Effects of electroacupuncture on conjunctival cell apoptosis and the expressions of apoptosis-related proteins Caspase-3,Fas and Bcl-2 in rabbits with dry eye syndrome

Objective:By observing the effects of electroacupuncture(EA)on the apoptosis of conjunctival cells of rabbits with dry eye syndrome(DES)and the expressions of apoptosis-related proteins Caspase-3,Fas and Bcl-2,to discuss the mechanism of EA in the treatment of DES from the perspective of cell apoptosis.Methods:Male New Zealand rabbits were randomly divided into a normal group(NG),a model group(MG),an EA group(EAG)and a sham EA group(SEAG).DES rabbit model was developed by eye drop of 0.1%benzalkonium chloride.The rabbit tear secretion and tear film break-up time(BUT)were measured;terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)assay was used to detect the apoptosis of conjunctival cells;the expressions of Caspase-3,Fas and Bcl-2 proteins in conjunctival cells were detected by immunohistochemistry.Results:Compared with the NG,the rabbit tear secretion decreased and the BUT was shortened in the MG(both P<0.01);compared with the MG and the SEAG,the rabbit tear secretion increased and the BUT was prolonged in the EAG(all P<0.05).Compared with the NG,the apoptosis of rabbit conjunctival cells increased(P<0.01),the expressions of Caspase-3 and Fas proteins increased(both P<0.05),and the expression of Bcl-2 protein decreased(P<0.01)in the MG;compared with the MG and the SEAG,the apoptosis of rabbit conjunctival cells decreased(both P<0.01),the expressions of Caspase-3 and Fas proteins decreased(all P<0.05),and the expression of Bcl-2 protein increased(both P<0.01)in the EAG.Conclusion:EA can inhibit the apoptosis of rabbit conjunctival cells,down-regulate the expressions of apoptosis-related proteins Caspase-3 and Fas,and up-regulate the expression of Bcl-2 protein,which may be one of the mechanisms of EA in treatment of DES.

Efficacy observation of acupuncture for dry eye syndrome of lung-yin deficiency pattern

Objective:To observe the clinical efficacy of combining two needling manipulations,Er Long Xi Zhu(two dragons playing with a pearl)and Guo Yan Re(heat produced to reach the eyes),in treating dry eye syndrome(DES)of lung-yin deficiency pattern.Methods:Fifty-six eligible DES patients of lung-yin deficiency were randomized into an observation group and a control group,with 28 cases in each group.Same acupoints were selected in the two groups:Cuanzhu(BL 2),Sizhukong(TE 23),Taiyang(EX-HN 5)and Fengchi(GB 20)were chosen as the major points and Feishu(BL 13)and Chize(LU 5)as the adjuvant.Er Long Xi Zhu and Guo Yan Re needling manipulations were applied in the observation group while twirling reinforcing manipulation was used in the control group.Treatment was conducted once per day in both groups,for two sets of 15 consecutive days at a 2-day interval.Changes in the symptom score,tear break-up time(BUT)and tear production were observed afterwards,and the clinical efficacy was also compared between the two groups.Results:The total effective rate was 92.8%in the observation group,higher than 71.4%in the control group,and the between-group difference was statistically significant(P<0.05).After treatment,the symptom score,tear BUT and tear production showed significant improvements in both groups(all P<0.05);the symptom score,BUT and tear production in the observation group were significantly different from those in the control group(all P<0.05).Conclusion:Given the same acupoint selection,combining Er Long Xi Zhu and Guo Yan Re needling manipulations can produce more significant clinical efficacy than twirling reinforcing manipulation in treating DES of lung-yin deficiency pattern.

Acupuncture for dry eye syndrome:a meta-analysis of randomized controlled trials

Objective： To summarize and critically assess the evidence from randomized controlled trials（RCTs） of acupuncture in treating dry eye syndrome（DES） according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses（PRISMA） statement and the Cochrane Collaboration recommendations.Methods： A search of PubMed, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Embase was made from their inception to August 2016, as well as Chinese, Japanese, and Korean databases. Two reviewers independently selected RCTs and assessed the methodological quality. Meta-analysis and the level of evidence were processed by RevMan 5.3 and the Grading of Recommendations Assessment, Development and Evaluation（GRADE）approach.Results： After selection, 8 trials were subjected to our systematic review. The methodological quality was low generally.The 3-10 weeks follow-up showed that acupuncture improved the tear film break-up time（BUT）（MD=1.33, 95%CI=1.01-1.66, 619 participants）. The mean difference of Schirmer＇s test was 1.73 mm（95%CI=1.28-2.18, 618participants） between the acupuncture group and the control group. The subjective variables exhibited no significant differences.Conclusion： The low methodological quality of the trials does not suggest drawing firm conclusions on the value of acupuncture therapy for DES. Acupuncture treatment may have some effects on the tear film BUT and Schirmer＇s test,but not on the subjective symptoms. Well-planned large-scale high-quality RCTs are needed to make it clear whether acupuncture is effective in treating DES.

