鬃针与针刺治疗干眼的疗效比较

Comparison of curative effect of bristle needle and acupuncture on dry eye

目的比较鬃针和针刺方法治疗干眼的临床疗效。方法将120例(240只眼)干眼患者采用随机数字表法分为鬃针组40例(80只眼)、针刺组38例(76只眼)和对照组42例(84只眼)。鬃针组予鬃针刺双眼上下泪小点治疗;针刺组予针刺双眼眼周穴位治疗;对照组予玻璃酸钠滴眼液点眼治疗。共治疗20 d为1个疗程。通过观察、记录3组患者治疗前后的临床症状积分、体征积分和治疗满意度评分,进行比较评价。结果(1)临床疗效比较:鬃针组治疗有效率(97.50%)高于针刺组(76.32%)和对照组(76.19%),差异有统计学意义(χ^2=8.961,P=0.023;χ^2=9.437,P=0.012)。(2)治疗满意度比较:鬃针组平均评分为(2.65±2.14),针刺组为(4.78±2.67),2组差异有统计学意义(t=7.652,P=0.000)。(3)临床观察指标比较:①3组患者治疗前各项指标比较,差异无统计学意义(均P>0.05);②3组患者治疗前后各项指标比较,鬃针组患者的眼部症状积分、泪液分泌试验(SIT)、泪膜破裂时间(BUT)、角膜荧光素染色(CFS)评分较治疗前均有改善,差异均有统计学意义(t=46.952、18.522、20.761、9.464,均P=0.000);针刺组患者的眼部症状积分、SIT、BUT较治疗前均有改善,差异均有统计学意义(t=26.086、9.662、7.101,均P=0.000);对照组患者的眼部症状积分、SIT较治疗前有所改善,差异有统计学意义(t=21.127、8.556,均P=0.000)。③3组患者治疗后各项指标比较,在眼部症状积分、SIT、BUT、CFS方面,鬃针组与针刺组(t=9.897,P=0.000;t=8.394,P=0.000;t=11.087,P=0.000;t=2.356,P=0.012)、对照组(t=17.514,P=0.000;t=11.693,P=0.000;t=15.734,P=0.000;t=5.022,P=0.002)分别进行比较,差异有统计学意义。结论在干眼的治疗方面,鬃针疗法比普通针刺法起效快,能够改善干眼患者的症状和体征,且治疗满意度好、安全、高效,具有临床应用价值。

OBJECTIVE To observe the clinical effect of bristle needle and acupuncture on dry eye.METHODS A total of 120 cases(240 eyes)of patients with dry eye were divided into bristle needle group with 40 cases(80 eyes),acupuncture group with 38 cases(76 eyes)and control group with 42 cases(84 eyes)by random number table.The bristle needle group was treated with bristle needle in lacrimal punctum of both eyes;the acupuncture group was treated with acupuncture of binocular periocular points;the control group was treated with sodium hyaluronate eye drops.The course of treatment was 20 days.The scores of clinical symptoms,physical signs and treatment satisfaction of the three groups were evaluated before and after treatment.RESULTS(1)Comparison of clinical effects:the clinical effects of the bristle needle group(97.50%)was higher than that of the acupuncture group(76.32%)and the control group(76.19%),and the differences were statistically significant(χ^2=8.961,P=0.023;χ^2=9.437,P=0.012).(2)Comparison of treatment satisfaction:the average score of the bristle needle group was 2.65±2.14 while it of acupuncture group was 4.78±2.67 and the difference was statistically significant(t=7.652,P=0.000).(3)Comparison of clinical observation indicators:①There was no significant difference among the three groups of patients before treatment(all P>0.05);②Comparison of various indicators before and after treatment among the three groups showed that ocular symptom scores,Schirmer I test(SIT),break-up time(BUT),and cornea fluorescein staining(CFS)scores all improved in bristle needle group,the differences were statistically significant(t=46.952,18.522,20.761,9.464;all P=0.000);in the acupuncture group,eye symptom scores,SIT,and BUT improved after treatment,and the differences were statistically significant(t=26.086,9.662,7.101;all P=0.000);ocular symptom scores and SIT of the control group patients improved after treatment,and the differences were statistically significant(t=21.127,8.556;both P=0.000).③After treatment,comparison of indicators(eye symptom scores,SIT,BUT and CFS)of the three groups showed that,the differences between the bristle needle group and acupuncture group(t=9.897,P=0.000;t=8.394,P=0.000;t=11.087,P=0.000;t=2.356,P=0.012),bristle needle group and control group(t=17.514,P=0.000;t=11.693,P=0.000;t=15.734,P=0.000;t=5.022,P=0.002)were statistically significant.CONCLUSIONS For treatment of dry eye,bristle needle was more effective than acupuncture,it relieved the symptoms and signs of patients,had better treatment satisfaction,safety and efficiency,and it was of clinical application values.