穴位埋线治疗泪液生成不足型干眼症:随机对照研究
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摘要
目的:比较穴位埋线疗法与常规人工泪液治疗方案缓解干眼症患者眼部相关症状的疗效。方法:将88例泪液生成不足型干眼症患者随机分为穴位埋线组(埋线组)和人工泪液对照组(药物组),每组44例,其中埋线组脱落3例。埋线组给予肝俞、脾俞、肾俞等穴位埋线治疗,埋线操作隔30 d行1次,共2次;药物组给予常规人工泪液滴眼,每日4～6次,每次1滴,治疗8周。检测两组治疗前、治疗4周后、治疗8周后及治疗结束后8、12周泪液乳铁蛋白含量,评估两组眼部干涩、异物感、视疲劳等相关症状评分的变化情况。结果:埋线组治疗4、8周后以及治疗结束后8、12周随访时眼部干涩、异物感、烧灼感、畏光感及视疲劳症状评分均较治疗前下降(均P<0.05);药物组治疗4、8周后眼表相关症状评分较治疗前下降(均P<0.05);随访时埋线组眼表相关症状评分明显低于药物组(均P<0.05)。治疗4、8周后及治疗结束后8、12周埋线组泪液乳铁蛋白含量均较治疗前上升(均P<0.05),药物组治疗后各时间点与治疗前相比无明显变化(P>0.05);治疗后各时间点,埋线组泪液乳铁蛋白含量均高于药物组(均P<0.05)。结论:埋线疗法可有效改善泪液生成不足型干眼症患者干涩、异物感、烧灼感、畏光感及视疲劳等眼表相关症状、增加泪液乳铁蛋白含量,随访期疗效优于人工泪液滴眼。
Objective To compare the therapeutic effects on the relevant symtoms in the patients with dry eye syndrome treated with the acupoint thread-embedding therapy versus topical artificial tears eye drops. Methods A total of 88 patients with dry eye syndrome of deficiency lacrima production were randomized into an acupoint thread-embedding therapy group(thread-embedding group) and a control group with topical artificial tears eye drops(medication group), 44 cases in each one. In the thread-embedding group, 3 cases were dropped out. In the thread-embedding group, Ganshu(BL18), Pishu(BL 20) and Shenshu(BL 23) etc. were selected and the acupoint thread-embedding therapy was operated once every 30 days, totally for two treatments. In the medication group, the topical artificial tears eye drops was used, 4 to 6 times a day, one drop each time, for 8 weeks totally. Separately, before treatment, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears were determined and the scores of the relevant symptoms of ocular surface such as eye dryness, foreign body sensation in the eyes and eye fatigue were evaluated. Results In the thread-embedding group, after 4-week and 8-week of treatment as well as in 8-week and 12-week follow-up, the scores of eye dryness, foreign body sensation, burning sensation of eye,phengophobia and eye fatigue were reduced significantly as compared with those before treatment(all P<0.05). In the medication group, the relevant symptoms of ocular surface were reduced after 4-week and 8-week treatment as compared with those before treatment(all P<0.05). In the follow-up, the scores of the relevant symptoms of ocular surface in the thread-embedding group were significantly lower than the medication group(all P<0.05). Separately, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears in the thread-embedding group were significantly increased as compared with those before treatment(all P<0.05). The change was not obvious as compared with that before treatment in the medication group(P>0.05). The levels of lactoferrin in tears at each time point after treatment in the thread-embedding group were higher than the medication group(P<0.05).Conclusion The acupoint thread-embedding therapy effectively improves in the relevant symptoms of ocular surface,such as eye dryness, foreign body sensation, burning sensation of eye, phengophobia and eye fatigue, and increases the level of lactoferrin in tears in the patients with dry eye syndrome of deficiency aqueous production. In the follow-up, the therapeutic effects of the acupoint thread-embedding therapy are significantly better than artificial tears eye drops.
