview of conservative, pharmacologic, and interventional treatment modalities for CIPN pain. Furthermore, it provides a level of evidence and degree of recommendation based on the United States Preventive Services Task Force (USPSTF) criteria for each specific treatment modality.
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Objective To evaluate the effect of acupuncture on peripheral neuropathy (PN) as measured by changes in nerve conduction studies (NCS). Methods 192 patients with PN were evaluated over a period of 1 year. In 17 patients diabetic neuropathy was found. 3 of these patients received acupuncture therapy according to classical Chinese medicine as defined by the Heidelberg model of TCM and all improved in NCS. Of the 14 non-specifically treated patients, 3 (21.4%) presented with improved NCS and 11 (78.6%) aggravated in NCS (P≪0.03). An overall of 47 patients met the criteria for PN of undefined aetiology, 21 patients received acupuncture therapy, while 26 patients received no specific treatment. All groups were examined by NCS before treatment and 4 months later. Results 1) Diabetic neuropathy, in the control-group 3 patients improved and 11 showed an aggravation. Comparison of groups was significantly different. 2) PN, 16 patients (76.2%) in the acupuncture group improved, while only 4 patients in the control group (15.4%) did so. 3 patients in the acupuncture group (14.3%) showed no change and 2 patients an aggravation (9.5%), whereas in the control group 7 patients showed no change (26.9%) and 15 an aggravation (57.7%).Comparison of the groups was significantly different. Conclusion There is a positive effect of acupuncture on PN, as measured by objective parameters (NCS).
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To seek the effective treatment for peripheral neuropathy induced by chemotherapeutic drugs. Sixty-four cases of peripheral neuropathy induced by Paclitaxel or Oxaliplatin were randomly divided into an acupuncture group and a medication group, 32 cases in each group. The acupuncture group was treated with therapeutic principle of dredging meridians and collaterals, tonifying qi and eliminating blood stasis, supplementing liver and kidney, nourishing blood and tendon. Hegu (LI 4), Taichong (LR 3), Zusanli (ST 36), Qihai (CV 6) and Quchi (LI 11) etc. were selected. The medication group was treated with intramuscular injection of Cobamamide. The neurotoxicity of two groups was compared with questionnaire of peripheral neuropathy induced by chemotherapeutic drugs before and after treatment. The total effective rate for sensory nerve disorder of acupuncture group was 66.7% (20/30), which was superior to that of 40.0% (12/30) in medication group (P < 0.05). Acupuncture is more effective than Cobamamide for treatment of peripheral neuropathy induced by chemotherapeutic drugs, especially for moderate and severe sensory nerve disorder induced by paclitaxel.
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Electrodiagnostic evaluation of patients with suspected polyneuropathy is useful for detecting and documenting peripheral abnormalities, identifying the predominant pathophysiology, and determining the prognosis for certain disorders. The electrodiagnostic classification of polyneuropathy is associated with morphologic correlates and is based upon determining involvement of sensory and motor fibers and distinguishing between predominantly axon loss and demyelinating lesions. Accurate electrodiagnostic classification leads to a more focused and expedient identification of the etiology of polyneuropathy in clinical situations.