筋膜松解针法治疗角结膜干燥症临床观察  

Clinical observation of Fascial Release Needling in Treatment of KCS

作　　者：武峙璇[1,2] 林春范 王殿一[4] 毛铁[2] 孙河[4] 李岩[4] WU Zhixuan;LIN Chunfan;WANG Dianyi;MAO Tie;SUN He;LI Yan(Heilongjiang University of Chinese Medicine,Harbin 150040,China;Heilongjiang Provincial Hospital,Harbin 150001,China;Heilongjiang Zhujiang Cardiovascular and Cerebrovascular Hospital,Harbin 150040,China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江省医院,黑龙江哈尔滨150001 [3]黑龙江珠江心脑血管医院,黑龙江哈尔滨150040 [4]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040

出　　处：《中医药信息》2023年第4期63-67,共5页Information on Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81674029);黑龙江省中医药管理局课题(ZHY2020-063,ZHY2022-141)。

摘　　要：目的:观察针刺松解筋膜触发点(MTrPs)治疗角结膜干燥症(KCS)的临床疗效。方法:选取符合纳入标准的KCS患者125例,按照随机、非盲、阳性治疗的平行对照原则,根据入组顺序将其分为药物对照组41例,传统针刺组42和观察组42例。药物对照组给予玻璃酸钠滴眼液滴双眼,每次1滴,每日5~6次;针刺对照组在药物对照组治疗基础上,使用传统针刺的方法进行治疗;观察组在药物对照组基础上联合针刺松解MTrPs治疗,均连续治疗4周。观察治疗前后基础泪液分泌试验(SIT)、泪膜破裂时间(BUT)、角膜荧光素染色评分(FL)及泪液白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的水平。结果:治疗前,两组患者SIT、BUT、FL和泪液白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)含量比较,差异无统计学意义(P>0.05);治疗后,观察组SIT、BUT、FL和泪液白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)含量均高于药物对照组和传统针刺组,差异有统计学意义(P<0.01)。观察组总有效率为92.7%(38/41),药物对照组总有效率为63.4%(26/41),传统针刺组为83.3%(35/42),观察组总有效率高于其他两组,差异有统计学意义(P<0.01,P<0.05)。结论:针刺松解MTrPs治疗KCS,可以改善干眼症状,降低泪液IL-6、TNF-α含量,减轻炎性反应,提升临床疗效。Objective:To observe the clinical efficacy of acupuncture in releasing fascial trigger points(MTrPs)for keratoconjunctival sicca(KCS).Methods:125 patients with KCS,who met the inclusion criteria,were randomly divided into the drug control group(n=41),the traditional acupuncture group(n=42)and the observation group(n=42).The drug control group was given Sodium Hyaluronate Eye Drop for both eyes,1 drop each time,5 or 6 times a day;on which basis,the traditional acupuncture group was treated with traditional needling,and the observation group was treated with acupuncture releasing MTrPs.The treatment for each group lasted for four weeks.The Schirmer I Test(SIT),break-up time(BUT),corneal fluorescein staining score(FL),and the levels of tear interleukin 6(IL-6)and tumor necrosis factor-α(TNF-α)were observed before and after the treatment in the three groups.Results:There were no statistical differences in SIT,BUT,FL,IL-6 and TNF-αamong the three groups before the treatment(P>0.05);after the treatment,the levels of SIT,BUT,FL,IL-6 and TNF-αwere higher in the observation group than those in the drug control group and in the traditional acupuncture group(P<0.01).The total effective rate of the treatment group was 92.7%(38/41),which was significantly higher than 63.4%(26/41)of the drug control group and 83.3%(35/42)of the traditional acupuncture group(P<0.01,P<0.05).Conclusion:Acupuncture releasing MTrPs can improve dry eye symptoms,decrease contents of IL-6 and TNF-αin tears,reduce inflammation and improve clinical efficacy in treatment of KCS.

关 键 词：角结膜干燥症 筋膜触发点 针刺 筋膜学 

分 类 号：R246.82[医药卫生—针灸推拿学]