微砭耳针联合A型肉毒毒素治疗伴焦虑抑郁症的特发性眼睑痉挛的疗效观察  

Observing the Efficacy of Micro-acupoint Ear Acupuncture Combined with Botulinum Toxin Type A in Treating Benign Essential Blepharospasm with Anxiety and Depression

作　　者：杨雪艳[1] 张学颖 YANG Xueyan;ZHANG Xueying(Foshan Hospital of Traditional Chinese Medicine,Foshan 528051,China)

机构地区：[1]广东省佛山市中医院,佛山528051 [2]广州中医药大学第八临床医学院,佛山528051

出　　处：《中国中医眼科杂志》2024年第10期936-941,共6页China Journal of Chinese Ophthalmology

摘　　要：目的观察微砭耳针联合A型肉毒毒素(BTX-A)治疗特发性眼睑痉挛(BEB合并焦虑抑郁的临床疗效。方法纳入2021年12月—2022年12月佛山市中医院眼科和神经内科门诊诊治的BEB合并焦虑抑郁的患者63例(126只眼)。采用随机数字表法分为肉毒素组、耳针组和联合组,每组21例(42只眼),依次予BTX-A、微砭耳针、微砭耳针联合BTX-A治疗。3组均观察6个月。记录3组患者的起效时间和疗效持续时间,治疗前后分别检测患者的焦虑自评量表(SAS)和抑郁自评量表(SDS)得分,记录数据进行统计分析。结果(1)BEB的起效时间及疗效持续时间:3组起效时间比较,差异有统计学意义(F=5.058,P=0.012)。与耳针组比较,肉毒素组、联合组起效时间均提前,差异均有统计学意义(t肉毒素=3.193,P=0.003;t联合组=3.835,P=0.000)。联合组与肉毒素组起效时间比较,差异无统计学意义(P>0.05)。3组疗效持续时间比较,差异有统计学意义(F=29.079,P=0.000)。与耳针组比较,肉毒素组和联合组疗效持续时间均延长,差异均有统计学意义(t_(肉毒素)=4.391、t_(联合组)=7.729,均P=0.000)。与肉毒素组比较,联合组疗效持续时间延长,差异有统计学意义(t=2.638,P=0.012)。(2)SDS评分:3组治疗后SDS评分均较治疗前降低,差异均有统计学意义(t_(耳针组)=4.498、t_(肉毒素组)=5.758、t_(联合组)=11.489,均P=0.000)。治疗后3组间比较,差异有统计学意义(F=5.343,P=0.007)。联合组SDS评分低于耳针组和肉毒素组,差异均有统计学意义(t_(耳针组)=3.284,P=0.002;t_(肉毒素组)=2.253,P=0.030),肉毒素组和耳针组SDS评分比较,差异无统计学意义(P>0.05)。(3)SAS评分:3组治疗后SAS评分均较治疗前降低,差异均有统计学意义(t_(耳针组)=4.603、t_(肉毒素组)=7.617、t_(联合组)=10.585,均P=0.000)。治疗后3组间比较,差异有统计学意义(F=14.845,P=0.000)。肉毒素组和联合组治疗后SAS评分均低于耳针组,差异均有统计学意OBJECTIVE To observe the clinical efficacy of micro-acupoint ear acupuncture combined with botulinum toxin type A(BTX-A)in treating benign essential blepharospasm(BEB)complicated by anxiety and depression.METHODS From December 2021 to December 2022,a total of 63 patients(126 eyes)with BEB and anxiety or depression were treated at the Ophthalmology and Neurology Outpatient Departments of Foshan Hospital of Traditional Chinese Medicine.The patients were randomly divided into three groups using a random number table method:The botulinum toxin group(BTG),the ear acupuncture group(EAG),and the combined treatment group(CTG),with 21 cases(42 eyes)in each group.The three groups received BTX-A,micro-acupoint ear acupuncture,and a combination of both treatments,respectively.All three groups were observed for six months.The onset time and duration of efficacy were recorded for each group.The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores were measured before and after treatment,and the data were statistically analyzed.RESULTS(1)Onset time and duration of efficacy of BEB:There were statistically significant differences in onset time among the three groups(F=5.058,P=0.012).Compared to the ear acupuncture group,both the botulinum toxin group and the combined treatment group had significantly shorter onset times(tBTG=3.193,P=0.003;tCTG=3.835,P=0.000).There was no statistically significant difference in onset time between the combined treatment group and the botulinum toxin group(P>0.05).There were statistically significant differences in the duration of efficacy among the three groups(F=29.079,P=0.000).Compared to the ear acupuncture group,both the botulinum toxin group and the combined treatment group had significantly longer durations of efficacy(tBTG=4.391,tCTG=7.729,both P=0.000).The duration of efficacy in the combined treatment group was significantly longer than in the botulinum toxin group(t=2.638,P=0.012).(2)SDS scores:The SDS scores of all three groups significantly decreased after treatment

关 键 词：特发性眼睑痉挛 A型肉毒毒素 眼轮匝肌 微砭耳针 焦虑抑郁 

分 类 号：R777.1[医药卫生—眼科] R246.82[医药卫生—临床医学]