Clinical effects of acupuncture for traumatic peripheral nerve injury: a meta-analysis of randomized controlled trials

This study aimed to systematically evaluate the clinical efficacy of acupuncture in the treatment of traumatic peripheral nerve injury (TPNI), and to provide more reliable evidence for high-quality clinical practice and decision-making.

Randomized controlled trials (RCTs) on acupuncture for TPNI were retrieved from China National Knowledge Infrastructure (CNKI), Chongqing VIP Information Co., Ltd. (VIP), Wan Fang, China Biomedical Literature Database, PubMed, Cochrane Library, Web of Science, and Embase from database inception to October 2025. Two researchers independently screened the literature according to inclusion and exclusion criteria, extracted data, and assessed the risk of bias. Meta-analysis was performed using Review Manager 5.4 software.

A total of 36 RCTs involving 2,798 patients were included. Meta-analysis showed that, compared with the non-acupuncture control group, acupuncture improved the total clinical effective rate (RR = 1.24, 95% CI [1.20, 1.28], p < 0.00001, I² = 27%), promoted neurological function score (MD = 1.04, 95% CI [0.53, 1.54], p < 0.0001, I² = 79%), reduced distal motor latency (DML) (MD = -0.49, 95% CI [-0.78, -0.20], p = 0.0008, I² = 79%), increased compound muscle action potential amplitude (CMAP) (MD = 1.88, 95% CI [0.20, 3.56], p = 0.03, I² = 98%), and raised sensory nerve conduction velocity (SCV) (MD = 5.14, 95% CI [2.33, 7.95], p = 0.003, I² = 81%). However, trial sequential analysis indicated that the cumulative sample sizes for CMAP and SCV did not reach the required information size, suggesting that the stability of the above findings remains limited. There was no significant difference in clinical effective rate and neurological function score among patients with different nerve plexus injuries. The improvement of DML, CMAP, and SCV in patients with brachial plexus injury was better than that in patients with lumbosacral plexus injury. The overall certainty of evidence in this study was rated as low.

Acupuncture can significantly improve the clinical effectiveness of traumatic peripheral nerve injury and is associated with no adverse reactions. However, given the suboptimal methodological quality of the included reviews, further well-designed randomized controlled trials are warranted to confirm our findings.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251168215, CRD420251168215.