针刺联合马来酸噻吗洛尔滴眼液对青光眼患者视网膜中央动脉血流、视力及自护能力的影响

Effects of Acupuncture-moxibustion Combined with Timolol Maleate Eye Drops on Blood Flow of Central Retinal Artery,Visual Acuity and Self-protection Ability in Glaucoma Patients

目的观察针刺联合马来酸噻吗洛尔滴眼液对青光眼患者视网膜中央动脉血流参数、视力水平及自护能力的影响。方法选取74例青光眼患者,根据随机数字表法分为对照组(37例)与观察组(37例)。对照组给予马来酸噻吗洛尔滴眼液治疗,观察组在对照组基础上联合针刺治疗,两组治疗4周后随访。对比分析两组治疗前后视网膜中央动脉收缩期血流峰值速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)、视力水平及自护能力情况,并检测眼部血浆中基质金属蛋白酶(MMP)、基质金属蛋白酶组织抑制因子-2(TIMP-2)的表达水平。结果观察组总有效率(94.6%)高于对照组(75.7%)(P=0.022);两组治疗后PSV、EDV均上升(P<0.05),RI下降(P<0.05),且观察组PSV、EDV参数均高于对照组(P<0.05),RI低于对照组(P<0.05);两组治疗后眼压及视野缺损水平均下降(P<0.05),视力水平均上升(P<0.05),且观察组眼压及视野缺损水平低于对照组(P<0.05),视力水平高于对照组(P<0.05);两组治疗后MMP、TIMP-2水平均显著降低(P<0.05),且观察组MMP、TIMP-2水平低于对照组(P<0.05);两组治疗后自护概念和责任感、技能评分均有升高(P<0.05),且观察组患者自护概念、责任感和技能明显优于对照组(P<0.05)。结论针刺联合马来酸噻吗洛尔滴眼液对青光眼患者疗效较好,可有效改善其视网膜中央动脉血流指标,提高视力水平及自护能力,并保持血浆中MMP、TIMP-2动态表达水平,促进康复。

Objective To observe the effects of acupuncture-moxibustion plus Timolol maleate eye drops on the blood flow parameters of central retinal artery,visual acuity and self-protection ability in glaucoma patients.Method Seventy-four glaucoma patients were divided into a control group(37 cases)and an observation group(37 cases)using the random number table method.The control group was treated with Timolol maleate eye drops,while the observation group was given additional acupuncture-moxibustion treatment.A follow-up study was conducted 4 weeks after treatment.The peak systolic velocity(PSV),end-diastolic velocity(EDV)and resistance index(RI)of central retinal artery,visual acuity and self-care ability in the two groups were compared and analyzed before and after treatment.The expression levels of matrix metalloproteinase(MMP)and tissue inhibitor of matrix metalloproteinase-2(TIMP-2)in ocular blood were also detected.Result The total effective rate in the observation group(94.6%)was higher than that in the control group(75.7%)(P=0.022);The PSV and EDV increased and the RI dropped after treatment in both groups,and the PSV and EDV were higher(P<0.05)and RI was lower(P<0.05)in the observation group than in the control group.The levels of intraocular tension and visual field defect decreased(P<0.05)and the visual acuity level increased(P<0.05)after treatment in both groups;the intraocular tension and visual field defect levels in the observation group were lower than those in the control group(P<0.05)and the visual acuity level in the observation group was higher than that in the control group(P<0.05).The levels of MMP and TIMP-2 dropped significantly after treatment in both groups(P<0.05),and were lower in the observation group than in the control group(P<0.05).The scores of self-protection sense,responsibility and skills all increased after treatment in the two groups(P<0.05),and were markedly better in the observation group than in the control group(P<0.05).Conclusion Acupuncture-moxibustion plus Timolol maleate eye drops can produce satisfactory efficacy in treating glaucoma patients.It can effectively improve the blood flow parameters of central retinal artery,increase visual acuity level and self-protection ability,maintain the dynamic expression levels of MMP and TIMP-2 in blood,and promote recovery.