Objective To compare the therapeutic effects on the relevant symtoms in the patients with dry eye syndrome treated with the acupoint thread-embedding therapy versus topical artificial tears eye drops. Methods A total of 88 patients with dry eye syndrome of deficiency lacrima production were randomized into an acupoint thread-embedding therapy group(thread-embedding group) and a control group with topical artificial tears eye drops(medication group), 44 cases in each one. In the thread-embedding group, 3 cases were dropped out. In the thread-embedding group, Ganshu(BL18), Pishu(BL 20) and Shenshu(BL 23) etc. were selected and the acupoint thread-embedding therapy was operated once every 30 days, totally for two treatments. In the medication group, the topical artificial tears eye drops was used, 4 to 6 times a day, one drop each time, for 8 weeks totally. Separately, before treatment, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears were determined and the scores of the relevant symptoms of ocular surface such as eye dryness, foreign body sensation in the eyes and eye fatigue were evaluated. Results In the thread-embedding group, after 4-week and 8-week of treatment as well as in 8-week and 12-week follow-up, the scores of eye dryness, foreign body sensation, burning sensation of eye,phengophobia and eye fatigue were reduced significantly as compared with those before treatment(all P<0.05). In the medication group, the relevant symptoms of ocular surface were reduced after 4-week and 8-week treatment as compared with those before treatment(all P<0.05). In the follow-up, the scores of the relevant symptoms of ocular surface in the thread-embedding group were significantly lower than the medication group(all P<0.05). Separately, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears in the thread-embedding group were significantly increased as compared with those before treatment(all P<0.05). The change was not obvious as compared with that before treatment in the medication group(P>0.05). The levels of lactoferrin in tears at each time point after treatment in the thread-embedding group were higher than the medication group(P<0.05).Conclusion The acupoint thread-embedding therapy effectively improves in the relevant symptoms of ocular surface,such as eye dryness, foreign body sensation, burning sensation of eye, phengophobia and eye fatigue, and increases the level of lactoferrin in tears in the patients with dry eye syndrome of deficiency aqueous production. In the follow-up, the therapeutic effects of the acupoint thread-embedding therapy are significantly better than artificial tears eye drops.
引文
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[16]周鹏鹏,黄学东,周渊.针药合治对干眼症反射性泪液分泌的影响[J].江苏中医药,2012,44(3):52-54.
[17]谢广芳,姚靖,王佳娣.针药并用治疗干眼症的临床疗效观察[J].针灸临床杂志,2012,28(12):25-27.
[18]徐红,刘坚,王顺,等.“濡润神珠针刺法治疗干眼”的临床疗效及其安全性评估[J].中国中医眼科杂志,2014,24(2):89-92.
[19]王华,杜元灏.针灸学[M].北京:中国中医药出版社,2012:186.
[20]孙文善.微创埋线:技术现状与发展趋势[J].中医外治杂志,2008,17(2):3-6.
[21]张选平,贾春生,王建岭,等.穴位埋线疗法的优势病种及应用规律[J].中国针灸,2012,32(10):947-951.
[2]刘祖国.眼表疾病学[M].北京:人民卫生出版社,2003:286-287.
[3]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:75.
[4]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:217.
[5]黎锦萍,周沛辉,陈硕,等.玻璃酸钠滴眼液与贝复舒滴眼液联合治疗干眼症效果[J].牡丹江医学院学报,2017,38(1):66-67.
[6]魏立新,杨威,王宏才,等.针灸对干眼症泪液分泌影响的疗效评价[J].中国针灸,2010,30(9):709-712.
[7]徐兴华,方晓丽.温通针法治疗干眼症疗效观察[J].中国针灸,2012,32(3):233-236.
[8]汪武雷.针刺眼五针治疗电脑干眼症58例[J].中国针灸,2015,35(11):1166.
[9]刘亚丽,杨丽娟,杨桂桂.电针治疗干眼症临床观察[J].吉林中医药,2012,32(12):1275-1276.
[10]武静,马晓昀,何琳萍.揿针埋针治疗干眼症临床疗效[J].长春中医药大学学报,2016,32(5):1033-1036.
[11]马宏杰,冯磊,王家良,等.揿针埋针对干眼症患者泪膜的影响[J].中国针灸,2018,38(3):273-275.
[12]陈陆泉.雷火灸治疗泪液缺乏性干眼症疗效观察[J].中国针灸,2008,28(8):585-586.
[13]宋小莉,邢雁飞,张德玉.雷火灸治疗干眼症38例临床观察[J].中医药导报,2012,20(5):77-78.
[14]鞠胜.雷火灸疗法治疗干眼症84例临床观察[J].中国现代药物应用,2012,6(17):64.
[15]冯惠群,海英.田维柱教授应用眼针治疗干眼症经验总结[J].光明中医,2013,28(3):465-466.
[16]周鹏鹏,黄学东,周渊.针药合治对干眼症反射性泪液分泌的影响[J].江苏中医药,2012,44(3):52-54.
[17]谢广芳,姚靖,王佳娣.针药并用治疗干眼症的临床疗效观察[J].针灸临床杂志,2012,28(12):25-27.
[18]徐红,刘坚,王顺,等.“濡润神珠针刺法治疗干眼”的临床疗效及其安全性评估[J].中国中医眼科杂志,2014,24(2):89-92.
[19]王华,杜元灏.针灸学[M].北京:中国中医药出版社,2012:186.
[20]孙文善.微创埋线:技术现状与发展趋势[J].中医外治杂志,2008,17(2):3-6.
[21]张选平,贾春生,王建岭,等.穴位埋线疗法的优势病种及应用规律[J].中国针灸,2012,32(10):947-951.