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acupuncture:evaluation:ophtalmologie:15.02 œil sec [14 Jul 2018 07:18]
Nguyen Johan
acupuncture:evaluation:ophtalmologie:15.02 œil sec [25 Apr 2020 07:27] (Version actuelle)
Nguyen Johan [1.2.1. Wei 2020]
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 ====== Œil sec : évaluation de l'​acupuncture ====== ====== Œil sec : évaluation de l'​acupuncture ======
 ===== Revues systématiques et méta-analyses ===== ===== Revues systématiques et méta-analyses =====
-==== Kim 2018 ☆☆  ​====+| ☆☆☆ | Preuves en faveur d’une efficacité et d’un effet spécifique de l’acupuncture | 
 +| ☆☆ | Preuves en faveur d’une efficacité de l’acupuncture | 
 +| ☆ |Preuves limitées en faveur d’une efficacité de l’acupuncture | 
 +| Ø |Absence de preuve ou preuves insuffisantes | 
 + 
 + 
 +==== Acupuncture générique ==== 
 + 
 + 
 + 
 + 
 + 
 +=== Kim 2018 ☆☆ ​ ===
  
  
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-==== Jiang 2017  ​====+=== Jiang 2017  ===
  
 Jiang Hui-ru, Liu Su-jun, Liu Peng, Xu Si-wei, Yang Yang, Zhang Kai-yong, Shou Yin, Zhang Bi-meng. Acupuncture for dry eye syndrome: a meta-analysis of randomized controlled trials Journal of Acupuncture and Tuina Science. 2017;​15(4):​263-269. ​  ​{{:​medias securises:​acupuncture:​evaluation:​ophtalmologie:​jiang-27825.pdf|[27825].}} ​ Jiang Hui-ru, Liu Su-jun, Liu Peng, Xu Si-wei, Yang Yang, Zhang Kai-yong, Shou Yin, Zhang Bi-meng. Acupuncture for dry eye syndrome: a meta-analysis of randomized controlled trials Journal of Acupuncture and Tuina Science. 2017;​15(4):​263-269. ​  ​{{:​medias securises:​acupuncture:​evaluation:​ophtalmologie:​jiang-27825.pdf|[27825].}} ​
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-==== Sheng 2015 ☆====+=== Sheng 2015 ☆===
  
 Sheng Xueyan, Yan Xingke, Xing Jiaming. [Meta-analysis on acupuncture for dry eyes based on the clinical literatures:​ a randomized controlled trial]. Journal of Gansu College of Traditional Chinese Medicine. 2015;​1:​56-60. ​  ​[186999]. ​ Sheng Xueyan, Yan Xingke, Xing Jiaming. [Meta-analysis on acupuncture for dry eyes based on the clinical literatures:​ a randomized controlled trial]. Journal of Gansu College of Traditional Chinese Medicine. 2015;​1:​56-60. ​  ​[186999]. ​
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 ^ Results|** 8 trials involving 553 participants** satisfied the minimum criteria for meta-analysis. The evidence showed that the overall effective rate of treatment within the group receiving acupuncture was higher than that in drug group, there were statistically significant differences (P<0. 05). | ^ Results|** 8 trials involving 553 participants** satisfied the minimum criteria for meta-analysis. The evidence showed that the overall effective rate of treatment within the group receiving acupuncture was higher than that in drug group, there were statistically significant differences (P<0. 05). |
 ^ Conclusion |**The overall effective rate of acupuncture for dry eyes is significantly superior to drug treatment**,​ and has no obvious adverse reactions. But given the lack of high quality randomized controlled research, and the existence of literature publication bias, it needs more well-designed,​ randomized controlled clinical trials to confirm the effect. | ^ Conclusion |**The overall effective rate of acupuncture for dry eyes is significantly superior to drug treatment**,​ and has no obvious adverse reactions. But given the lack of high quality randomized controlled research, and the existence of literature publication bias, it needs more well-designed,​ randomized controlled clinical trials to confirm the effect. |
-==== Su 2014 ☆☆====+=== Su 2014 ☆☆===
  
