针刺治疗肝经郁热型干眼症的疗效及对焦虑情绪的影响  

Effect of Acupuncture for the Treatment of Dry Eye Syndrome of Stagnated Heat in Liver Meridian and Its Effect on Anxiety Mood

作　　者：李惠真 汪旬[2] 陈奕群 张志玲[2] LI Hui-Zhen;WANG Xun;CHEN Yi-Qun;ZHANG Zhi-Ling(The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518000 Guangdong,China;Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518000 Guangdong,China;The Eighth Affiliated Hospital of Sun Yat-Sen University,Shenzhen 518000 Guangdong,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518000 [2]深圳市中医院,广东深圳518000 [3]中山大学附属第八医院,广东深圳518000

出　　处：《广州中医药大学学报》2023年第8期1948-1953,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省自然科学基金项目(编号:2020A1515010775);李惠林广东省名老中医药专家传承工作室建设项目;深圳市医疗卫生三名工程项目(编号:SZSM201512043)。

摘　　要：【目的】观察针刺治疗肝经郁热型干眼症的疗效及其对焦虑情绪的影响。【方法】将78例肝经郁热型干眼症患者随机分为观察组和对照组,每组各39例。对照组给予聚乙烯醇滴眼液滴眼治疗,观察组在对照组的基础上加用针刺治疗,疗程为1个月。观察2组患者治疗前后主观症状评分、泪膜破裂时间(break-up time,BUT)、泪液分泌试验(Schirmer I test,SIT)、角膜荧光染色结果(fluorescein,FL)评分以及焦虑自评量表(SAS)评分的变化情况,并评价2组患者的临床疗效和焦虑改善疗效。【结果】(1)治疗1个月后,观察组的总有效率为89.74%(35/39),对照组为71.79%(28/39),组间比较,观察组的总有效率(χ^(2)检验)和总体疗效(秩和检验)均优于对照组(P<0.05)。(2)治疗后,2组患者的眼睛干燥感、异物感、疲劳感、烧灼感、不适感、视力波动等各项主观症状评分及总积分均较治疗前明显降低(P<0.05),且观察组的降低作用均明显优于对照组(P<0.05或P<0.01)。(3)治疗后,2组患者的BUT、SIT、FL评分均较治疗前明显改善(P<0.05),且观察组的改善作用均明显优于对照组(P<0.01)。(4)治疗后,2组患者的SAS评分均较治疗前明显降低(P<0.05),且观察组的降低作用明显优于对照组(P<0.01)。(5)治疗后,观察组的焦虑恢复正常率为89.29%(25/28),对照组为48.15%(13/27),组间比较(χ^(2)检验),观察组的焦虑改善疗效明显优于对照组(P<0.05)。【结论】在人工泪液治疗基础上加用针刺治疗肝经郁热型干眼症患者疗效确切,可有效改善患者临床症状和焦虑情绪,其疗效优于单纯人工泪液治疗。Objective To investigate the therapeutic effect of acupuncture for dry eye syndrome with stagnated heat in liver meridian and to observe its effect on anxiety mood.Methods Seventy-eight patients with dry eye syndrome of stagnated heat in liver meridian type were randomly divided into the observation group and the control group,with 39 cases in each group.The control group was given Polyvinyl Alcohol Eye Drops and the observation group was treated with acupuncture based on the treatment for the control group.Both groups were treated for a period of one month.The changes in subjective symptom scores,tear film break-up time(BUT),Schirmer I test(SIT),corneal fluorescein staining(FL)scores and self-rating anxiety scale(SAS)scores in the two groups before and after treatment were observed.After treatment,the clinical efficacy and anxiety improvement efficacy of the two groups were evaluated.Results(1)After one month of treatment,the overall effective rate of the observation group was 89.74%(35/39)and that of the control group was 71.79%(28/39).The intergroup comparison showed that the overall effective rate(tested by Chi-square test)and overall efficacy(tested by rank sum test)of the observation group were superior to those of the control group(P<0.05).(2)After treatment,the scores of subjective symptoms of dry sensation,foreign body sensation,fatigue,burning sensation,and discomforts in the eyes and fluctuating visual acuity as well as the total symptom scores in both groups were significantly decreased compared with those before treatment(P<0.05),and the effect on decreasing the above scores in the observation group was significantly superior to that in the control group(P<0.05 or P<0.01).(3)After treatment,the BUT,SIT and FL scores of patients in both groups were significantly improved compared with those before treatment(P<0.05),and the effect on improving the scores in the observation group was significantly superior to that in the control group(P<0.01).(4)After treatment,the SAS scores of both groups were signifi

关 键 词：针刺 人工泪液治疗 干眼症 肝经郁热 焦虑 泪膜破裂时间 泪液分泌试验 角膜荧光染色 

分 类 号：R246.82[医药卫生—针灸推拿学]