针刺配合中药及人工泪液治疗肝肾阴亏型泪液缺乏性干眼症的疗效观察  

Observation on the Efficacy of Acupuncture plus Chinese Medication and Artificial Tears in Treating Aqueous Tear Deficiency Dry Eye Due to Yin Deficiency of Liver and Kidney

作　　者：朱华英[1] 项敏泓[2] 陈峰 刘新泉[1] 王大虎[1] ZHU Hua-ying;XIANG Min-hong;CHEN Feng;LIU Xin-quan;WANG Da-hu(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Putuo Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China;Shanghai Baoshan District Yanghang Town Community Health Center,Shanghai 201901,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海中医药大学附属普陀医院,上海200062 [3]上海市宝山区杨行镇社区卫生服务中心,上海201901

出　　处：《上海针灸杂志》2019年第4期421-428,共8页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市卫生和计划生育委员会课题(201840196);上海市普陀区中心医院英才计划(2017202B)

摘　　要：目的观察针刺配合中药及人工泪液治疗肝肾阴亏型泪液缺乏性干眼症的临床疗效。方法将80例肝肾阴亏型泪液缺乏性干眼症患者随机分为A组30例、B组25例和C组25例。A组采用针刺配合中药及人工泪液治疗,B组采用中药配合人工泪液治疗,C组采用单纯人工泪液治疗。观察各组治疗前后视力、泪液分泌试验(Schirmer I test, SIT)、泪膜破裂时间(break-up time, BUT)、角膜荧光染色(fluorescein staining, FL)、眼部症状评分及中医证候评分的变化情况,并比较各组临床疗效。结果 A组治疗后双眼视力与同组治疗前比较,差异均具有统计学意义(P<0.01);B组治疗后左眼视力与同组治疗前比较,差异具有统计学意义(P<0.05)。各组治疗后双眼SIT、BUT、FL评分与同组治疗前比较,差异均具有统计学意义(P<0.01)。A组治疗后双眼视力评分、SIT与B组和C组比较,差异均具有统计学意义(P<0.01,P<0.05)。A组和B组治疗后双眼BUT、FL评分与C组比较,差异均具有统计学意义(P<0.05,P<0.01)。B组治疗后右眼FL评分与C组比较,差异具有统计学意义(P<0.05)。A组和B组治疗后各项眼部症状(干涩感、异物感、疲劳感)评分与同组治疗前比较,差异均有统计学意义(P<0.01);C组治疗后干涩感、疲劳感评分与同组治疗前比较,差异均有统计学意义(P<0.01,P<0.05)。A组治疗后各项眼部症状评分与C组比较,差异均具有统计学意义(P<0.01);B组治疗后干涩感评分与C组比较,差异具有统计学意义(P<0.05)。A组总有效率为93.3%,B组为80.0%,C组为40.0%;A组中医证候总有效率为90.0%,B组为80.0%,C组为8.0%。A组和B组总有效率及中医证候总有效率与C组比较,差异均具有统计学意义(P<0.01)。结论针刺配合中药及人工泪液是一种治疗肝肾阴亏型泪液缺乏性干眼症的有效方法,可缓解患者症状,提高视力。Objective To observe the clinical efficacy of acupuncture plus Chinese medication and artificial tears in treating aqueous tear deficiency dry eye due to yin deficiency of liver and kidney. Method Eighty patients with aqueous tear deficiency dry eye due to yin deficiency of liver and kidney were randomized into group A of 30 cases, group B of 25 cases and group C of 25 cases. Group A was intervened by acupuncture plus Chinese medication and artificial tears, while group B was intervened by Chinese medication plus artificial tears, and group C was intervened by artificial tears alone. The visual acuity, Schirmer I test (SIT), break-up time (BUT), fluorescein staining (FL), eye symptom scores and TCM symptom scores in the three groups were observed before and at the end of the treatment, and the clinical efficacies were compared. Result The binocular visual acuity showed a significant change after the treatment in group A (P<0.01), while the left visual acuity showed a significant change after the treatment in group B (P<0.05). The binocular SIT, BUT and FL scores all showed a significant change after the treatment in the three groups (P<0.01). After the treatment, the binocular visual acuity and SIT score in group A were significantly different from those in group B and group C (P<0.01, P<0.05);the binocular BUT and FL score in group A and group B were significantly different from those in group C (P<0.05, P<0.01);the right FL score in group B was significantly different from that in group C (P<0.05). The eye symptom scores (dryness, foreign body sensation and fatigue) showed a significant change after the treatment in group A and group B (P<0.01), while the eye symptom scores (dryness and fatigue) showed a significant change after the treatment in group C (P<0.01, P<0.05). After the treatment, the eye symptom scores in group A were significantly different from those in group C (P<0.01);the eye symptom score (dryness) in group B was significantly different from that in group C (P<0.05). The total effective rate wa

关 键 词：针刺疗法 人工泪液 干眼症 肝肾阴亏 针药并用 泪膜破裂时间 泪液分泌试验 

分 类 号：R246.81[医药卫生—针灸推拿学]