揿针联合耳穴压丸治疗干眼的疗效观察  

Observational Study on the Efficacy of Press Needle Combined with Auricular Point Pressing Treatment for Dry Eye

作　　者：吴嘉琳 鲁望[3] 张意[3] 赵海音[3] WU Jialin;LU Wang;ZHANG Yi;ZHAO Haiyin(Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学,上海201203 [2]上海市浦东新区南码头社区卫生服务中心,上海200125 [3]上海中医药大学附属龙华医院,上海200032

出　　处：《中国中医眼科杂志》2024年第11期1041-1046,共6页China Journal of Chinese Ophthalmology

基　　金：上海市卫生健康委员会卫生行业临床研究专项(20234Y0051);上海市三年行动计划-重大临床研究项目(SHDC2020CR3018A);上海市闵行区科学自然基金(2023MHZ038)。

摘　　要：目的观察揿针联合耳穴压丸治疗干眼的临床疗效。方法纳入2022年8月—2023年1月诊治的干眼患者62例(124只眼),证属肝肾阴虚证,随机分为对照组和治疗组,最终纳入对照组30例(60只眼),治疗组31例(62只眼)。对照组予0.1%玻璃酸钠滴眼液点双眼,治疗组予揿针联合耳穴压丸治疗。2组均治疗4周。分别于治疗前、后检查患者泪膜破裂时间(BUT)、泪液分泌试验(SⅠT)、眼表疾病指数(OSDI)评分和中医证候积分。结果(1)干眼指标:2组治疗前后比较,BUT、SⅠT均较治疗前延长,而OSDI评分均较治疗前下降,差异均有统计学意义(BUT:t_(治疗组)=44.680、t_(对照组)=22.380,均P=0.000;SⅠT:t_(治疗组)=30.548、t_(对照组)=17.689,均P=0.000;OSDI评分:t_(治疗组)=32.061、t_(对照组)=35.643,均P=0.000)。2组治疗后比较,治疗组BUT、SⅠT均长于对照组,而OSDI评分低于对照组,差异均有统计学意义(tBUT=11.780、tSⅠT=7.010、t_(OSDI)=4.369,均P=0.000)。(2)中医证候积分:2组治疗前后比较,治疗组治疗后的中医证候积分较治疗前下降,差异有统计学意义(t=11.152,P=0.000)。对照组中医证候积分与治疗前比较,差异无统计学意义(P>0.05)。2组治疗后比较,治疗组中医证候积分低于对照组,差异有统计学意义(t=4.864,P=0.000)。(3)临床疗效:治疗组的总有效率为100.00%,高于对照组的90.00%,差异有统计学意义(χ^(2)=4.558,P=0.033)。结论揿针联合耳穴压丸治疗干眼能有效改善干眼患者的临床症状,且安全有效,值得临床推广。OBJECTIVE To observe the clinical efficacy of press needle combined with auricular point pressing treatment for dry eye.METHODS A total of 62 patients(124 eyes)diagnosed with dry eye due to liver-kidney Yin deficiency between August 2022 and January 2023 were included in the study.They were randomly divided into a control group(CG)and a treatment group(TG),with 30 patients(60 eyes)in the control group and 31 patients(62 eyes)in the treatment group.The control group received 0.1%sodium hyaluronate eye drops in both eyes,while the treatment group received press needle combined with auricular point pressing treatment.Both groups were treated for four weeks.The tear film breakup time(BUT),Schirmer I test(SⅠT),ocular surface disease index(OSDI)scores,and Traditional Chinese Medicine(TCM)syndrome scores were measured before and after treatment.RESULTS(1)Dry eye indicators:After treatment,BUT and SⅠT were significantly prolonged,and OSDI scores were significantly reduced in both groups compared to before treatment,with statistically significant differences(BUT:t_(TG)=44.680,t_(CG)=22.380,both P=0.000;SⅠT:t_(TG)=30.548,t_(CG)=17.689,both P=0.000;OSDI scores:t_(TG)=32.061,t_(CG)=35.643,both P=0.000).The treatment group showed longer BUT and SⅠT and lower OSDI scores than the control group after treatment,with statistically significant differences(tBUT=11.780,t_(SⅠT)=7.010,t_(OSDI)=4.369,all P=0.000).(2)TCM syndrome scores:The TCM syndrome scores of treatment group decreased significantly after treatment compared to before treatment,with statistically significant differences(t=11.152,P=0.000).There were no statistically significant difference in TCM syndrome scores between the control group before and after treatment(P>0.05).The TCM syndrome scores in the treatment group were significantly lower than those in the control group after treatment,with a statistically significant difference(t=4.864,P=0.000).(3)Clinical efficacy:The total effective rate in the treatment group was 100.00%,which was higher than 90.00%in

关 键 词：揿针 耳穴压丸 干眼 肝肾阴虚证 疗效 

分 类 号：R777.34[医药卫生—眼科] R246.82[医药卫生—临床医学]