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Press needle and plum-blossom needle combination significantly lowers pro-inflammatory cytokines in diabetic peripheral neuropathyAcupuncture Techniques May Improve Nerve Function in Diabetic Patients

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Key Takeaway
Consider press needle and plum-blossom needle combination to reduce pro-inflammatory cytokines and improve nerve function in DPN.

This randomized controlled trial enrolled 225 patients with diabetic peripheral neuropathy (DPN) to evaluate the effects of press needle embedding combined with plum-blossom needle tapping. The intervention was compared against a sham needle group (simulated operations using blunt sham needles) and a control group (no additional cutaneous acupuncture interventions) over a 6-month follow-up period.

Primary outcomes included serum levels of pro-inflammatory cytokines. The treatment group showed significantly lower levels of TNF-α (Cohen's d: 0.753-1.364), IL-6 (0.517-1.456), and IL-1β (0.756-1.681) compared to both the sham and control groups (P < 0.001). Secondary outcomes showed that the treatment group achieved statistically greater improvements in sensory and motor nerve conduction velocity (P < 0.05) and superior scores in modified Toronto Clinical Neuropathy Score (mTCNS) and Total Neuropathy Score (TNS) compared to other groups (P < 0.001).

Safety and tolerability profiles were reported as favorable, with no specific adverse events or discontinuations noted. While the study suggests a mechanism involving the inhibition of persistent neuroinflammatory cascades, this remains a proposed mechanism. The results suggest that this combined acupuncture technique may improve DPN by reducing systemic inflammation and improving nerve function.

How this fits prior evidence

How this fits prior evidence: This finding extends previous evidence regarding non-pharmacological interventions for DPN. Specifically, it complements the finding that Moxibustion combination therapies improve nerve conduction and clinical scores in diabetic neuropathy. While previous evidence highlighted the role of microvascular alteration as a determinant for DPN prevalence and the use of alpha-lipoic acid for symptom relief and structural repair, this study provides a specific acupuncture-based approach to target pro-inflammatory cytokines.

Researchers conducted a randomized controlled trial to see if specific acupuncture techniques could help people with diabetic peripheral neuropathy (DPN). The study included 225 patients. The treatment group received a combination of press needle embedding and plum-blossom needle tapping, while other groups received sham needles or no additional acupuncture.

The results showed that the acupuncture group had significantly lower levels of certain inflammatory markers, such as IL-1β, IL-6, and TNF-α, compared to the other groups. Additionally, patients receiving the acupuncture treatment showed better nerve conduction speeds and improved scores on clinical scales used to measure neuropathy symptoms.

While the study suggests these techniques may help by reducing inflammation and improving nerve function, it is important to note that this is a specific clinical trial. The results are promising for managing symptoms, but you should talk to your doctor to see if these treatments are right for your specific condition.

What this means for you:
Acupuncture may lower inflammation and improve nerve function in some patients with diabetic neuropathy.

Common questions

What did the study find regarding nerve function?

The study found that the group receiving press needle embedding and plum-blossom needle tapping showed significantly better improvements in both sensory and motor nerve conduction velocity compared to the control and sham groups.

How did the treatment affect inflammation?

The treatment group showed significantly lower levels of three specific inflammatory markers: IL-1β, IL-6, and TNF-α. These levels were notably lower than those found in the groups that received sham needles or no extra acupuncture.

Is this acupuncture treatment safe for patients with neuropathy?

The study reported a favorable safety and tolerability profile for the acupuncture treatments used. However, you should always consult with your healthcare provider to discuss the best treatment plan for your specific needs.

Study Details

Study typeRct
EvidenceLevel 2
PublishedSep 2026
View Original Abstract ↓
ObjectiveTo evaluate the clinical efficacy and safety of combined press needle and plum-blossom needle therapy in patients with diabetic peripheral neuropathy (DPN), and to explore its therapeutic mechanism related to neuroinflammation.MethodsA total of 225 DPN patients were enrolled and randomly divided into a treatment group, a control group and a sham needle group at a 1:1:1 ratio. All participants received basic treatment with oral epalrestat and mecobalamin for 6 months. The treatment group was administered press needle embedding combined with plum-blossom needle tapping; the sham needle group received identical simulated operations using blunt sham needles without effective stimulation; the control group received no additional cutaneous acupuncture interventions. Serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected as primary outcomes. Secondary outcomes included motor and sensory nerve conduction velocity (NCV), nerve action potential amplitudes, modified Toronto Clinical Neuropathy Score (mTCNS) and Total Neuropathy Score (TNS).ResultsAfter 6 months of treatment, the levels of TNF-α, IL-6 and IL-1β in the treatment group were significantly lower than those in the control group and the sham needle group (P < 0.001). The Cohen’s d values of TNF-α, IL-6 and IL-1β in the treatment group at the 2nd, 4th and 6th month were 0.753–1.364, 0.517–1.456 and 0.756–1.681 respectively, which were 1.5 to 2 times those of the other two groups. Compared with baseline, the treatment group yielded statistically greater improvements in all measured sensory conduction velocity (SCV) and motor conduction velocity (MCV) (all P < 0.05). Compared with the treatment group after intervention, the control and sham needle groups had significantly lower median, ulnar and sural SCV, median and ulnar MCV, ulnar sensory amplitude, ulnar, peroneal and tibial motor amplitude (all P < 0.05).The improvements of mTCNS and TNS in the treatment group at the 2nd, 4th and 6th month were markedly superior to those in the control and sham needle groups (P < 0.001).ConclusionCombined therapy of press needles and plum blossom needles lowers pro-inflammatory cytokine levels, elevates NCV, improves DPN-associated scale scores, and ameliorates the function of both small and large nerve fibers, with favorable safety and tolerability profiles. Its therapeutic mechanism may involve inhibition of persistent neuroinflammatory cascades.Clinical Trial Registrationhttp://itmctr.ccebtcm.org.cn, identifier ITMCTR2025000607.
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