A recent randomized controlled trial (RCT) conducted at Shanghai Municipal Hospital of Traditional Chinese Medicine and Fudan University Eye and ENT Hospital provides evidence that acupuncture at a single acupoint—Jingming (BL1)—significantly improves tear secretion in patients with moderate to severe dry eye disease (DED), outperforming standard artificial tear treatment [1].
Over an 8-week treatment course, patients receiving targeted acupuncture demonstrated a statistically significant increase in tear production as measured by the Schirmer I test (SIT), as well as improvements in patient-reported symptom scores. Notably, the increase in SIT in the acupuncture group was 5.75 mm greater than in the artificial tears (AT) group (P < 0.05) [1].
Study Design
The study enrolled 120 patients diagnosed with moderate to severe DED, according to criteria set by the Dry Eye Workshop II (DEWS II). Participants were randomized into two groups: an acupuncture group (n=60) and an artificial tears control group (n=60). Inclusion criteria included Ocular Surface Disease Index (OSDI) scores ≥23 and SIT scores ≤10 mm/5 min in at least one eye [1].
Acupuncture Intervention Details
The acupuncture intervention targeted the bilateral Jingming (BL1) point exclusively. Sterile single-use disposable needles (size 0.18 mm × 15 mm) were inserted perpendicularly into BL1 to a depth of approximately 5 mm. The goal of insertion was to induce the deqi sensation. Manipulation was performed until visible tear secretion was stimulated—considered an indication of effective lacrimal activation [1].
Each session lasted 30 minutes and was performed three times per week over an 8-week period, totaling 24 sessions. No electrical stimulation was applied; manual needle manipulation was used exclusively. Needles were retained for the duration of each session [1].
Outcomes and Measurements
Primary Outcome – Tear Production:
- Schirmer I test (without anesthesia) showed a significant increase in the acupuncture group from a baseline average of 4.73 ± 2.03 mm to 10.42 ± 4.48 mm at 8 weeks. In comparison, the AT group showed only a minimal increase from 4.58 ± 2.15 mm to 5.10 ± 2.39 mm [1].
Secondary Outcomes – Symptom and Ocular Surface Evaluation:
- OSDI Scores: The acupuncture group saw a reduction of 24.67 ± 16.83 points from baseline, significantly greater than the 16.18 ± 12.33-point reduction in the AT group (P < 0.05) [1].
- Tear Break-Up Time (TBUT): No significant difference between the two groups was observed.
- Corneal Fluorescein Staining (CFS): Both groups improved slightly but not significantly between groups [1].
Biomedical Mechanisms and Theoretical Rationale
While no cytokine assays or imaging (e.g., MRI, AS-OCT) were reported in this study, the authors hypothesize that stimulation of BL1 directly activates the parasympathetic innervation of the lacrimal gland via reflex arc pathways, enhancing lacrimal secretion. The observed increase in tear production corroborates this proposed mechanism, although further biochemical validation is required [1].
Safety Profile
Five adverse events related to acupuncture were recorded (e.g., mild bruising or transient discomfort), all resolving spontaneously without clinical intervention. No serious adverse events occurred, supporting acupuncture’s safety when administered by licensed acupuncturists [1].
The study’s design, exclusive use of a single acupoint, and quantifiable biomedical outcomes provide a replicable protocol for treating moderate to severe dry eye using acupuncture. These findings suggest that BL1 stimulation should be considered a viable adjunct or standalone treatment, particularly when artificial tears fail to provide adequate relief [1].
Source:
1. Hu, S., Zhao, Y., Wei, Y., & Zhang, Z. (2022). "Efficacy of Acupuncture at Jingming (BL1) Acupoint for Moderate to Severe Dry Eye Disease: A Randomized Controlled Trial." *Journal of Clinical Medicine*, 11(16), 4746.