Research on Acupuncture-moxibustion for Dry Eye Syndrome

Dry eye syndrome （DES） is a commonly encountered ophthalmological disease, with a relatively high incidence, and expects an effective treatment method. Acupunctureoxibustion therapy promotes tear production of lacrimal gland without causing a trauma, and thus has a great advantage in treating DES. Through literature analysis, this article summarized the research progress in both clinical practice and mechanism of acupuncture- moxibustion in treating DES during the recent 10 years, for providing valuable references for the application of acupuncture-moxibustion for DES.

Effect of eye acupuncture on plasma PGF_(2α) in patients of primary dysmenorrhea

Objective To observe the clinical curative effect of eye acupuncture therapy on primary dysmenorrhea and the effect on content of prostaglandin F2α （PGF2α） in peripheral blood of menstrual periods. Methods One hundred and ten cases of primary dysmenorrhea were randomly divided into an eye acupuncture group （60 cases） and a medication group （50 cases）. In the eye acupuncture group, lower-jiao area, liver area, kidney area, heart area and spleen area, etc. were selected according to syndrome differentiation, and the eye acupuncture therapy was applied. In the medication group, 300 mg Ibuprofen sustained release capsule was orally administrated 1–2 days before menstrual onset or when the symptoms appeared, once every 12 hours, for 3–5 days totally, 3 menstrual periods constituting one therapeutic course. The content of PGF2α in peripheral blood, and the curative effects and recurrence 3 and 6 months after treatment were observed. Results Three months after treatment, the cured rate was 55.0% （33/60） and the total effective rate was 95.0% （57/60） in the eye acupuncture group, which were superior to those of 34.0% （17/50） and 82.0% （41/50） in the medication group （both P0.05）. According to the following-up after 6 menstrual cycles, the recurrence rate of 9.1% （3/33） in the acupuncture group was significantly lower than that of 35.3% （6/11） in medication group. The contents of PGF2α in peripheral blood of menstrual periods were reduced after treatment in the two groups （both P0.01）. Conclusion The curative effect of eye acupuncture on primary dysmenorrhea is significant, with the level of PGF2α in peripheral blood of menstrual periods reduced.

Influence of electroacupuncture on histomorphology of lacrimal glands and ocular surface in experimental dry eye syndrome

Objective： To observe the influence of electroacupuncture （EA） on histomorphologies of lacrimal glands, cornea and conjunctiva in experimental dry eye syndrome, and to explore the repair effects of EA on lacrimal glands and ocular surface damage. Methods： Twenty-four healthy male New Zealand rabbits were randomly divided into a normal group, a model group, an EA group and a medication group, 6 rabbits in each group. Experimental dry eye syndrome models were prepared in rabbits by using 0.1% benzalkonium chloride for eye drops. Tear secretion volume, break-up time of tear film （BUT） and corneal fluorescein staining score were observed before and after the treatment. Periodic acid Schiff （PAS） staining method was used to observe the changes of conjunctival goblet cells in rabbits. After hematoxylin eosin （HE） staining, morphological changes of rabbit cornea, conjunctiva and lacrimal gland tissues were observed under light microscope. Results： Compared with the normal group, tear secretion volume and BUT were significantly reduced （both P^0.01）, while the corneal fluorescein staining score was significantly increased （P〈O.01） in the model group. Compared with the model group, tear secretion volume and BUT were significantly increased, while the corneal fluorescein staining score was significantly decreased in the EA group and the medication group （all P〈0.01）. Compared with the normal group, the number of conjunctival goblet cells in the model group was significantly reduced; compared with the model group, the numbers of conjunctival goblet cells were all relatively higher in the EA group and the medication group. Pathological lesions of cornea, conjunctiva and lacrimal glands all showed improvement by HE staining in the EA group and the medication group after the intervention. Conclusion： EA can improve tear secretion and tear film stability of rabbit dry eye syndrome, and repair the pathologic lesions of conjunctival goblet cells, corneal epithelia, cornea, conjunctiva and lacrimal glands.

Effects of dry eye syndrome and tear film mucin treated with acupuncture

Objective To explore the therapeutic effects and mechanism of dry eye syndrome treated with acupuncture therapy. Methods Thirty cases （60 eyes） of dry eye syndrome were treated with both local and distal acupuncture. Jingrning （睛明 BL 1）, Cuanzhu （攒竹 BL 2）, Tatiyang （太阳 EX-HN 5） and Quchi （曲池 LI 11） were selected; tear secretion quantity, break up time of tear film （BUT） and expression of tear film mucin were observed before and after treatment. Results Tear secretion quantity was increased and break up time of tear film was prolonged after acupuncture therapy, indicating the significant differences （both P〈0.05）; meanwhile, the expression of tear film mucin was increased [（0.67 ± 0.1） ng vs （0.89 ± 0.23） ng, P〈0.05]. Conclusion Acupuncture can promote the expression of tear film mucin, enhance the stability of tear film and remarkably improve the symptoms of dry eye.

