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Acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial

OBJECTIVE: Dry eye is a common disease with great health burden and no satisfactory treatment. Traditional Chinese medicine, an increasingly popular form of complementary medicine, has been used to treat dry eye but studies have been inconclusive. To address this issue, we conducted a randomised inv...

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Autores principales: Tong, Louis, Htoon, Hla Myint, Hou, Aihua, Acharya, Rajendra Udyavara, Tan, Jen-Hong, Wei, Qi-Ping, Lim, Pat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093252/
https://www.ncbi.nlm.nih.gov/pubmed/30123846
http://dx.doi.org/10.1136/bmjophth-2018-000150
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author Tong, Louis
Htoon, Hla Myint
Hou, Aihua
Acharya, Rajendra Udyavara
Tan, Jen-Hong
Wei, Qi-Ping
Lim, Pat
author_facet Tong, Louis
Htoon, Hla Myint
Hou, Aihua
Acharya, Rajendra Udyavara
Tan, Jen-Hong
Wei, Qi-Ping
Lim, Pat
author_sort Tong, Louis
collection PubMed
description OBJECTIVE: Dry eye is a common disease with great health burden and no satisfactory treatment. Traditional Chinese medicine, an increasingly popular form of complementary medicine, has been used to treat dry eye but studies have been inconclusive. To address this issue, we conducted a randomised investigator-masked study which included the robust assessment of disease mechanisms. METHODS AND ANALYSIS: Eligible participants (total 150) were treated with artificial tear (AT) alone, with added eight sessions of acupuncture (AC) or additional daily oral herb (HB) over a month. RESULTS: Participants treated with AC were more likely to respond symptomatically than those on AT (88% vs 72%, p=0.039) with a difference of 16% (95% CI: 0.18 to 31.1). The number-to-treat with AC to achieve response in one person was 7 (3 to 157). Participants in the AC group also had reduced conjunctival redness (automatic grading with Oculus keratograph) compared with AT (p=0.043) and reduced tear T helper cell (Th1)-cytokine tumour necrosis factor α (p=0.027) and Th2-cytokine interleukin 4 concentrations (p=0.038). AC was not significantly superior to AT in other outcomes such as tear osmolarity, tear evaporation rates, corneal staining and tear break-up times. No significant adverse effects were encountered. HB was not significantly different in the primary outcome from AT (80% vs 72%, p=0.26). CONCLUSIONS: AC is safe and provides additional benefit in mild to moderate dry eye up to 1 month, compared with ATs alone. Treatment is associated with demonstrable molecular evidence of reduced inflammation. Provided that suitably qualified practitioners are available to implement standardised treatment, AC may be recommended as adjunctive therapy to AT. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT02219204)registered on 14 August 2014.
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spelling pubmed-60932522018-08-17 Acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial Tong, Louis Htoon, Hla Myint Hou, Aihua Acharya, Rajendra Udyavara Tan, Jen-Hong Wei, Qi-Ping Lim, Pat BMJ Open Ophthalmol Original Article OBJECTIVE: Dry eye is a common disease with great health burden and no satisfactory treatment. Traditional Chinese medicine, an increasingly popular form of complementary medicine, has been used to treat dry eye but studies have been inconclusive. To address this issue, we conducted a randomised investigator-masked study which included the robust assessment of disease mechanisms. METHODS AND ANALYSIS: Eligible participants (total 150) were treated with artificial tear (AT) alone, with added eight sessions of acupuncture (AC) or additional daily oral herb (HB) over a month. RESULTS: Participants treated with AC were more likely to respond symptomatically than those on AT (88% vs 72%, p=0.039) with a difference of 16% (95% CI: 0.18 to 31.1). The number-to-treat with AC to achieve response in one person was 7 (3 to 157). Participants in the AC group also had reduced conjunctival redness (automatic grading with Oculus keratograph) compared with AT (p=0.043) and reduced tear T helper cell (Th1)-cytokine tumour necrosis factor α (p=0.027) and Th2-cytokine interleukin 4 concentrations (p=0.038). AC was not significantly superior to AT in other outcomes such as tear osmolarity, tear evaporation rates, corneal staining and tear break-up times. No significant adverse effects were encountered. HB was not significantly different in the primary outcome from AT (80% vs 72%, p=0.26). CONCLUSIONS: AC is safe and provides additional benefit in mild to moderate dry eye up to 1 month, compared with ATs alone. Treatment is associated with demonstrable molecular evidence of reduced inflammation. Provided that suitably qualified practitioners are available to implement standardised treatment, AC may be recommended as adjunctive therapy to AT. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT02219204)registered on 14 August 2014. BMJ Publishing Group 2018-06-18 /pmc/articles/PMC6093252/ /pubmed/30123846 http://dx.doi.org/10.1136/bmjophth-2018-000150 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Original Article
Tong, Louis
Htoon, Hla Myint
Hou, Aihua
Acharya, Rajendra Udyavara
Tan, Jen-Hong
Wei, Qi-Ping
Lim, Pat
Acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial
title Acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial
title_full Acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial
title_fullStr Acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial
title_full_unstemmed Acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial
title_short Acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial
title_sort acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093252/
https://www.ncbi.nlm.nih.gov/pubmed/30123846
http://dx.doi.org/10.1136/bmjophth-2018-000150
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