Purpose To explore the value of shear wave elastography(SWE)in evaluating the therapeutic effect of acupuncture in patients with diabetic peripheral neuropathy(DPN).Materials and Methods Sixty patients with type 2 DPN treated at the Department of Endocrinology and Preventive Treatment Center in the First Affiliated Hospital of Nanchang University from February 13,2022 to June 3 2023 were selected prospectively,and were divided by random number table into group A(30 cases)who received hypoglycemic plus mecobalamin tablets,and group B(30 cases)who received acupuncture in addition to the treatment given to group A.Routine ultrasound and SWE were conducted to measure the diameter,cross-sectional area and Young's modulus(E)of the median nerve and tibial nerve before and after treatment.Electrophysiological examination was also performed to obtain motor nerve conduction velocity and sensory nerve conduction velocity of the median nerve and tibial nerve before and after treatment.Additionally,a control group comprising 30 healthy adults was included as the control group,and the above ultrasonic parameters were obtained.The changes in the above parameters before and after treatment were compared among the groups,and the effectiveness of acupuncture was assessed based on electromyography results.Furthermore,a receiver operating characteristic curve was constructed for the difference in E(ΔE)of the median nerve and tibial nerve.Results There were no significant differences in diameter,cross-sectional area and E of the median nerve and tibial nerve between group A and group B before treatment(P>0.05),but they were higher than those in control group(P<0.05,P<0.001).After treatment,the E values of the median nerve and tibial nerve in group B were lower than those in group A(P=0.036,0.025),and the E value in both group A and B remained significantly higher than those in control group(all P<0.001).There were no significant differences in diameter and cross-sectional area of the median nerve and tibial nerve among group A,B and control group after treatment(F=0.824,0.176,0.106,0.982,P>0.05).The E values of the median nerve and tibial nerve in group A and group B were significantly lower after treatment compared with those before treatment(group A:t=5.422,4.429,both P<0.001;group B:t=6.110,7.081,both P<0.001).The area under the curve,sensitivity,specificity and optimal cutoff value for ΔE of the median nerve and tibial nerve were 0.920,95%,90%,4.600 kPa;and 0.820,85%,70%,6.250 kPa,respectively.However,there was no significant difference in diagnostic efficiency(Z=1.489,P=0.136).Conclusion SWE can provide information regarding the elastic modulus of peripheral nerves and evaluate nerve hardness,it offers a non-invasive and effective method for evaluating the therapeutic effect in DPN patients.

Purpose To explore the value of shear wave elastography(SWE)in evaluating the therapeutic effect of acupuncture in patients with diabetic peripheral neuropathy(DPN).Materials and Methods Sixty patients with type 2 DPN treated at the Department of Endocrinology and Preventive Treatment Center in the First Affiliated Hospital of Nanchang University from February 13,2022 to June 3 2023 were selected prospectively,and were divided by random number table into group A(30 cases)who received hypoglycemic plus mecobalamin tablets,and group B(30 cases)who received acupuncture in addition to the treatment given to group A.Routine ultrasound and SWE were conducted to measure the diameter,cross-sectional area and Young's modulus(E)of the median nerve and tibial nerve before and after treatment.Electrophysiological examination was also performed to obtain motor nerve conduction velocity and sensory nerve conduction velocity of the median nerve and tibial nerve before and after treatment.Additionally,a control group comprising 30 healthy adults was included as the control group,and the above ultrasonic parameters were obtained.The changes in the above parameters before and after treatment were compared among the groups,and the effectiveness of acupuncture was assessed based on electromyography results.Furthermore,a receiver operating characteristic curve was constructed for the difference in E(ΔE)of the median nerve and tibial nerve.Results There were no significant differences in diameter,cross-sectional area and E of the median nerve and tibial nerve between group A and group B before treatment(P>0.05),but they were higher than those in control group(P<0.05,P<0.001).After treatment,the E values of the median nerve and tibial nerve in group B were lower than those in group A(P=0.036,0.025),and the E value in both group A and B remained significantly higher than those in control group(all P<0.001).There were no significant differences in diameter and cross-sectional area of the median nerve and tibial nerve among group A,B and control group after treatment(F=0.824,0.176,0.106,0.982,P>0.05).The E values of the median nerve and tibial nerve in group A and group B were significantly lower after treatment compared with those before treatment(group A:t=5.422,4.429,both P<0.001;group B:t=6.110,7.081,both P<0.001).The area under the curve,sensitivity,specificity and optimal cutoff value for ΔE of the median nerve and tibial nerve were 0.920,95%,90%,4.600 kPa;and 0.820,85%,70%,6.250 kPa,respectively.However,there was no significant difference in diagnostic efficiency(Z=1.489,P=0.136).Conclusion SWE can provide information regarding the elastic modulus of peripheral nerves and evaluate nerve hardness,it offers a non-invasive and effective method for evaluating the therapeutic effect in DPN patients.