Summary on Clinical Experience of Acupuncture Treating Dry Eye Syndromes

Dry eye syndromes （DES） refer to discomfort in the eye region, visual disturbance, poor stability of lacrimal film, inflammation of eye surface and its potential injury due to many factors of abnormal lacrimation. Patients with this condition can experience a dry sensation in the eyes, foreign body sensation,

Efficacy of electroacupuncture for patients with dry eye syndromes:a randomized controlled trial

Objective To observe the efficacy of electroacupuncture(EA)in treating dry eye syndromes(DES)and its regulatory effects on patient’s quality of life(QOL),anxiety,and depression.MethodsBy following a randomized controlled study design,eligible DES patients were allocated to an EA group(EAG)or an acupuncture group(AG).Patients in the AG were intervened by acupuncture alone,while in the EAG,electrical stimulation was applied to Cuanzhu(BL2)and Taiyang(EX-HN5)in addition to the same treatment in the AG.Changes in clinical manifestations,ocular surface disease index(OSDI),Schirmer tear test-1(STT-1),tear-film break-up time(TF-BUT),cornea fluorescein staining(CFS),and corneal sensitivity(CS)were observed,as well as changes in the short-form 36-item health survey(SF-36)and hospital anxiety and depression scale(HADS)scores.ResultsThe scores of clinical symptoms,OSDI,and CFS decreased significantly in both EAG and AG when compared with the baseline values(P<0.05),respectively,while the TF-BUT and CS increased significantly(P<0.05),and the tear secretion of patients in the EAG increased(P<0.05).Compared with those before treatment,the scores of physical role functioning,general health perception,emotional role functioning,and mental health of patients in both EAG and AG showed significant increases after treatment(P<0.05),together with a marked decrease in the score of anxiety(P<0.05).Compared with the AG,the EAG obtained a more significant increase in STT-1(P<0.05).ConclusionDES patients respond well to both EA and acupuncture treatments,manifested by prolonged TF-BUT and improvement of CS.Meanwhile,the two approaches can improve QOL and reduce anxiety.Furthermore,EA appears more effective in increasing tear secretion than acupuncture alone.

Clinical efficacy of electroacupuncture in controlling myopia in children and its influence on retinal blood flow

Objective:To observe the clinical efficacy of electroacupuncture(EA)in controlling myopia in children and its effect on retinal blood flow.Methods:Sixty-eight myopic children were randomly divided into an observation group and a control group,with 34 cases in each group.The control group was given auricular acupressure treatment alone,and the observation group was treated with EA once a week in addition to the treatment used in the control group.The spherical equivalent refraction(SER)and axial length(AL)were measured at baseline,and after 3 months and 6 months of treatment.Optical coherence tomography angiography was used to measure the vessel density(VD)and perfusion density(PD)in the surface layer of the retina.Results:After 3 months and 6 months of treatment,the changes in SER between the two groups were not statistically significant(P>0.05).After 3 months of treatment,the changes in AL between the two groups were not statistically significant(P>0.05);after 6 months of treatment,the change amount of AL in the observation group was smaller than that in the control group(P<0.05);after 3 months and 6 months of treatment,the changes in VD and PD in the surface layer of the retina in the observation group were significantly greater than those in the control group(P<0.01).Conclusion:EA treatment once a week for 6 months can delay the increase of AL and improve the retinal surface blood flow in myopic children.

Diverse Needling Methods for Dry Eye Syndrome:A Randomized Controlled Study

Objective： To explore a proper acupuncture treatment protocol for dry eye syndrome （DES）, by comparing the therapeutic effects between ordinary acupuncture and electroacupuncture （EA）. Methods： Forty-seven eligible subjects with DES were randomized into an acupuncture group （n=23） and an EA group （n=24）. With the same acupoint formula, the acupuncture group was treated with ordinary acupuncture, and the EA group was treated with ordinary acupuncture plus electrical stimulation. After a treatment course, eye symptom score, Schirmer test （SIT）, Break-up Time （BUT） of tear film, Corneal Fluorescein Staining （CFS）, and Visual Analogue Scale （VAS） were adopted in evaluation and comparison of the two groups. Results： The total effective rate was 79.2% in the EA group versus 56.5% in the acupuncture group, and the difference was statistically significant （P〈0.05）. After treatment, both groups had marked improvements in eye symptom score, SIT, BUT, CFS, and VAS values （P〈0.001）; the EA group was better than acupuncture group in improving eye symptom score and SIT value （both P〈0.05）; the differences were insignificant in comparing VAS, BUT and CFS results between the two groups （P〉0.05）. Conclusion： Both EA and ordinary acupuncture are effective in treating DES, but EA is better than ordinary acupuncture in improving eye symptom and SIT score.