Qiju Nectar Drink And Qiju Clinical Studies With Acupuncture Treatment Of Lung And Kidney Dry Eye Drink Nectar

Dry eye is a major, common medical condition with significant health and economic burden in Singapore and worldwide. It is a holistic problem affected by living habits, nutrition and underlying systemic disease, inducing a significant decrease in quality-of-life. The hallmark of this disease is raised tear osmolarity and inflammation. There is no definitive cure for this condition, as treatment in the form of lubricants is only symptomatic and treatment with cyclosporine eyedrops is expensive and may not be well tolerated.Following the rise in international interest in complementary medicine, randomized-controlled studies in dry eye using Traditional Chinese Medicine (TCM) have been published, with mixed results.Therefore a clinical study was conducted involving herbal and acupuncture therapy on lung and kidney yin deficiency type of dry eye. This was only recently completed at Singapore Chung Hwa Medical Institution during the period from October2012-September2013, with support by the hospital administration, using prospective, randomized and controlled study, In the study, the aim was to evaluate the efficacy of TCM herbal medicine "qi ju gan lu yin" in treating dry eye, compared to the same herbal preparation with acupuncture and a total of89age-and gender-matched subjects were recruited.This thesis consists of the literature review and clinical study.The literature review includes two reports, in the first report, it mainliy reviewed the dry eye researches conducted by Singapore National Eye Centre in recent years which covers the etiology, histopathology, clinical features, diagnosis and treatment of the dry eye disease. In the second report, it mainly reviewed the TCM acupuncture and moxibustion dry eye treatment assessments conducted by overseas and Chinese researchers in recent years.Clinical study:Objective:to evaluate the efficacy of TCM herbal medicine "qi ju gan lu yin" in treating dry eye, compared to the same herbal preparation with acupuncture.Methods:At Singapore Chung Hwa Medical Institution during the period from October2012-September2013, a total of89age-and gender-matched subjects were recruited. This included44in Group1, the oral TCM Herbal Medicine Group, and45in Group2, the TCM Combined Herbal and acupuncture Group. Acupuncture was performed twice a week,20minutes each session, for a period of30days.All participants had dry eyes as the main complaint and were aged40-70years old. All subjects had good general health, no ocular disease, were non-smokers and did not wear contact lenses. The inclusion criteria include a positive score in the SPEED Questionnaire (Standard Patient Evaluation for Eye Dryness Questionnaire).Results:Pre-and post-treatment measurements of Schirmer1test (Sit) and TBUT test were performed. Sit (mm/5min) was improved in Group1(p=0.04) but not2(p=0.668). The interventions were more effective with regard to Tear Break-Up Time (TBUT) on group1(p=0.001) compared to Group2(p=0.099).At the post treatment visit, Group1had significantly higher TBUT than Group2(Z=7.013p=0.001for Group1; Z=1.650, p=0.099in Group2). However, no significant differences were found in Sit readings between the two groups (Z=-1.441, p=0.150). in terms of symptoms, the total%improvement in SPEED was similar at54.4%and53.3%for Groups1and2respectively. The actual improvement in SPEED score was3.58±5.40and4.40±7.82in the two groups respectively. There was no significant difference between the two groups (t=0.520, p=0.604).To increase the validity of the study, a different method of assessing symptoms based on the visual analog scale was also used (SANDE)(published previously by Schaumberg DAet al.,2007). The percentage improvement in the SANDE in Group1and2was61%and55.5%respectively. Actual SANDE improvement for Groups1and2were24.01±23.99and22.70±24.33respectively (t=-0.252, p=0.802).Furthermore the TCM lung and kidney yin deficiency score aggregates for Group1was68.18%and for Group2was71.11%.These scores were similarly improved by treatment in both Groups by3.76±6.04and4.50±5.81(t=-0.205, p=0.838).Conciusion:The findings demonstrate the potential usefulness of TCM treatment in commonly seen dry eye disease in Singapore. In this study, acupuncture does not demonstrate any additional therapeutic effect over and above herbal medication alone. In fact, for TBUT, Group1(TCM Herbal Medicine alone) has in fact shown a better result than the combined TCM methods. The result findings suggest that with more research, TCM herbal medicine may be used as an alternative approach to treat dry eyes in Singapore.