Conjuctivitis Sicca: A Comparison of Traditional Chinese and Western Medical Symptoms

In traditional Chinese medicine (TCM) three syndromes are said to be associated with conjunctivitis sicca: Liver-Yin deficiency, Liver-Yang excess and Liver fire. The diagnosis of one of these syndromes requires the use of a specific combination of points for acupuncture. We used an extensive questionnaire of autonomic nervous system disturbances to suggest points that should be treated on a western medical basis. This prospective study was performed to answer two questions: i. Is it possible to associate the complaints of our patients with a TCM syndrome? ii. Is there any difference between the results using a TCM combination of points and those selected with our western method? Thirty seven patients with conjunctivitis sicca were enrolled in the study and asked to complete two questionnaires. In one, autonomic nervous system complaints were evaluated; in the second, the symptoms of the three relevant TCM syndromes were specifically asked for. The results of both questionnaires were compared. Our “western medical” combination of points for therapy consisted of local points, and points related to the autonomic nervous system complaints and to the five Chinese elements. In total we recorded 29 different symptoms associated with conjunctivitis sicca. According to the TCM questionnaire, 21 patients had a deficit of Liver-Yin, 5 had a Liver-Yang excess and 10 suffered from Liver fire. One patient had symptoms of Liver-Yin and Liver-Yang. Yet all patients had symptoms of more than one Chinese syndrome. Only 4 out of 37 patients seemed to belong clearly to only one TCM syndrome. So the evaluation of symptoms according to the TCM system proved to be inadequate compared with the western “autonomic” system. Points for therapy resulting from the western system were similar to the points proposed by the TCM system. We conclude that the points proposed by both methods are similar for the treatment of conjunctivitis sicca, but we believe that for western medical doctors it is easier to find a successful combination of points with the western method asking about complaints of the autonomic nervous system.