Einfluss der Laser-Akupunktur auf die psychovegetative Spannung bei Keratoconjunctivitis sicca – eine RCT-Studie (Randomized Controlled Trial)

Abstract

IntroductionKeratoconjunctivitis sicca (KCS) is an impairment of the tear film but also of the general well-being. Local treatment with artificial tears frequently showed insufficient results. Patients with such negative results were treated with acupuncture in earlier studies indicating clinical effectiveness. This was especially the case in patients with a nervous disposition indicating that the effectiveness of the acupuncture was dependent on a psycho-vegetative reduction in tension. The question this study addresses is ‘Can acupuncture have an effect on the psyche or vegetative function?’ With vegetative dystonia and activation of the sympathetic nervous-system, perspiration increases, Mydriasis (dilation of the pupil) occurs, as well as changes in the psychological state (mood swings). The influence of acupuncture on the tear film and on the general well-being were examined in this study. MethodTo observe the tension of the sympathetic system, we measured the skin contact level by attaching AgCl electrodes on the thenar and antithenar of the untrained hand. For determination of skin contact level and habituation, computer assisted measurement by way of measurement of the pupillary diameter a TV pupillometer 1050 by whittaker cooperation was used. Evaluation of mood and the psychic condition was by means of the Zerssen patient self-rating questionnaire.The tear film was evaluated by slit lamp, Schirmer, break up time and Bengal-Rosa staining.The tests were repeated after 3 months. Randomised weekly treatments of laser acupuncture and sham-laser, double-blind were carried out for 10 weeks. For statistical analyses the paired t-test was employed. Results20 patients with KCS (17 women, 3 men) were observed. After acupuncture with the Verum laser (group A) the diameter of the pupil reduced 1,4 average, 0,1 mm after the group B (Placebo-laser-group). Perspiration reduced and skin tension values improved from 41,4 to 48,8 (group A) and 37,1 to 37,8 (Placebo group B) as did the emotional well-being (according to Zerssen) from 21,6 to 13,0 in group A, producing a statistically significant difference between the first and second measurement in the examinations of the two groups of experimentees.There were improvements in the clinical examinations of the Verum laser group Changes of the BUT, the Lipid-interference and the drop frequency of artificial tears were significant too (p < 0,05). Bengal-Rosa staining and Schirmer tests however, produced no statistically significant difference. ConclusionThe results of this study show that acupuncture has a positive influence on vegetative reactivity and psychic tension in patients with KCS.