郑氏“过眼热”针法治疗糖尿病眼底出血临床观察
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摘要
目的:观察郑氏"过眼热"针法治疗糖尿病眼底出血的临床疗效。方法:采用自身前后对照方法,将符合纳入标准的34例糖尿病眼底出血患者均给予基础治疗(口服降糖药或者注射胰岛素,保证血糖控制在正常范围),在此基础上给予针刺治疗,穴取风池、太阳、睛明、攒竹、三阴交、合谷,风池穴用"过眼热"针法操作,太阳穴用"热补法"操作,睛明穴用"压针缓进法"操作,攒竹穴用"喜鹊登梅法"操作,余穴用平补平泻法,每天治疗1次,6次为一疗程,疗程间休息1 d,治疗4个疗程,并于治疗结束后半年进行随访。观察患者治疗前后中医症状积分、眼底病理检查结果及视力改善情况并评定疗效。结果:治疗后34例(68只患眼)患者视力、中医症状积分、眼底微血管瘤和出血点数均较治疗前明显改善(均P<0.05);治疗后总有效率为88.2%(60/68);随访时患者视力、中医症状积分、眼底病理改变均较治疗前明显改善(均P<0.05),且都稳定在治疗结束时的水平(均P>0.05)。结论:郑氏"过眼热"针法治疗糖尿病眼底出血能够改善症状,促进眼底出血的吸收、提高视力。
Objective To observe the clinical effect of ZHENG ' Guo-Yan-Re needling technique for diabetic fundus hemorrhage. Methods With before-after study design, 34 patients with diabetic eyeground hemorrhage were treated with basic treatment(oral administration of antidiabetic medication or insulin injections to ensure blood glucose in the normal range); in addition, acupuncture was given at bilateral Fengchi(GB 20), Taiyang(EX-HN 5), Jingming(BL 1), Cuanzhu(BL2), Sanyinjiao(SP 6) and Hegu(LI 4). The ZHENG ' Guo-Yan-Re needling technique was applied at Fengchi(GB 20); the heat reinforcing needling technique was applied at Taiyang(EX-HN 5); the slow needle insertion technique was applied at Jingming(BL 1); and the Xique-Dengmei needling technique was applied at Cuanzhu(BL 2); the neutral supplementation and draining method was applied at remaining acupoints. The acupuncture was given once a day, 6 times as one course, and totally 4 courses were given with an interval of 1 day between courses. The follow-up visit was 6 months after treatment. The TCM symptom scores, fundus examination results and vision improvement were observed before and after treatment, and the effect was observed. Results Compared before treatment, the visual acuity, TCM symptom scores, fundus microaneurysm and hemorrhage points in 34 patients(68 eyes) were significantly improved after treatment(P<0.05). The total effective rate was88.2%(60/68) after treatment; at follow-up visit, the visual acuity, TCM symptom scores and fundus pathological changes were all improved(P<0.05) and stable at the post-treatment level(P>0.05). Conclusion ZHENG ' Guo-Yan-Re needling technique could improve symptoms, promote the absorption of fundus hemorrhage, and improve vision in patients with diabetic fundus hemorrhage.
Objective To observe the clinical effect of ZHENG ' Guo-Yan-Re needling technique for diabetic fundus hemorrhage. Methods With before-after study design, 34 patients with diabetic eyeground hemorrhage were treated with basic treatment(oral administration of antidiabetic medication or insulin injections to ensure blood glucose in the normal range); in addition, acupuncture was given at bilateral Fengchi(GB 20), Taiyang(EX-HN 5), Jingming(BL 1), Cuanzhu(BL2), Sanyinjiao(SP 6) and Hegu(LI 4). The ZHENG ' Guo-Yan-Re needling technique was applied at Fengchi(GB 20); the heat reinforcing needling technique was applied at Taiyang(EX-HN 5); the slow needle insertion technique was applied at Jingming(BL 1); and the Xique-Dengmei needling technique was applied at Cuanzhu(BL 2); the neutral supplementation and draining method was applied at remaining acupoints. The acupuncture was given once a day, 6 times as one course, and totally 4 courses were given with an interval of 1 day between courses. The follow-up visit was 6 months after treatment. The TCM symptom scores, fundus examination results and vision improvement were observed before and after treatment, and the effect was observed. Results Compared before treatment, the visual acuity, TCM symptom scores, fundus microaneurysm and hemorrhage points in 34 patients(68 eyes) were significantly improved after treatment(P<0.05). The total effective rate was88.2%(60/68) after treatment; at follow-up visit, the visual acuity, TCM symptom scores and fundus pathological changes were all improved(P<0.05) and stable at the post-treatment level(P>0.05). Conclusion ZHENG ' Guo-Yan-Re needling technique could improve symptoms, promote the absorption of fundus hemorrhage, and improve vision in patients with diabetic fundus hemorrhage.