 ¤Su Jing, Liu Xinquan, Miao Wanhong. [Acupuncture therapy in treating keratoconjunctivitis sicca: a systematic review]. China Journal of Chinese Ophthalmology. 2014;​1:​40-46. ​  ​[186907]. ​ ¤Su Jing, Liu Xinquan, Miao Wanhong. [Acupuncture therapy in treating keratoconjunctivitis sicca: a systematic review]. China Journal of Chinese Ophthalmology. 2014;​1:​40-46. ​  ​[186907]. ​
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 ^Conclusions |**According to evidences, acupuncture therapy could relieve Keratoconjunctivitis Sicca patients’ ocular symptom significantly compared with artificial tears**. More specifically,​ acupuncture therapy could improve the quality of tears as well as the increase of tear output. | ^Conclusions |**According to evidences, acupuncture therapy could relieve Keratoconjunctivitis Sicca patients’ ocular symptom significantly compared with artificial tears**. More specifically,​ acupuncture therapy could improve the quality of tears as well as the increase of tear output. |
  
-==== Liu 2012 ☆ ====+=== Liu 2012 ☆ ===
  
 Liu Min, Liu Mailan, Yu Meiling, Lan Lei, Yin Haiyan, Luo Ling, Tang Yong, Song Jiantao. [Acupuncture therapy for dry eye: a systematic review]. Chinese Journal of Chinese Ophthalmology. 2012;​4:​242-246. ​  ​[186938]. ​ Liu Min, Liu Mailan, Yu Meiling, Lan Lei, Yin Haiyan, Luo Ling, Tang Yong, Song Jiantao. [Acupuncture therapy for dry eye: a systematic review]. Chinese Journal of Chinese Ophthalmology. 2012;​4:​242-246. ​  ​[186938]. ​
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 ^ Conclusions |**Acupuncture or acupuncture with artificial tears would be a more effective treatment to improve the symptoms, increase the tear secretion and tear film stability in patients with dry eye, compared with artificial tears**. However, it still needs high-quality randomized controlled trials to verify the efficacy and safety of acupuncture therapy for dry eye. | ^ Conclusions |**Acupuncture or acupuncture with artificial tears would be a more effective treatment to improve the symptoms, increase the tear secretion and tear film stability in patients with dry eye, compared with artificial tears**. However, it still needs high-quality randomized controlled trials to verify the efficacy and safety of acupuncture therapy for dry eye. |
  
