AB0469 THE EFFECTS OF ACUPUNCTURE ON XEROSTOMIA, XEROPHTHALMIA AND ANTIBODY MODIFICATION IN PATIENTS WITH SJŐGREN SYNDROME: A META-ANALYSIS

医学 干眼症 荟萃分析 针灸科 随机对照试验 置信区间 内科学 优势比 口干 儿科 物理疗法 维生素 唾液 替代医学 病理 维生素A缺乏 视黄醇
作者
Tzu‐Hao Li,Yen‐Ying Kung,Chang‐Youh Tsai
标识
DOI:10.1136/annrheumdis-2019-eular.1765
摘要

Background

Xerostomia and xerophthalmia are common chief complaints among patients with Sjőgren syndrome (SS) but there has been no satisfying pharmacy to relieve the associated symptoms; hence the effectiveness of other non-pharmacological interventions such as acupuncture should be accessed.

Objectives

To access the therapeutic effects of acupuncture on xerostomia and xerophthalmia in patient with SS.

Methods

We conducted a meta-analysis of randomized clinical trials (RCTs) which evaluated the effectiveness of xerostomia and xerophthalmia in SS. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Chongqing Weipu Database (CQVIP), China Academic Journals Full-text Database, AiritiLibrary, Chinese Electronic Periodicals Service (CEPS), China National Knowledge Infrastructure (CNKI) Database were searches through Oct, 2018 to select studies. Data for evaluation of subjective and objective xerostomia was extracted and was assessed with random-effects meta-analysis.

Results

After searching, a total of 680 references were yielded and five RCTs were included, covering 460 patients dry mouth resulted from SS, among whom 229 patients received acupuncture and 231 patients were control group. Acupuncture group was associated with higher subjective response rate (odds ratio 3.036, 95% confidence interval [CI] 1.828 – 5.042, P < 0.001, Fig. 1) and increased salivary flow rate (weighted mean difference [WMD] 3.066, 95% CI 2.969 – 3.164, P < 0.001, Fig. 2), as an objective marker. Regarding xerophthalmia, acupuncture group revealed less dry eye visual analog scale (VAS, WMD -1.035, 95% CI -1.457 - -1.673, P < 0.001, Fig. 3), better Schirmer test (WMD 2.357, 95% CI 1.021 – 3.692, P = 0.001, Fig. 4) and trend of longer break-up time (WMD 4.927, 95% CI -0.055 – 9.908, P = 0.053, Fig. 5). In addition, two studies examined IgG levels, which were lower in the acupuncture group (WMD -166.857, 95% CI -233.138 - -100.576, P < 0.001, Fig. 6).

Conclusion

In the present meta-analysis, acupuncture improves both subjective and objective markers of xerostomia and xerophthalmia in patients with SS and is considered as an option of non-pharmacological treatment.

References

[1] Vivino FB. Sjogren’s syndrome: Clinical aspects. Clin Immunol. 2017;182:48-54. [2] Kuklinski E, Asbell PA. Sjogren’s syndrome from the perspective of ophthalmology. Clin Immunol. 2017;182:55-61.

Disclosure of Interests

None declared

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