Evidence map for randomized controlled trials of treatment of acupuncture and moxibustion for dry eye disease

Objective: This study systematically integrated the clinical evidence on acupuncture and moxibustion treatments for dry eye disease through evidence mapping, with the aim of providing more intuitive and reliable evidence-based support for the clinical management of dry eye disease with acupuncture and moxibustion. Methods: Randomized controlled trials (RCTs) on acupuncture and moxibustion for dry eye disease published from database inception to December 1, 2025 were retrieved from China National Knowledge Infrastructure (CNKI), VIP Database, WanFang Data, China Biology Medicine disc (CBM), PubMed, Web of Science, Embase, and the Cochrane Library. The methodological quality of the included RCTs was evaluated using the Risk of Bias 2.0 (RoB 2.0) tool. An evidence map was used to present the basic characteristics, interventions, outcome indicators, and quality assessment results of the included studies. Results: A total of 319 studies were included. Six traditional Chinese medicine (TCM) syndrome types were involved, among which liver-kidney yin deficiency syndrome was the most common, accounting for 54.55%. Regarding interventions, 17 types of monotherapy and 31 types of combination therapy were identified. Outcome indicators were classified into 13 categories, with the top three most frequently used being ocular surface health assessment indicators, TCM symptom scores, and clinical efficacy. Overall, the methodological quality of the included literature was generally low. Conclusion: Acupuncture and moxibustion show certain advantages in the treatment of dry eye disease; however, the methodological design of existing RCTs still requires improvement. The application of TCM-related outcome indicators in dry eye disease assessment, as well as the standardized use of TCM syndrome differentiation, also need to be strengthened. Future studies should strictly adhere to randomization requirements and appropriately handle data to provide higher-level evidence supporting acupuncture and moxibustion for dry eye disease.