针刺对青光眼性视神经萎缩患者视觉诱发电位的影响

Effect of acupuncture on visual evoked potentials in patients with glaucomatous optic atrophy

目的观察针刺对青光眼性视神经萎缩患者视觉诱发电位的影响。方法采用前瞻性随机对照研究,选取于2014年10月—2015年12月就诊于新疆医科大学附属中医医院眼科的眼压稳定的青光眼性视神经萎缩患者72例。随机分为试验组与对照组,每组36例。试验组针刺攒竹、瞳子髎、四白、目窗、合谷、风池、太冲穴,双侧取穴。直刺四白、瞳子髎、合谷、风池、太冲穴0.5~1.0cm,平刺攒竹穴0.3~0.5cm,直刺目窗穴0.1~0.3cm,得气后留针20min。1次/d,针刺时间为2个月。对照组只需静养。在针刺前、治疗2个月后和治疗结束4个月后测量试验组患者最佳矫正视力、视觉诱发电位P100峰潜时和振幅的变化,对照组测量项目和时间同试验组,进行组内和组间对比。在观察期间,对2组患者眼压升高者均给予对症治疗,使用眼液控制眼压:马来酸噻吗洛尔滴眼液(武汉五景药业有限公司,5mL/支),或者布林佐胺噻吗洛尔滴眼液(爱尔康公司,5mL/支),滴患眼1~2滴/次,2次/d。结果治疗2个月后和治疗结束4个月后,与治疗前比较,2组内自身比较最佳矫正视力、P100峰潜时差异均无统计学意义,试验组组内比较振幅升高,差异有统计学意义(P<0.05)。组间比较试验组较对照组振幅明显升高,差异有统计学意义(P<0.05)。结论针刺可以改善青光眼性视神经萎缩患者视觉诱发电位P100的振幅,且安全性高。

Objective To observe the effect of acupuncture for glaucomatous optic atrophy on patten-visual evoked potential(P-VEP). Methods A prospective randomized controlled study was conducted in 72 patients with glaucomatous optic atrophy who had stable intraocular pressure from October 2014 to December 2015 in the Department of Ophthalmology, Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University. They were randomly divided into experimental group and control group, 36 cases in each group. The experimental group was treated with acupuncture at cuánzhú, Tóngzǐliáo, Sì bái, Mù chuāng, Hégǔ, fēngchí and Taichong, and bilateral acupoints were selected. Direct needling at Tóngzǐliáo, Sì bái, Hégǔ, fēngchí and Taichong points is 0.5~1.0 cm, plain needling at cuánzhú point is 0.3~0.5 cm, direct needling at Mù chuāng point is 0.1~0.3 cm, and needle retention is 20 minutes after deqi. Once a day for 2 months. The control group only needed rest. The best corrected visual acuity, visual evoked potential P100 peak latency and amplitude of the experimental group were measured before acupuncture, 2 months after treatment and 4 months after the end of treatment. The measurement time of the control group was compared with that of the experimental group. During the observation period, symptomatic treatment was given to patients with elevated intraocular pressure in both groups. Eye drops were used to control intraocular pressure: Timolol Maleate Eye Drops(Wuhan Wujing medicione Co.Ltd., 5 mL each one), or Brinzolam Timolol Eye Drops(SA Alcon-Couvreur N V, 5 mL each one), twice a day with 1~2 drops each time. Results After 2 months treatment and 4 months after the end of treatment, there was no significant difference in the best corrected visual acuity and P100 peak latency between the two groups compared with before treatment. The amplitude of comparison in the experimental group increased, and the difference was statistically significant(P<0.05). The amplitude of the experimental group was significantly higher than that of the control group(P<0.05). Conclusion Acupuncture could improve the amplitude of visual evoked potential P100 in glaucomatous optic atrophy patients with high safety.