-==== Lee MS 2011 ☆ ====+=== Lee MS 2011 ☆ ===
  
  
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 ^Results |**Six RCTs met all the inclusion criteria**. Three RCTs compared the effects of acupuncture with artificial tears in patients with xerophthalmia or Sjögren syndrome. A meta-analysis of these data showed that acupuncture improved tear break-up times (p < 0.0001), Schirmer test scores (p < 0.00001), response rates (p = 0.002) and the region of cornea fluorescent staining (p = 0.0001) significantly more than artificial tears did. The other three RCTs compared the effects of acupuncture plus artificial tears with artificial tears alone. Two of these studies failed to show significant effects of acupuncture,​ while one reported significant effects. For Schirmer test scores and frequency of artificial tear usage, two RCTs reported superior effects of acupuncture plus artificial tears, while one RCT failed to do so.| ^Results |**Six RCTs met all the inclusion criteria**. Three RCTs compared the effects of acupuncture with artificial tears in patients with xerophthalmia or Sjögren syndrome. A meta-analysis of these data showed that acupuncture improved tear break-up times (p < 0.0001), Schirmer test scores (p < 0.00001), response rates (p = 0.002) and the region of cornea fluorescent staining (p = 0.0001) significantly more than artificial tears did. The other three RCTs compared the effects of acupuncture plus artificial tears with artificial tears alone. Two of these studies failed to show significant effects of acupuncture,​ while one reported significant effects. For Schirmer test scores and frequency of artificial tear usage, two RCTs reported superior effects of acupuncture plus artificial tears, while one RCT failed to do so.|
 ^ Conclusion |**These results provide limited evidence for the effectiveness of acupuncture for treating dry eye**. However, the total number of RCTs, the total sample size and the methodological quality were too low to draw firm conclusions.| ^ Conclusion |**These results provide limited evidence for the effectiveness of acupuncture for treating dry eye**. However, the total number of RCTs, the total sample size and the methodological quality were too low to draw firm conclusions.|
 +
 +
 +==== Comparaison de techniques d'​acupuncture ====
 +
 +
 +
 +=== Wei 2020 ===
 +
 +
 +Wei QB, Ding N, Wang JJ, Wang W, Gao WP. Acupoint selection for the treatment of dry eye: A systematic review and meta-analysis of randomized controlled trials. Exp Ther Med. 2020;​19(4):​2851-2860. ​  ​{{:​medias securises:​acupuncture:​evaluation:​ophtalmologie:​wei-207791.pdf|[207791]}}. [[https://​www.ncbi.nlm.nih.gov/​pmc/​articles/​pmid/​32256769/​|doi]]
 +
 +^Background|The effectiveness of acupuncture in the treatment of dry eye has been confirmed, but the association between acupoint selection and therapeutic effect has remained to be elucidated. |
 +^Obejctive| In the present study, a systematic review and meta-analysis were performed to evaluate the effect of periocular acupoints and periocular acupoints plus body acupoints compared with AT for the treatment of dry eye disease (DED). |
 +^Methods|The PubMed, Cochrane Library, Embase, Ovid, China National Knowledge Infrastructure and Chonqing VIP Information,​ Co., Ltd. databases were searched with entries until 10 July 2018 considered. Only randomized controlled trials (RCTs) were included. Meta-analyses were performed to compare the effects of acupuncture with those of conventional treatment (including AT or other non-acupuncture therapies). The primary outcomes, including tear break-up time (BUT), Schirmer'​s I test (SIT) result and Symptom scores were analyzed. Subgroup analysis was performed for periocular acupoints only and periocular acupoints plus body acupoints. |
 +^Results and conclusions| A total of **12 studies comprising 900 participants** were included. In the primary meta-analysis,​ a significant improvement in the BUT [n=1,209, weighted mean difference (WMD)=1.01, 95% CI: 0.56-1.84, P<​0.00001],​ SIT result (n=1,107, WMD=1.98, 95% CI: 0.44-3.34, P<​0.00001) and Symptom scores (n=402, WMD=-1.02, 95% CI: -1.33 to -0.72, P<​0.00001) was obtained to evaluate the clinical efficacy of acupuncture and AT. Furthermore,​ periocular acupoints plus body acupoints were more effective in the treatment of DED. However, the total sample size of subjects with only periocular acupoints in the treatment of DED was too small to get any firm conclusions. Further large RCTs are warranted. |
 +
 +=== Kim 2018 ===
 + 
 +
 +Kim BH, Kim MH, Kang SH, Nam HJ. Optimizing acupuncture treatment for dry eye syndrome: a systematic review. BMC Complement Altern Med. 2018;​18(1):​145. ​  ​{{:​medias securises:​acupuncture:​conduites therapeutiques:​ophtalmologie:​kim-165748.pdf|[165748].}}
 +
 +^Background| In a former meta-analysis review, acupuncture was considered a potentially effective treatment for dry eye syndrome (DES), but there were heterogeneities among the outcomes. We updated the meta-analysis and conducted subgroup analysis to reduce the heterogeneity and suggest the most effective acupuncture method based on clinical trials. |
 +^Methods|We searched for randomized controlled trials (RCTs) in 10 databases (MEDLINE, EMBASE, CENTAL, AMED, SCOPUS, CNKI, Wangfang database, Oriental Medicine Advanced Searching Integrated System (OASIS), Koreamed, J-stage) and searched by hand to compare the effects of acupuncture and artificial tears (AT). We also conducted subgroup analysis by (1) method of intervention (acupuncture only or acupuncture plus AT), (2) intervention frequency (less than 3 times a week or more than 3 times a week), (3) period of treatment (less than 4 weeks or more than 4 weeks), and (4) acupoints (BL1, BL2, ST1, ST2, TE23, Ex-HN5). The Bucher method was used for subgroup comparisons. |
 +^Results| Nineteen studies with 1126 patients were included. Significant improvements on the Schirmer test (weighted mean difference[WMD],​ 2.14; 95% confidence interval[CI],​ 0.93 to 3.34; p = 0.0005) and break up time (BUT) (WMD, 0.98; 95% CI, 0.79 to 1.18; p <​ 0.00001) were reported. In the subgroup analysis, **acupuncture plus AT treatment had a weaker effect in BUT but a stronger effect on the Schirmer test and a better overall effect than acupuncture alone. For treatment duration, treatment longer than 1 month was more effective than shorter treatment. With regard to treatment frequency, treatment less than three times a week was more effective than more frequent treatment. In the acupoint analysis, acupuncture treatment including the BL2 and ST1 acupoints was less effective than treatment that did not include them.** None of those factors reduced the heterogeneity.|
 +^ Conclusions|Acupuncture was more effective than AT in treating DES but showed high heterogeneity. Intervention differences did not influence the heterogeneity.|
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