左氏醒神明目针治疗原发性开角型青光眼视神经萎缩的疗效观察  

Observing the Efficacy of ZUO's Xingshen Mingmu Acupuncture in Treating Optic Atrophy of Primary Open-angle Glaucoma

作　　者：鞠品 赵磊[2] 左韬[2] JU Pin;ZHAO Lei;ZUO Tao(Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)

机构地区：[1]辽宁中医药大学,沈阳110032 [2]辽宁中医药大学附属第二医院,沈阳110034

出　　处：《中国中医眼科杂志》2024年第10期917-921,共5页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金项目(82104714);辽宁省老中医药专家左韬学术经验继承工作项目[辽中医药函2021-1]。

摘　　要：目的 观察左氏醒神明目针法治疗原发性开角型青光眼视神经萎缩的疗效。方法 纳入2022年5月—2023年2月辽宁中医药大学附属第二医院眼科诊治的原发性开角型青光眼视神经萎缩患者72例(72只眼),证属肝郁气滞证,均以右眼作为研究对象。随机分为对照组和试验组,每组36例(36只眼)。对照组予腺苷钴胺片口服,试验组在对照组的基础上联合左氏醒神明目针法治疗。2组均观察4周。分别于治疗前和治疗后检查受试者的最佳矫正视力(BCVA)、视野改变[包括视野指数(VFI)、图形标准差(PSD)、平均缺损(MD)]、视神经纤维层(RNFL)厚度和中医证候积分(TCMS)。结果 (1)BCVA:试验组治疗后BCVA较治疗前改善,差异有统计学意义(t=2.078,P=0.041)。对照组治疗后BCVA与治疗前比较,差异无统计学意义(P>0.05)。治疗后2组间比较,试验组BCVA优于对照组,差异有统计学意义(t=2.146,P=0.035)。(2)视野改变:试验组治疗后VFI较治疗前升高,PSD、MD均较治疗前降低,差异均有统计学意义(t_(VFI)=2.882,P=0.005;t_(PSD)=2.114,P=0.038;t_(MD)=2.601,P=0.011)。对照组治疗后的VFI、PSD、MD与治疗前比较,差异均无统计学意义(P>0.05)。治疗后2组间比较,试验组VFI高于对照组,MD低于对照组,差异均有统计学意义(t_(VFI)=2.102、t_(MD)=2.103,均P=0.039)。(3)RNFL厚度:2组治疗前、后RNFL厚度比较及治疗后2组间比较,差异均无统计学意义(P>0.05)。(4)TCMS:试验组治疗后TCMS较治疗前降低,差异有统计学意义(t=7.869,P=0.000)。对照组治疗后TCMS与治疗前比较,差异无统计学意义(P>0.05)。治疗后2组间比较,试验组TCMS低于对照组,差异有统计学意义(t=6.795,P=0.000)。结论 左氏醒神明目针法可有效改善原发性开角型青光眼视神经萎缩肝郁气滞证患者的主要症状体征。OBJECTIVE To observe the efficacy of ZUO´s Xingshen Mingmu acupuncture in treating optic atrophy in primary open-angle glaucoma patients.METHODS From May 2022 to February 2023,72 patients(72 eyes)with optic atrophy due to primary open-angle glaucoma were treated at the Ophthalmology Department of the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.All patients were diagnosed with liver Qi stagnation syndrome,and only the right eye of each patient was included in the study.The patients were randomly divided into a control group and an experimental group,with 36 cases(36 eyes)in each group.The control group received oral administration of adenosylcobalamin tablets,while the experimental group received ZUO´s Xingshen Mingmu acupuncture in addition to the control group´s treatment.Both groups were observed for four weeks.Best corrected visual acuity(BCVA),visual field index(VFI),pattern standard deviation(PSD),mean deviation(MD),retinal nerve fiber layer(RNFL)thickness,and Traditional Chinese Medicine syndrome scores(TCMS)were measured before and after treatment.RESULTS(1)BCVA:After treatment,BCVA in the experimental group improved compared to before treatment,and the difference was statistically significant(t=2.078,P=0.041).There was no statistically significant difference in BCVA between the control group before and after treatment(P>0.05).After treatment,BCVA in the experimental group was better than that in the control group,and the difference was statistically significant(t=2.146,P=0.035).(2)Field of vision changes:After treatment,VFI in the experimental group increased,and PSD and MD decreased compared to before treatment,and the differences were all statistically significant(tVFI=2.882,P=0.005;tPSD=2.114,P=0.038;tMD=2.601,P=0.011).There was no statistically significant difference in VFI,PSD,and MD between the control group before and after treatment(P>0.05).After treatment,VFI in experimental group was higher than that in control group,MD was lower than that in control grou

关 键 词：青光眼 视神经萎缩 针刺 肝郁气滞证 

分 类 号：R774.63[医药卫生—眼科] R246.82[医药卫生—临床医学]