石氏针刺手法干预治疗肝肾阴虚型白涩病临床疗效观察

Clinical efficacy on xerosis conjunctivitis of liver and kidney yindeficiency treated with SHI's acupuncture manipulation

目的:比较针刺配合石氏手法、常规针刺及人工泪液治疗对肝肾阴虚型白涩病患者的疗效差异。方法:将108例患者随机分成常规针刺组、石氏手法组和人工泪液组,每组36例。3组共脱落15例,其中常规针刺组脱落4例,石氏手法组6例,人工泪液组5例。常规针刺组针刺患侧睛明、球后,双侧三阴交、太溪,留针20min;石氏手法组在常规针刺组取穴操作的基础上,加用水沟,并采用石氏手法操作,两组均每周针刺3次,治疗3周;人工泪液组采用玻璃酸钠滴眼液滴眼治疗,每日5次,治疗3周。于治疗前、首次治疗后即刻、治疗3周后观察各组主观症状评分、基础泪液分泌试验、泪膜破裂时间情况。结果:1主观症状评分:治疗后即刻、治疗3周后各组评分均较治疗前有显著降低(均P<0.05);治疗后即刻,石氏手法组和人工泪液组均较常规针刺组降低明显(均P<0.05);治疗3周后,石氏手法组较常规针刺组和人工泪液组降低明显(均P<0.05)。2基础泪液分泌试验:治疗后即刻,石氏手法组、人工泪液组较治疗前均显著改善(均P<0.05);治疗3周后,常规针刺组、石氏手法组较治疗前均显著改善(均P<0.05);治疗后即刻,人工泪液组较常规针刺组、石氏手法组显著改善(均P<0.05);而治疗3周后,常规针刺组、石氏手法组则均优于人工泪液组(均P<0.05)。3泪膜破裂时间:治疗3周后,常规针刺组、石氏手法组较治疗前显著延长(均P<0.05);治疗3周后,常规针刺组、石氏手法组较人工泪液组泪膜破裂时间明显延长(均P<0.05)。结论:石氏针刺手法干预在改善肝肾阴虚型白涩病主观症状方面,兼有常规针刺和人工泪液治疗的长处,而对于促进泪液分泌和泪膜修复方面,石氏手法干预相对于常规针刺,短期内未显现明显优势。

Objective To compare the efficacy of the patients of xerosis conjunctivitis with liver and kidney yin deficiency among the combined therapy of acupuncture and Shi＇s manipulation, common acupuncture and artificial tears therapy. Methods One hundred and eigtlt patients were randomized into an acupuncture group, a SHI＇s manipulation group and an artificial tears group, 36 cases in each group. A total of 15 cases dropped out before the end of the study, including 4 cases in the acupuncture group, 6 cases in the SHI＇s manipulation group, and 5 cases in the artificial tears group. In the acupuncture group, acupuncture was applied to Jingming （BL1） and Qiuhou （EX-HN 7） on the affected side, and tbe bilateral Sanyinjiao （SP 6） and Taixi （KI 3）. The needles were retained {or 20 mitt. In the SHI＇s manipulation group, on the basis of the treatment as the acupuncture group, Shuigou （GV26） was added and stimulated with SHI＇s acupuncture manipulation. In these two groups, acupuncture was given 3 times a week, totally for 3 weeks. In the artificial tears group, sodium hyaluronate eye drops were used, 5 times a day, for 3 weeks totally. Separately, before treatment, at the moment after the 1st treatment and to weeks after treatment, the subjective symptom score, Schirmer I test, breakup time （BUT） of tear film were ob- served in each group. Results （1） Subjective symptom score： at the moment after the 1 st treatment and 3 weeks after treatment, the scores in each group were all reduced significantly as compared with those before treatment （all P〈0.05）. At the moment after the 1st treatment, the score in the SHI＇s manipulation group and the artifi- cial tears group was reduced apparently as compared with that in the acupuncture group （both P〈0. 05）. In 3 weeks of treatment, the score in the SHI＇s manipulation group was reduced apparently as compared with the acu- puncture group and the artificial tears group （both P〈0.05）. （2） For Schirmer I test, at the moment of the 1st treatment, the result in the SHI＇s manipulation group and the artificial tears group was improved significantly as compared with that before treatment （both P〈0. 05）. In 3 weeks of treatment, the result in the acupuncture group and the SHI＇s manipulation group group was improved significantly as compared with that before treatment （both P〈0.05）. At the moment of the 1st treatment, the result in the artificial tears group was improved signifi- cantly as compared with the acupuncture group and the SHI＇s manipulation group （both P〈0.05）. In 3 weeks of treatment, the result in the acupuncture group and the SHI＇s manipulation group was better than that in the artifi- cial tears group separately （both P〈0.05）. （3） For BUT, the result in the acupuncture group and the SHI＇s ma nipulation group was prolonged significantly as compared with that before treatment and was prolonged apparently as compared with that in the artificial tears group （both P〈0.05） in 3 weeks of treatment. Conclusion The interven- tion of SHI＇s acupuncture manipulation relieves the subjective symptoms of xerosis conjunctivitis of liver and kidney yin deficiency and achieves the same efficacy as the common acupuncture and artificial tears treatment. It does not present the apparent advantages as the common acupuncture in the short term for promoting the tear secretion and tears film repair.