基于正交设计眼周穴位摩灸法治疗重度VDT型视疲劳临床方案优化研究

Clinical research on optimization of VDT visual fatigue plan by thunder-fire moxibustion combined massage on acupoints around eye based on orthogonal experimental design

目的通过正交设计分析灸穴时间、摩穴时间、取穴方案3因素对眼周穴位摩灸法治疗VDT型视疲劳临床疗效的差异,优选最佳摩灸法参数。方法将180例VDT视疲劳患者进行正交试验,每组20例,疗程均为7 d。以L9(34)正交表安排试验,研究包括灸穴时间(0.5 min、1 min、2 min)、摩穴时间(0.5 min、1 min、2 min)、取穴方案(太阳+阳白+四白+攒竹、太阳+阳白+四白+印堂、太阳+阳白+四白)。采用治疗前后的视疲劳症状和体征积分改善分数做观察指标,进行统计分析。结果A为主要因素;B为重要因素,C为非主要因素;对因素水平均值进行比较,因本试验指标越大越好,A取A3,B取B2,C取C1。从而得到最佳试验方案A3B2C1,即灸穴时间2 min、摩穴时间1 min、取穴方案为太阳+阳白+四白。该治疗方案对VDT型视疲劳症状改善可能最显著。结论眼周穴位摩灸法采用灸穴时间2 min、摩穴时间1 min、取穴方案为太阳+阳白+四白的治疗方案可能为眼周穴位摩灸法治疗VDT型视疲劳的最优参数组合,该方案减少了操作护士的劳累程度及操作时间,提高了每日工作量,减少患者支付费用,造福更多患者。

OBJECTIVE To figure out the optimum treatment regimen with different duration of thunder-fire moxibustion,acupoint massage and acupoints combination on visual display terminal(VDT)visual fatigue by orthogonal experimental trial.METHODS A total of 180 patients with VDT were randomly divided into nine treatment groups(n=20)according to the orthogonal experimental design,and moxibustion time(A),massage time(B),and acupoint scheme(C)were three factors in this trial.The L9(34)of orthogonal array was used for arrangement of experiment,duration of thunder-fire moxibustion(0.5 min,1 min,2 min),acupoint massage(0.5 min,1 min,2 min)and acupoint selection plan(combination of Taiyang,Yangbai,Sibai and Cuanzu;combination of Taiyang,Yangbai,Sibai and Yintang;combination of Taiyang,Yangbai and Sibai)were studied.The intervention lasted for 7 days.Symptoms and signs of visual fatigue were observed before and after intervention for analysis.RESULTS A was the main factor;B was an important factor and C was a minor factor.Due to the fact that larger experimental indexes yielded more accurate result,A3B2C1 was set as the optimal protocol(moxibustion for 2 min,massage for 1 min,and acupoint treatment on Taiyang,Yangbai and Sibai).This plan might alleviate VDT visual fatigue most effectively.CONCLUSIONS The possible optimal treatment scheme was the combination of moxibustion for 2 min,massage for 1 min on acupoint as Taiyang,Yangbai and Sibai.This solution took less labor and time,and it was more efficient in terms of daily workload and time consumption in addition to less cost and it would benefit more patients.