针刺综合治疗原发性开角型青光眼疗效观察
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摘要
目的观察针刺综合治疗原发性开角型青光眼的临床疗效,对该病的疗效进行客观评价。方法收集原发性开角型青光眼患者28例(53眼)。采用自身前后对照的方法,观察针刺治疗3个月后患者眼压、视野平均缺损(MD)、视野平均光敏感度(MS)、视力和视功能损害眼病患者生存质量量表评分的变化,并进行临床疗效评定。结果 28例(53眼)患者治疗后眼压较治疗前明显下降(P<0.01);治疗后MD、MS及视力较治疗前无明显改善(P>0.05);治疗后视功能损害眼病患者生存质量量表评分较治疗前明显下降(P<0.01);临床总有效率为86.8%;疗效同年龄、病程、治疗时间之间均不具备相关性(P>0.05)。结论针刺综合治疗可以有效降低原发性开角型青光眼患者眼压,控制患者MD和MS的恶化程度,有效维持患者的视力,提高患者的生存质量,并且相同的病程,接受治疗时间越长,疗效越好。
Objective To observe the clinical efficacy of comprehensive acupuncture treatment in treating primary open-angle glaucoma, and to objectively evaluate the therapeutic efficacy. Method Twenty-eight patients(53 eyes) who received acupuncture treatment were recruited. By adopting a self-control design, the changes of intraocular tension, mean defect(MD) of vision field, mean sensitivity(MS), vision, and score of Quality of Life Scale for Patients with Visual Impairment(QLSPVI) were observed after 3-month acupuncture treatment. Result The intraocular tension of the 28 patients declined obviously after the treatment(P<0.01); MD, MS and vision didn't show significant improvements after the treatment(P>0.05); the QLSPVI score dropped significantly after the treatment(P<0.01); the total effective rate was 86.8%; the therapeutic efficacy wasn't correlated with age, disease duration, and treatment duration(P>0.05). Conclusion Acupuncture treatment can effectively reduce the intraocular tension, control the deterioration of MD and MS, maintain the level of vision, and enhance the quality of life of patients with primary open-angle glaucoma; with the same disease duration, the longer the treatment, the better the therapeutic efficacy.
Objective To observe the clinical efficacy of comprehensive acupuncture treatment in treating primary open-angle glaucoma, and to objectively evaluate the therapeutic efficacy. Method Twenty-eight patients(53 eyes) who received acupuncture treatment were recruited. By adopting a self-control design, the changes of intraocular tension, mean defect(MD) of vision field, mean sensitivity(MS), vision, and score of Quality of Life Scale for Patients with Visual Impairment(QLSPVI) were observed after 3-month acupuncture treatment. Result The intraocular tension of the 28 patients declined obviously after the treatment(P<0.01); MD, MS and vision didn't show significant improvements after the treatment(P>0.05); the QLSPVI score dropped significantly after the treatment(P<0.01); the total effective rate was 86.8%; the therapeutic efficacy wasn't correlated with age, disease duration, and treatment duration(P>0.05). Conclusion Acupuncture treatment can effectively reduce the intraocular tension, control the deterioration of MD and MS, maintain the level of vision, and enhance the quality of life of patients with primary open-angle glaucoma; with the same disease duration, the longer the treatment, the better the therapeutic efficacy.
引文
[1]艾力江·艾尔肯,具尔提·哈第尔.原发性开角型青光眼的相关基因研究进展[J].国际眼科杂志,2014,14(4):651-653.
[2]邓志峰,李建平,何伟.原发性开角型青光眼流行病学研究现状[J].菏泽医学专科学校学报,2006,18(4):71-75.
[3]汪俊,崔巍.我国原发性青光眼流行病学研究进展[J].国际眼科杂志,2012,12(4):667-670.
[4]游剑,简晖,章余兰,等.中西医结合治疗青光眼的临床研究进展[J].江西中医学院学报,2008,21(5):84-86.
[5]葛坚.问题和争论是学科发展的动力——原发性闭角型青光眼分类争论的启示[J].中华眼科杂志,2006,42(11):964-966.
[6]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:281.
[7]于强,李绍珍,陈和年,等.视功能损害眼病患者生存质量量表的研究[J].中华眼科杂志,1997,33(4):307-310.
[8]李苑碧,彭清华.原发性开角型青光眼发病机制及其中西医治疗研究进展[J].辽宁中医药大学学报,2014,16(8):146-149.
[9]金明,赵家良.原发性开角型青光眼发病机理研究进展[J].中国中医眼科杂志,1997,7(3):177-180.
