针刺治疗水液缺乏型干眼:随机对照试验  

Acupuncture for aqueous deficiency dry eye:a randomized controlled trial

作　　者：刘雪 高卫萍[3] 赵楠[4] 颉瑞萍 刘成勇 LIU Xue;GAO Wei-ping;ZHAO Nan;JIE Rui-ping;LIU Cheng-yong(Ophthalmology Department,Affiliated Hospital of Gansu University of CM,Lanzhou 730000,China;First Clinical College of Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu Province;Ophthalmology Department,Affiliated Hospital of Nanjing University of Chinese Medicine;Gansu Lanzhou Purui Ophthalmology Hospital;Acupuncture-Moxibustion and Rehabilitation Department,Affiliated Hospital of Nanjing University of Chinese Medicine)

机构地区：[1]甘肃中医药大学附属医院眼科,兰州730000 [2]南京中医药大学第一临床学院,江苏南京210023 [3]南京中医药大学附属医院眼科 [4]甘肃兰州普瑞眼科医院 [5]南京中医药大学附属医院针灸康复科

出　　处：《中国针灸》2023年第11期1235-1238,共4页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金资助项目:82074526;甘肃省自然青年科技基金项目:22JR5RA615;甘肃省自然科学基金项目:22JR11RA130。

摘　　要：目的:比较针刺和玻璃酸钠滴眼液治疗水液缺乏型干眼的临床疗效及安全性。方法:将60例(120只眼)水液缺乏型干眼患者随机分为观察组(30例,脱落1例)和对照组(30例,脱落1例)。对照组予玻璃酸钠滴眼液滴眼,一次1滴,一天4次,连续14 d;观察组予针刺治疗,穴取双侧上睛明、攒竹、丝竹空、太阳、瞳子髎,一天1次,每6 d休息1 d,连续14 d。比较两组患者治疗前后泪河高度(TMH)、基础泪液分泌试验(SⅠT)、眼表疾病指数量表(OSDI)评分、非接触式泪膜破裂时间(NIBUT)、角膜荧光素钠染色(FLS)评分,并观察两组治疗的安全性。结果:与治疗前比较,两组患者治疗后TMH、SⅠT和NIBUT均增高(P<0.01,P<0.05),FLS评分降低(P<0.01);观察组患者治疗后OSDI评分降低(P<0.01)。治疗后观察组TMH、SⅠT高于对照组(P<0.01),OSDI评分低于对照组(P<0.01)。两组均未出现不良反应及不良事件。结论:针刺和玻璃酸钠滴眼液均能有效治疗水液缺乏型干眼,在增加TMH、促进基础泪液分泌及减轻患者主观症状方面,针刺治疗有明显优势;针刺治疗干眼操作安全。Objective To compare the clinical efficacy and safety of acupuncture and sodium hyaluronate eye drop in the treatment of aqueous deficiency dry eye.Methods A total of 60 patients(120 eyes)with aqueous deficiency dry eye were randomly divided into an observation group(30 cases,1 case dropped out)and a control group(30 cases,1 case dropped out).In the control group,sodium hyaluronate eye drop were used,one drop at a time,4 times a day,for 14 consecutive days.In the observation group,acupuncture was applied at bilateral Shangjingming(Extra),Cuanzhu(BL 2),Sizhukong(TE 23),Taiyang(EX-HN 5),and Tongziliao(GB 1),once a day,treatment for 6 days with the interval of 1 day was required,for 14 consecutive days.The tear meniscus height(TMH),SchirmerⅠtest(SⅠT),ocular surface disease index(OSDI)score,non-invasive tear break-up time(NIBUT),and corneal fluorescein sodium staining(FLS)score were compared between the two groups before and after treatment,and the safety of the treatment of the two groups was observed.Results Compared with those before treatment,after treatment,TMH,SⅠT and NIBUT were increased(P<0.01,P<0.05),and FLS scores were decreased(P<0.01)in the two groups;the score of OSDI was reduced(P<0.01)in the observation group.After treatment,in the observation group,TMH and SⅠT were higher than those in the control group(P<0.01),and the score of OSDI was lower than that in the control group(P<0.01).No adverse reactions and adverse events were observed in the two groups.Conclusion Acupuncture and sodium hyaluronate eye drop can both effectively treat aqueous deficiency dry eye,acupuncture has obvious advantages in improving TMH and basic tear secretion,and reducing the subjective symptoms of patients.Acupuncture for dry eye is safe.

关 键 词：水液缺乏型干眼 针刺 泪河高度 泪液分泌量 眼表症状 随机对照试验 

分 类 号：R246.8[医药卫生—针灸推拿学]