Systematic review of 319 RCTs maps acupuncture and moxibustion for dry eye disease.
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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.
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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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