[10]张海滨,林东晓,颜橙红,等.原发性青光眼患者眼部血流动力学的观察[J].现代实用医学,2009,21(5):517-518.
[11]梁厚成.开角型青光眼视神经损害的发生机制[J].第四军医大学学报,1999,20(8):732-735.
[12]张永梅.原发性开角型青光眼的遗传学研究[D].内蒙古大学,2015.
[13]宁波.MYOC基因在原发性开角型青光眼发病过程中的作用研究[D].中国医科大学,2009.
[14]李明.高眼压与开角型青光眼的关系及药物治疗[J].国际眼科杂志,2012,12(2):333-334.
[15]王秋燕,胡竹林.选择性激光小梁成形术治疗开角型青光眼的研究进展[J].国际眼科杂志,2011,12(5):828-829.
[16]黄汉平,黄由在.非穿透性与改良小梁手术用于开角型青光眼的疗效评价[J].临床合理用药杂志,2014,7(8):94-95.
[17]盛燦若.针刺治疗青光眼的初步观察[J].上海中医药杂志,1956,2(8):25-26.
[18]黄叔仁.针刺行间对原发性青光眼、眼压影响的研究[J].中医杂志,1963,13(8):19-20.
[19]赫群.针灸治疗原发性青光眼概况[J].中国针灸,1999,19(1):58-60.
[20]曹双凤,沈保强.耳压结合体针治疗失眠症78例[J].陕西中医,2009,30(6):714-715.
[21]邓晓辉,孙军.古代医家对青风内障的辨证治疗[J].中国中医药现代远程教育,2012,10(5):96.
[22]杨选频,郑华.点刺降压沟为主治疗高血压病69例[J].江西中医药,2003,34(1):37.
[2]邓志峰,李建平,何伟.原发性开角型青光眼流行病学研究现状[J].菏泽医学专科学校学报,2006,18(4):71-75.
[3]汪俊,崔巍.我国原发性青光眼流行病学研究进展[J].国际眼科杂志,2012,12(4):667-670.
[4]游剑,简晖,章余兰,等.中西医结合治疗青光眼的临床研究进展[J].江西中医学院学报,2008,21(5):84-86.
[5]葛坚.问题和争论是学科发展的动力——原发性闭角型青光眼分类争论的启示[J].中华眼科杂志,2006,42(11):964-966.
[6]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:281.
[7]于强,李绍珍,陈和年,等.视功能损害眼病患者生存质量量表的研究[J].中华眼科杂志,1997,33(4):307-310.
[8]李苑碧,彭清华.原发性开角型青光眼发病机制及其中西医治疗研究进展[J].辽宁中医药大学学报,2014,16(8):146-149.
[9]金明,赵家良.原发性开角型青光眼发病机理研究进展[J].中国中医眼科杂志,1997,7(3):177-180.
[10]张海滨,林东晓,颜橙红,等.原发性青光眼患者眼部血流动力学的观察[J].现代实用医学,2009,21(5):517-518.
[11]梁厚成.开角型青光眼视神经损害的发生机制[J].第四军医大学学报,1999,20(8):732-735.
[12]张永梅.原发性开角型青光眼的遗传学研究[D].内蒙古大学,2015.
[13]宁波.MYOC基因在原发性开角型青光眼发病过程中的作用研究[D].中国医科大学,2009.
[14]李明.高眼压与开角型青光眼的关系及药物治疗[J].国际眼科杂志,2012,12(2):333-334.
[15]王秋燕,胡竹林.选择性激光小梁成形术治疗开角型青光眼的研究进展[J].国际眼科杂志,2011,12(5):828-829.
[16]黄汉平,黄由在.非穿透性与改良小梁手术用于开角型青光眼的疗效评价[J].临床合理用药杂志,2014,7(8):94-95.
[17]盛燦若.针刺治疗青光眼的初步观察[J].上海中医药杂志,1956,2(8):25-26.
[18]黄叔仁.针刺行间对原发性青光眼、眼压影响的研究[J].中医杂志,1963,13(8):19-20.
[19]赫群.针灸治疗原发性青光眼概况[J].中国针灸,1999,19(1):58-60.
[20]曹双凤,沈保强.耳压结合体针治疗失眠症78例[J].陕西中医,2009,30(6):714-715.
[21]邓晓辉,孙军.古代医家对青风内障的辨证治疗[J].中国中医药现代远程教育,2012,10(5):96.
[22]杨选频,郑华.点刺降压沟为主治疗高血压病69例[J].江西中医药,2003,34(1):37.