迎香透刺鼻通法治疗干眼的临床疗效分析  

Clinical Effect Analysis of the Combination of Point-to-point Acupuncture from Yingxiang(LI20)to Bitong(EX-HN8)Method in the Treatment of Dry Eye

作　　者：常春丽 刘静[1] 陈泽秦[1] 高伟[1] 黄家兰 王松[1] CHANG Chunli;LIU Jing;CHEN Zeqin;GAO Wei;HUANG Jialan;WANG Song(Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430010,China)

机构地区：[1]武汉市中医医院,武汉430010

出　　处：《中国中医眼科杂志》2023年第10期916-921,共6页China Journal of Chinese Ophthalmology

基　　金：武汉市医学科研项目(WZ20C42)。

摘　　要：目的观察迎香透刺鼻通法治疗干眼的临床疗效。方法纳入2020年3月—2022年3月武汉市中医医院诊治的干眼患者90例(180只眼),证属肺阴不足证,根据治疗方案不同分为对照组和观察组各45例(90只眼)。对照组予0.1%玻璃酸钠滴眼液联合针刺治疗。观察组在对照组的基础上联合迎香透刺鼻通法治疗。2组均治疗14 d。分别于治疗前和治疗后检测2组患者的中医证候积分、眼表疾病指数(OSDI)评分、泪膜破裂时间(BUT)、泪液分泌试验(SⅠT)、角膜荧光染色(FL)评分、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和超敏C反应蛋白(hs-CRP)。记录以上数据并做统计分析。结果2组治疗前中医证候积分、OSDI评分、BUT、SⅠT、FL评分、IL-1β、IL-6和hs-CRP比较,差异均无统计学意义(P>0.05)。(1)中医证候积分:2组治疗后中医证候积分均较治疗前降低(t观察组=87.408,t对照组=67.091,均P=0.000)。治疗后2组间比较,观察组较对照组降低(t=12.357,P=0.000)。(2)干眼指标:2组治疗后,BUT(t观察组=97.153,t对照组=93.519,均P=0.000)、SⅠT(t观察组=101.560,t对照组=74.021,均P=0.000)均较治疗前升高,FL(t观察组=59.418,t对照组=40.207,均P=0.000)、OSDI评分(t观察组=43.839,t对照组=19.948,均P=0.000)均较治疗前降低。治疗后2组间比较,观察组BUT(t=17.851,P=0.000)、SⅠT(t=20.995,P=0.000)均高于对照组,FL(t=13.071,P=0.000)、OSDI评分(t=8.576,P=0.000)均低于对照组。(3)炎症因子:2组治疗后IL-1β(t观察组=173.191,t对照组=36.212,均P=0.000)、IL-6(t观察组=99.879,t对照组=58.046,均P=0.000)、hs-CRP(t观察组=109.941,t对照组=85.140,均P=0.000)均较治疗前降低。治疗后2组间比较,观察组IL-1β(t=15.481,P=0.000)、IL-6(t=21.248,P=0.000)、hs-CRP(t=20.247,P=0.000)均较对照组降低。(4)临床疗效:观察组总有效率高于对照组(χ2=5.884,P=0.015)。以上比较差异均有统计学意义。结论迎香透刺鼻通法治疗干眼可有效改善患者�OBJECTIVE To observe the clinical effect of point-to-point acupuncture from Yingxiang(LI20)to Bitong(EX-HN8)method in the treatment of dry eyes.METHODS A total of 90 dry eye patients(180 eyes)who were admitted to Wuhan Hospital of Traditional Chinese Medicine from March 2020 to March 2022 were included.They were classified as lung Yin deficiency syndrome type,and divided into the control group(CG)and the observation group(OG)according to different treatment plans,with 45 patients(90 eyes)in each group.The control group was treated with 0.1%sodium hyaluronate eye drops combined with acupuncture,while the observation group was treated with point-to-point acupuncture from Yingxiang(LI20)to Bitong(EX-HN8)on the basis of the control group.Both groups were treated for 14 days.The TCM syndrome scores,eye surface disease index(OSDI)scores,tear film break-up time(BUT),SchirmerⅠtest(SⅠT),corneal fluorescein staining(FL)scores,and the level of interleukin-1β(IL-1β),interleukin-6(IL-6),and high-sensitivity C-reactive protein(hs-CRP)were measured before and after treatment.The above data were recorded and statistically analyzed.RESULTS There were no statistically significant differences in TCM syndrome scores,OSDI scores,BUT,SIT,FL scores,and the level of IL-1β,IL-6,and hs-CRP between the two groups before treatment(P>0.05).(1)TCM syndrome scores:The TCM syndrome scores of both groups after treatment decreased when compared to those before treatment(tOG=87.408,tCG=67.091,both P=0.000).Compared between the two groups after treatment,the observation group had lower TCM syndrome scores than the control group(t=12.357,P=0.000).(2)Dry eye indicators:After the treatment,BUT(tOG=97.153,tCG=93.519,both P=0.000)and SⅠT(tOG=101.560,tCG=74.021,both P=0.000)in both groups increased after treatment,while FL scores(tOG=59.418,tCG=40.207,both P=0.000)and OSDI scores(tOG=43.839,tCG=19.948,both P=0.000)in both groups decreased after treatment.After treatment,the BUT(t=17.851,P=0.000)and SIT(t=20.995,P=0.000)in the observation group w

关 键 词：干眼 迎香透刺鼻通 泪腺功能 证候积分 眼表疾病指数评分 

分 类 号：R246.82[医药卫生—针灸推拿学]