Acupuncture for acute hordeolum

Abstract

Background Hordeolum is an acute, purulent inflammation of the eyelid margin usually caused by obstructed orifices of the sebaceous glands of the eyelid. The condition, which affects sebaceous glands internally or externally, is common. When the meibomian gland in the tarsal plate is affected, internal hordeolum occurs, while when the glands of Zeis or Moll associated with eyelash follicles are affected, external hordeolum, or stye occurs. The onset of hordeolum is usually self limited, and may resolve in about a week with spontaneous drainage of the abscess. When the condition is severe, it can spread to adjacent glands and tissues. Recurrences are very common. As long as an internal hordeolum remains unresolved, it can develop into a chalazion or generalized eyelid cellulitis. Acupuncture is a traditional Chinese medical therapy aimed to treat disease by using fine needles to stimulate specific points on the body. However, it is unclear if acupuncture is an effective and safe treatment for acute hordeolum. Objectives The objective of this review was to investigate the effectiveness and safety of acupuncture to treat acute hordeolum compared with no treatment, sham acupuncture, or other active treatment. We also compared the effectiveness and safety of acupuncture plus another treatment with that treatment alone. Search methods We searched CENTRAL, Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE, Embase, PubMed, Latin American and Caribbean Health Sciences Literature Database (LILACS), three major Chinese databases, as well as clinical trial registers all through 7 June 2016. We reviewed the reference lists from potentially eligible studies to identify additional randomised clinical trials (RCTs). Selection criteria We included RCTs of people diagnosed with acute internal or external hordeola. We included RCTs comparing acupuncture with sham acupuncture or no treatment, other active treatments, or comparing acupuncture plus another treatment versus another treatment alone. Data collection and analysis We used standard methodological procedures used by Cochrane. Main results We included 6 RCTs with a total of 531 participants from China. The mean age of the participants ranged from 18 to 28 years. Four RCTs included participants diagnosed with initial acute hordeolum with a duration of less than seven days; one RCT included participants diagnosed with initial acute hordeolum without specifying the duration; and one RCT included participants with recurrent acute hordeolum with a mean duration of 24 days. About 55% (291/531) of participants were women. Three RCTs included participants with either external or internal hordeolum; one RCT included participants with only external hordeolum; and two RCTs did not specify the type of hordeolum. Follow-up was no more than seven days after treatment in all included RCTs; no data were available for long-term outcomes. Overall, the certainty of the evidence for all outcomes was low to very low, and we judg...

The quality of Cochrane systematic reviews of acupuncture: an overview

“…However, according to the results of some CSRs, acupuncture seems to produce more positive effects than sham acupuncture or no treatment for pain or quality of life. Comparing CSRs of acupuncture in the past five years (2015-2019) with CSRs of acupuncture in the preceding years, we can find an increase of more than 10% in the coincidence rate of 9 of 16 items (1,3,4,9,10,11,12,15,16); among them, the items 10, 15 and 16 had an increase of more than 35%, and the items 4, 11 and 12 of more than 20%. Meanwhile, the coincidence rate of 3 items (5,6,14) has decreased, particularly item 6 with a decrease of more than 30%.…”

“…With regard to acupuncture safety, 24 reviews (48%) reported adverse events in the included RCTs, eleven reviews (22%) did not report information about adverse events [8, 20, 22, 32-34, 37, 41, 42, 48, 50], and 15 reviews (30%) reported no adverse events [7, 9, 11, 17, 18, 21, 26, 28, 29, 38-40, 43, 49, 56]. Regarding the main adverse events, 9 reviews reported unbearable pain or pain caused by anxiety [12,13,15,16,36,47,51,52,54]; 5 reviews reported headache, dizziness or even syncope [14,16,23,35,51]; 2 reviews reported local infection [10,23]; 3 reviews reported local fever or swelling [10,31,47]; 2 reviews reported blood stasis [19,31]; one review reported allergy [30]; and one review reported ear irritation [47].…”

“…Almost half of CSRs were of high or medium quality: 8 CSRs (16%) were assessed as high quality, and 16 CSRs (32%) were assessed as medium quality. The highest quality CSRs were related to neuropathic pain in adults [24], glaucoma [29], postoperative nausea and vomiting [30], acute hordeolum [10], premenstrual syndrome [7], carpal tunnel syndrome [15], symptomatic gastroparesis [38] and depression [45].…”

Risk of bias assessment of sequence generation: a study of 100 systematic reviews of trials

“…However, when examining the reasons given, one review had rated a study as high ROB for sequence generation, but the justification said there was a lack of information reported, which would have been more appropriately rated as ‘unclear’ ROB [8]. The justification of one study [9] relates more to ROB related to allocation concealment than sequence generation.…”

“…Details of this protocol number unclear.”Sozen 2011b: “The participants were randomised into two groups, drained and non-drained, according to the admission protocol number. Nature of this protocol number unclear.”Cheng et al [9]1 (16.7%)Randomisation may have not been executed properly as there was a large difference in the number of participants in each arm; the acupuncture arm had 25/109 (40%) more participants than the control group. A random number table was used to generate sequence.…”