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| Systematic review and Meta-analysis of the efficacy of acupuncture and acupuncture combined with herbal medicine for treating xerostomia and dry eye in patients with Sjögren’s syndrome |
| Hits 631 Download times 252 Received:March 13, 2025 |
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| DOI
10.11656/j.issn.1672-1519.2025.08.10 |
| Key Words
acupuncture;xerostomia;dry eye;randomized controlled trial（RCT）;Sjögren’s syndrome;Meta-analysis;combined acupuncture and herbal medicine |
| Author Name | Affiliation | E-mail | | LI Jianbin | First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
National Clinical Research Center for Acupuncture and Moxibustion, Tianjin 300381, China
Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China | | | LIU Wei | First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
National Clinical Research Center for Acupuncture and Moxibustion, Tianjin 300381, China
Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China | fengshiliuwei@163.com |
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| Abstract
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| [Objective] To evaluate the efficacy of acupuncture and acupuncture-medicine combination therapy in improving the symptoms of dry mouth and dry eyes in patients with Sjögren’s syndrome through systematic review and Meta-analysis. [Methods] We searched databases including CNKI，Wanfang Data，VIP，CBM，PubMed，Cochrane Library，Embase，and Web of Science，collecting randomized controlled trials（RCTs） on acupuncture or acupuncture-medicine combination therapy for dry mouth and dry eyes symptoms in Sjögren’s syndrome patients，published up to October 1，2024. Two researchers independently screened the literature，extracted data，and assessed the risk of bias. Meta-analysis was performed using RevMan 5.4 software，with effect sizes calculated using standardized mean difference（SMD） and odds ratio（OR），and heterogeneity between studies was assessed. [Results] This study included 16 randomized controlled trials（RCTs） with 1 319 patients diagnosed with Sjögren’s syndrome. Meta-analysis showed that acupuncture alone compared to control groups demonstrated no statistically significant difference [OR=3.73，95%CI（0.42，33.08），P=0.24]，while combined acupuncture and medication therapy showed significant clinical efficacy advantages [OR=3.60，95%CI（2.53，5.11），P＜0.05]. Regarding objective biological indicators，acupuncture significantly increased salivary flow rate [MD=1.98，95%CI（0.20，3.75），P＜0.05]，and combined acupuncture and medication therapy similarly increased salivary flow rate significantly [MD=0.25，95%CI（0.03，0.47），P＜0.05]. Schirmer test results indicated that combined acupuncture and medication therapy effectively improved tear secretion in Sjögren’s syndrome patients [MD=1.47，95%CI（0.54，2.40），P＜0.05]. However，heterogeneity persisted even after subgroup analyses based on treatment duration（>4 weeks/≤4 weeks） and intervention approach（acupuncture alone/combined acupuncture and medication），with heterogeneity remaining above 50%，suggesting po tential sources of heterogeneity may involve differences in practitioner techniques，acupoint selection specificity，and baseline characteristics of study populations. In symptom assessment dimensions，the treatment groups significantly reduced traditional Chinese medicine syndrome scores [SMD=-1.29，95%CI（-1.97，-0.61），Z=-3.74，P＜0.05] and ESSPRI scores [SMD=-1.73，95%CI（-2.51，-0.95），Z=-4.34，P＜0.05]. Despite heterogeneity reaching 84.9% and 90% respectively，sensitivity analysis confirmed the robustness of results. Random effects models were applied to all outcome measures with high heterogeneity. Systematic analysis of heterogeneity sources indicated that practitioner qualifications，intervention protocol details（such as acupoint selection and treatment frequency），and differences in efficacy evaluation timepoints may be key factors affecting inter-study heterogeneity. [Conclusion] Acupuncture and acupuncture-medicine combination therapy significantly improved clinical efficacy，salivary flow rate，Schirmer test results，traditional Chinese medicine syndrome scores，and ESSPRI scores in patients with Sjögren’s syndrome，with good safety. Future large-scale，high-quality randomized controlled trials are needed to further verify the long-term efficacy of acupuncture and explore the specific mechanisms of different acupuncture schemes. |
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