Optimal acupuncture protocol improving symptoms of typical dry eye syndrome: meta-analysis and systematic review
Previous meta-analyses have shown a superiority of acupuncture over artificial tear for treating typical dry eye syndrome (DES). However, given that the acupuncture protocols were quite diverse in the randomized controlled trials (RCTs) included in the meta-analyses, it is necessary to establish the...
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Elsevier
2023-07-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023054348 |
| _version_ | 1797771414524133376 |
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| author | Joon-Gon Park Bong Hyo Lee Ji-Ho Na Ji-Hyeo Jung Chang-Hyun Song |
| author_facet | Joon-Gon Park Bong Hyo Lee Ji-Ho Na Ji-Hyeo Jung Chang-Hyun Song |
| author_sort | Joon-Gon Park |
| collection | DOAJ |
| description | Previous meta-analyses have shown a superiority of acupuncture over artificial tear for treating typical dry eye syndrome (DES). However, given that the acupuncture protocols were quite diverse in the randomized controlled trials (RCTs) included in the meta-analyses, it is necessary to establish the acupuncture guidelines. Thus, the optimal acupuncture protocol involved in improvements of tear-film breakup time (BUT) or Schirmer tear test (STT) was examined by meta-analyses for RCTs in patients with typical DES. Eight databases until Jun 2018 were searched for 21 RCTs (n = 1542 eyes) comparing effectiveness of acupuncture versus artificial tear control. Indirect comparison of Bucher analysis was used to find specific acupoints (SAPs) improving BUT or STT by comparing the outcomes between subgroups of the RCTs including and excluding certain SAPs. Meta-analysis was examined for the outcomes in subgroups of the RCTs based on the number of SAPs, and network meta-analysis was for multiple pairwise comparisons across the protocols using the SAPs to yield relative effects. The Bucher analyses identified nine SAPs with positive effects on BUT or STT, and the positive relations of two SAPs involved in improvements of both BUT and STT suggested potential combinations of three (‘KI3–LI4–SP6’ or ‘KI3–GB14–ST2’) or four SAPs (‘KI3–BL1–EX-HN7–SP6’). Subgroup meta-analyses showed the SAP-depending improvements of BUT or STT in the subgroups including more than three SAPs, compared with the artificial tear control. Meta-regression and network meta-analyses revealed significant correlations between the number of SAPs and the improvements of BUT and STT, and demonstrated that acupuncture using four SAPs for 21–30 days, particularly at two–three times per week, can be optimal for improving the symptoms of typical DES. These results provide useful information for guiding acupuncture in clinical trials for DES. |
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| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-12T21:36:12Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
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| series | Heliyon |
| spelling | doaj.art-27394c8bf2e14a75b757d92325c0175f2023-07-27T05:58:58ZengElsevierHeliyon2405-84402023-07-0197e18226Optimal acupuncture protocol improving symptoms of typical dry eye syndrome: meta-analysis and systematic reviewJoon-Gon Park0Bong Hyo Lee1Ji-Ho Na2Ji-Hyeo Jung3Chang-Hyun Song4College of Korean Medicine, Daegu Haany University, Gyeongsan, 38610, Republic of KoreaCollege of Korean Medicine, Daegu Haany University, Gyeongsan, 38610, Republic of Korea; Department of Acupuncture, Moxibustion and Acupoint, College of Korean Medicine, Daegu Haany University, Daegu, 42158, Republic of KoreaCollege of Korean Medicine, Daegu Haany University, Gyeongsan, 38610, Republic of KoreaCollege of Korean Medicine, Daegu Haany University, Gyeongsan, 38610, Republic of KoreaCollege of Korean Medicine, Daegu Haany University, Gyeongsan, 38610, Republic of Korea; Department of Anatomy and Histology, College of Korean Medicine, Daegu Haany University, Gyeongsan, 38610, Republic of Korea; Corresponding author. College of Korean Medicine, Daegu Haany University, Gyeongsan, 38610, Republic of Korea.Previous meta-analyses have shown a superiority of acupuncture over artificial tear for treating typical dry eye syndrome (DES). However, given that the acupuncture protocols were quite diverse in the randomized controlled trials (RCTs) included in the meta-analyses, it is necessary to establish the acupuncture guidelines. Thus, the optimal acupuncture protocol involved in improvements of tear-film breakup time (BUT) or Schirmer tear test (STT) was examined by meta-analyses for RCTs in patients with typical DES. Eight databases until Jun 2018 were searched for 21 RCTs (n = 1542 eyes) comparing effectiveness of acupuncture versus artificial tear control. Indirect comparison of Bucher analysis was used to find specific acupoints (SAPs) improving BUT or STT by comparing the outcomes between subgroups of the RCTs including and excluding certain SAPs. Meta-analysis was examined for the outcomes in subgroups of the RCTs based on the number of SAPs, and network meta-analysis was for multiple pairwise comparisons across the protocols using the SAPs to yield relative effects. The Bucher analyses identified nine SAPs with positive effects on BUT or STT, and the positive relations of two SAPs involved in improvements of both BUT and STT suggested potential combinations of three (‘KI3–LI4–SP6’ or ‘KI3–GB14–ST2’) or four SAPs (‘KI3–BL1–EX-HN7–SP6’). Subgroup meta-analyses showed the SAP-depending improvements of BUT or STT in the subgroups including more than three SAPs, compared with the artificial tear control. Meta-regression and network meta-analyses revealed significant correlations between the number of SAPs and the improvements of BUT and STT, and demonstrated that acupuncture using four SAPs for 21–30 days, particularly at two–three times per week, can be optimal for improving the symptoms of typical DES. These results provide useful information for guiding acupuncture in clinical trials for DES.http://www.sciencedirect.com/science/article/pii/S2405844023054348Artificial tearAcupuncture protocolKeratoconjunctivitis siccaMeridianSchirmerTear-film breakup time |
| spellingShingle | Joon-Gon Park Bong Hyo Lee Ji-Ho Na Ji-Hyeo Jung Chang-Hyun Song Optimal acupuncture protocol improving symptoms of typical dry eye syndrome: meta-analysis and systematic review Heliyon Artificial tear Acupuncture protocol Keratoconjunctivitis sicca Meridian Schirmer Tear-film breakup time |
| title | Optimal acupuncture protocol improving symptoms of typical dry eye syndrome: meta-analysis and systematic review |
| title_full | Optimal acupuncture protocol improving symptoms of typical dry eye syndrome: meta-analysis and systematic review |
| title_fullStr | Optimal acupuncture protocol improving symptoms of typical dry eye syndrome: meta-analysis and systematic review |
| title_full_unstemmed | Optimal acupuncture protocol improving symptoms of typical dry eye syndrome: meta-analysis and systematic review |
| title_short | Optimal acupuncture protocol improving symptoms of typical dry eye syndrome: meta-analysis and systematic review |
| title_sort | optimal acupuncture protocol improving symptoms of typical dry eye syndrome meta analysis and systematic review |
| topic | Artificial tear Acupuncture protocol Keratoconjunctivitis sicca Meridian Schirmer Tear-film breakup time |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023054348 |
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