蝶腭神经节联合眼周穴位针刺治疗干眼的临床观察

The Efficacy of Acupuncture at Phenomaxillary Ganglion and Periocular Acupiont for the Treatment of Dry Eye

[目的]研究蝶腭神经节联合眼周穴位针刺治疗干眼的临床疗效。[方法]平行对照病例研究,纳入2014年1月至2015年10月于温州医科大学附属眼视光医院就诊患者88例,按治疗方法不同分为针刺组和对照组各44例。针刺组采用蝶腭神经节联合眼周穴位(上睛明、攒竹、丝竹空、四百)治疗3周,对照组采用人工泪液(羟糖苷滴眼液)治疗3周,治疗前、治疗后1h及治疗后4周分别评估眼表疾病指数((ocular surface disease index,OSDI)、泪膜破裂时间(tear break-up time,BUT)、Schirmer I试验、角膜荧光素染色评分的变化,采用协方差分析比较两组疗效。[结果](1)治疗后1h两组间比较,OSDI、BUT、角膜荧光素染色评分两组间差异均无统计学意义,但Schirmer I试验差异有统计学意义(P=0.00<0.01)。(2)治疗后4周两组间比较,OSDI(P<0.01),BUT(P=0.018<0.05)、Schirmer I试验(P=0.001<0.01),差异均有统计学意义;角膜荧光素染色评分无统计学意义。[结论]蝶腭神经节联合眼周穴位针刺可以有效改善干眼症状,促进泪液分泌,改善泪膜的稳定性,疗效优于人工泪液。

[Objective] To evaluate the effects of acupuncture at phenomaxillary ganglion and periocular acupiont in treating dry eye. [Methods] With parallel controlled study, 88 patients with dry eye were randomly divided into acupuncture group（n=44） and control group（n=44）, acupuncture group was conducted with acupuncture at phenomaxillary ganglion and periocular acupiont（BL1,BL2,ST2,TE23） for 3 weeks,the control group was applied with artificial tears（hypromellose 2910,dextran 70 and glycerol eye drops）.Main outcome measures：the ocular surface disease index（OSDI）,tear film break-up time（BUT）,Schirmer I test and the scores of fluorescence staining. Those were measured at before treatments, 1 hour and 4 weeks after treatments. [Results]（1） 1 hour after treatment：compared with control group,there was statistically significant difference for the improvement of tears secretion as measured by Schirmer I test in the acupuncture group（P〈0.01）,but there was no statistical difference including OSDI,BUT and the scores of fluorescence staining.（2） 4 weeks after treatment：compared with control group, the OSDI（P〈0.01）,BUT（P =0.018 0.05） and Schirmer I test（P =0.001 0.01） were significantly improved in the acupuncture group at 4 weeks after the end of acupuncture treatment. [Conclusions] Acupuncture at phenomaxillary ganglion and periocular acupiont can improve dry eye symptoms,promote tear secretion and extent film break-up time in patients with dry eye.