针刺联合α-硫辛酸治疗糖尿病性眼肌麻痹的临床观察

Clinical study on acupuncture combination α-thioctic acid treating diabetic ophthalmoplegia

目的探讨针刺联合α-硫辛酸注射液对糖尿病性眼肌麻痹的治疗作用。方法 120例单眼糖尿病性眼肌麻痹患者随机分为单纯药物组60例和针药联合组60例,单纯药物组采用α-硫辛酸注射液治疗,针药联合组在此基础上配合针刺治疗,取穴睛明、四白、太阳、攒竹、瞳子髎、三阴交、足三里、阳陵泉、肾俞、涌泉、丝竹空、球后、合谷、承泣、光明等,每日1次,7 d为1个疗程,治疗14 d后,比较2组患者疗效及血液流变学指标变化。结果单药治疗组,痊愈20例,好转16例,无效24例,总有效率60%;针药联合组痊愈41例,好转10例,无效9例,总有效率85%(c2=9.404,P=0.002)。治疗前2组患者血液流变学指标(全血黏度、血浆黏度、红细胞比容、红细胞变形指数)无明显差异(P>0.05),治疗后针药联合组各指标较单纯药物组明显改善(P<0.05),单纯药物组治疗前后无明显变化(P>0.05)。结论针刺联合α-硫辛酸注射液可以提高糖尿病性眼肌麻痹的疗效,可能与改善患者血液流变学有关。

OBJECTIVE To explore the therapeutic effects of acupuncture combined with α-thioctic acid for diabetic ophthalmoplegia. METHODS One hundred and twenty cases with diabetic ophthalmoplegia were randomly divided into monotherapy group of 60 cases and needle plus medicine group of 60 cases. Alpha thioctic acid injection were used as drug treatment, acupuncture with drug group was treated with acupoint as J īngmíng（BL1）, Sìbái（ST2）,Tàiyáng（EX-HN5）,Cuánzhú（BL2）, Tóngzǐliáo（GB1）, Sānyīnjiāo（SP6）, Zúsānlǐ（ST36）, Yánglíngquán（GB34）,Shènyú（BL23）, Yǒngquán（KI1）, Sīzhúkōng（TE23）, Qiúhòu（EX-HN7）, Hégǔ（LI4）, Chéngqì（ST1）, Guāngmíng（GB37）, 1 times a day, 7 days as a course. Effectiveness and blood rheology detection value of two groups were com-pared after two weeks. RESULTS In monotherapy group, 20 cases were cured, 16 cases were improved, 24 had no effect, the total effective rate was 60%;In the other group, 41 cases were recovered, 10 cases were improved, 9 had no effect and the total effective rate was 85%. The indexes of blood rheology（whole blood viscosity, plasma viscosity,hematocrit value, erythrocyte deformation index） of two groups before treatment showed no significant difference（P〈0.05）. These indexes of the needle medicine combination group decreased after treatment and were lower than the monotherapy group（P〈0.05）. The drug group showed no significant change after treatment（P〉0.05）. CONCLUSIONS Acupuncture combined with α-lipoic acid injection could improve the curative effect of diabetic ophthalmoplegia that may be related to improve hemorheology.