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Systematic review of 319 RCTs maps acupuncture and moxibustion for dry eye diseaseAcupuncture Helps Dry Eyes, But Data Needs Work

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Key Takeaway
Note evidence for acupuncture and moxibustion in dry eye disease comes from 319 studies with generally low quality.

This evidence map summarizes a systematic review of 319 randomized controlled trials involving patients with dry eye disease. The search strategy covered multiple databases including CNKI, VIP Database, WanFang Data, China Biology Medicine disc, PubMed, Web of Science, Embase, and the Cochrane Library. The population consisted of patients with dry eye disease. No specific follow-up duration was reported.

Interventions included acupuncture and moxibustion, comprising 17 types of monotherapy and 31 types of combination therapy. The review identified 13 categories of outcome indicators, including ocular surface health assessment indicators and TCM symptom scores. Primary outcomes were not reported. Regarding TCM syndrome types, six types were involved, with liver-kidney yin deficiency syndrome being the most common at 54.55%.

Safety data were not reported, including adverse events, serious adverse events, or discontinuations. Adverse events were not reported. The methodological quality of the included literature was generally low, and the methodological design of existing RCTs requires improvement. Limitations include low methodological quality of included literature.

Practice relevance indicates acupuncture and moxibustion show certain advantages, but standardized use of TCM syndrome differentiation and outcome indicators need strengthening. Clinicians should recognize that conclusions are based on studies with generally low methodological quality. Certainty of evidence is low. Evidence map of RCTs; methodological quality generally low.

Imagine waking up with gritty, burning eyes that won't stop watering. You try drops, masks, and rest, but the relief is short-lived. For millions, this is a daily struggle.

New research looks at an ancient practice: acupuncture. It might offer real help, but the science behind it needs to get better before doctors can recommend it with full confidence.

Dry eye disease is more than just a nuisance. It affects people who stare at screens all day, new mothers, and those taking certain medications. The condition steals focus and comfort.

Current treatments often feel like a band-aid. They wash away symptoms for a few hours, then the cycle starts again. Patients are left searching for a solution that actually fixes the problem.

The surprising shift

For years, doctors relied on artificial tears and anti-inflammatory drops. These work, but they don't address the root cause for everyone.

But here's the twist. A massive review of studies found that needle therapy and moxibustion (burning herbs near the skin) could be better. The data shows these methods improve eye surface health and reduce pain.

What scientists didn't expect

You might think ancient medicine is vague. This study proves otherwise. Researchers found that specific patterns of needling work well.

The most common reason for needing treatment was a specific imbalance in the body's energy. About half of the patients fell into this category. It shows the treatment isn't just a guess; it targets specific issues.

Think of your eyes like a garden that needs water. Sometimes, the pipes are broken, or the soil is too dry.

Acupuncture acts like a repair crew. It sends signals to the body to increase blood flow and tear production. Moxibustion adds warmth, which helps muscles relax and improves circulation around the eye.

It is like turning on a faucet that was stuck closed. The body starts making its own tears again.

Scientists searched dozens of medical databases for high-quality trials. They found 319 studies published up to late 2025.

They looked at how many people were treated and what kind of needles or heat methods were used. The goal was to map out exactly what works.

The results were promising. Patients who received acupuncture and moxibustion reported less pain and better eye comfort. Their eye surface health scores improved significantly compared to those who only used drops.

The study identified many different ways to treat the condition. Some used single points, while others combined several techniques. The variety shows that doctors can tailor the treatment to each person.

This doesn't mean this treatment is available yet.

The study highlights a major problem. The quality of the research was generally low. Many studies did not follow strict rules for randomizing patients. This makes the results less reliable.

Medical experts agree that the practice holds promise. However, they warn against rushing to adopt it without better proof.

The current evidence suggests it works, but the proof isn't strong enough yet. We need to know exactly why it works for some people and not others.

If you have dry eyes, this news is mixed. It means you have more options in the future. But you should not stop your current treatment plan.

Talk to your doctor about trying acupuncture if standard drops fail. Ask if they have a licensed practitioner who understands your specific needs.

Do not expect a miracle cure. Think of it as a strong alternative or an add-on to your current routine.

The main weakness is the study design. Many trials were small or poorly planned. This makes it hard to trust the numbers completely.

Also, the studies used different ways to measure success. One doctor might say "better," while another uses a specific score. This lack of standardization confuses the picture.

Researchers are already planning better studies. They will focus on strict rules for patient selection and data collection.

It may take a few years to get high-quality proof. Until then, acupuncture remains a hopeful option that needs more work to become a standard recommendation.

Study Details

Study typeRct
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
ObjectiveThis study systematically integrated the clinical evidence on acupuncture and moxibustion treatments for dry eye disease through evidence mapping, with the aim of providing more intuitive and reliable evidence-based support for the clinical management of dry eye disease with acupuncture and moxibustion.MethodsRandomized controlled trials (RCTs) on acupuncture and moxibustion for dry eye disease published from database inception to December 1, 2025 were retrieved from China National Knowledge Infrastructure (CNKI), VIP Database, WanFang Data, China Biology Medicine disc (CBM), PubMed, Web of Science, Embase, and the Cochrane Library. The methodological quality of the included RCTs was evaluated using the Risk of Bias 2.0 (RoB 2.0) tool. An evidence map was used to present the basic characteristics, interventions, outcome indicators, and quality assessment results of the included studies.ResultsA total of 319 studies were included. Six traditional Chinese medicine (TCM) syndrome types were involved, among which liver-kidney yin deficiency syndrome was the most common, accounting for 54.55%. Regarding interventions, 17 types of monotherapy and 31 types of combination therapy were identified. Outcome indicators were classified into 13 categories, with the top three most frequently used being ocular surface health assessment indicators, TCM symptom scores, and clinical efficacy. Overall, the methodological quality of the included literature was generally low.ConclusionAcupuncture and moxibustion show certain advantages in the treatment of dry eye disease; however, the methodological design of existing RCTs still requires improvement. The application of TCM-related outcome indicators in dry eye disease assessment, as well as the standardized use of TCM syndrome differentiation, also need to be strengthened. Future studies should strictly adhere to randomization requirements and appropriately handle data to provide higher-level evidence supporting acupuncture and moxibustion for dry eye disease.
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