引文
[1]Yang W,Lu J,Weng J,et a1.Prevalence of diabetes among men and women in China[J].N Engl J Med,2011,362(25):2425-2426.
[2]James M,Goodchild C,Bashir S,et al.Report on the creation of a diabetes register and retinopathy screening outcomes in the Mid-West of Ireland[J].Ir J Med Sci,2016,185(1):151-159.
[3]Ostri C.Intraocular surgery in a large diabetes patient population:risk factors and surgical results[J].Acta Ophthalmol,2014,92(6):593-594.
[4]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2014年版)[J].中国糖尿病杂志,2014,22(8):2-42.
[5]Shrivastava U,Misra A.Need for Ethnic-Specific Guidelines for Prevention,Diagnosis,and Management of Type 2 Diabetes in South Asians[J].Diabetes Technol Ther,2015,17(6):435-439.
[6]张智龙,吉学群,张玉红,等.调理脾胃针法治疗糖尿病视网膜病变对照研究[J].中国针灸,2006,26(12):839-842.
[7]苏全德,武华清,杨玉平,等.针刺治疗糖尿病眼底出血45例[J].中国针灸,2013,33(5):394.
[8]中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志,2014,50(11):851-865.
[9]郑魁山.郑氏针灸全集[M].北京:人民卫生出版社,2000:296-300.
[10]段俊国,金明,接传红,等.糖尿病视网膜病变中医诊疗标准[J].世界中西医结合杂志,2011,6(7):632-637.
[11]Kumar P,Kumar V,Ravani R,et al.Subretinal tissue plasminogen-assisted vitrectomy for posttraumatic full-thickness macular hole with submacular hemorrhage[J].Indian JOphthalmol,2018,66(3):474-476.
[12]孙润洁,田亮,方晓丽,等.郑氏针法学术流派的形成与传承研究[J].中国针灸,2017,37(3):331-334.
[13]宋忠阳,秦晓光,孙润杰,等.“过眼热”手法为主针刺治疗儿童弱视[J].中国针灸,2017,37(11):1183-1186.
[14]张守康,邓晓辉,张丽霞,等.电梅花针治疗青少年近视多中心临床观察[J].中国中医眼科杂志,2011,21(2):74-77.
[15]陶晓雁,茹凯,郎松,等.针刺眼周奇穴治疗青少年近视疗效观察[J].上海针灸杂志,2010,29(10):643-645.
[16]杨骏,李传富,徐春生,等.健康成人合谷穴、后溪穴的针刺fMRI比较研究[J].世界中医药,2014,9(12):1575-1580.
[2]James M,Goodchild C,Bashir S,et al.Report on the creation of a diabetes register and retinopathy screening outcomes in the Mid-West of Ireland[J].Ir J Med Sci,2016,185(1):151-159.
[3]Ostri C.Intraocular surgery in a large diabetes patient population:risk factors and surgical results[J].Acta Ophthalmol,2014,92(6):593-594.
[4]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2014年版)[J].中国糖尿病杂志,2014,22(8):2-42.
[5]Shrivastava U,Misra A.Need for Ethnic-Specific Guidelines for Prevention,Diagnosis,and Management of Type 2 Diabetes in South Asians[J].Diabetes Technol Ther,2015,17(6):435-439.
[6]张智龙,吉学群,张玉红,等.调理脾胃针法治疗糖尿病视网膜病变对照研究[J].中国针灸,2006,26(12):839-842.
[7]苏全德,武华清,杨玉平,等.针刺治疗糖尿病眼底出血45例[J].中国针灸,2013,33(5):394.
[8]中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志,2014,50(11):851-865.
[9]郑魁山.郑氏针灸全集[M].北京:人民卫生出版社,2000:296-300.
[10]段俊国,金明,接传红,等.糖尿病视网膜病变中医诊疗标准[J].世界中西医结合杂志,2011,6(7):632-637.
[11]Kumar P,Kumar V,Ravani R,et al.Subretinal tissue plasminogen-assisted vitrectomy for posttraumatic full-thickness macular hole with submacular hemorrhage[J].Indian JOphthalmol,2018,66(3):474-476.
[12]孙润洁,田亮,方晓丽,等.郑氏针法学术流派的形成与传承研究[J].中国针灸,2017,37(3):331-334.
[13]宋忠阳,秦晓光,孙润杰,等.“过眼热”手法为主针刺治疗儿童弱视[J].中国针灸,2017,37(11):1183-1186.
[14]张守康,邓晓辉,张丽霞,等.电梅花针治疗青少年近视多中心临床观察[J].中国中医眼科杂志,2011,21(2):74-77.
[15]陶晓雁,茹凯,郎松,等.针刺眼周奇穴治疗青少年近视疗效观察[J].上海针灸杂志,2010,29(10):643-645.
[16]杨骏,李传富,徐春生,等.健康成人合谷穴、后溪穴的针刺fMRI比较研究[J].世界中医药,2014,9(12):1575-1580.