方氏头皮针飞针疗法治疗干眼的临床观察

Clinical observation of Fang's scalp needle flying needle therapy in the treatment of dry eye

目的观察方氏头皮针飞针疗法治疗干眼的临床疗效。方法纳入2021年6月—2022年1月期间经佛山市中医院眼科和针灸科门诊收治的干眼患者68例(136只眼),随机分为对照组和头针组,每组34例(68只眼)。对照组只采用0.1%玻璃酸钠滴眼液治疗;头针组在对照组的基础上选择方氏头皮针飞针疗法治疗。观察和比较2组治疗前、治疗4周后眼表疾病指数表(OSDI)量表评分、泪膜破裂时间(BUT)、泪液分泌试验(SⅠT)及泪河高度的变化。结果(1)BUT:2组间治疗前比较,差异无统计学意义(P>0.05);治疗4周后,2组BUT较治疗前均延长,差异均有统计学意义(t头针组=-21.628,t对照组=-7.322,均P=0.000),2组间比较,头针组长于对照组,差异有统计学意义(t=11.173,P=0.000)。(2)SⅠT:2组间治疗前比较,差异无统计学意义(P>0.05);治疗4周后,2组SⅠT均增长,差异均有统计学意义(t头针组=-13.514,t对照组=-4.927,均P=0.000),2组间比较,头针组长于对照组,差异有统计学意义(t=6.783,P=0.000)。(3)泪河高度:2组间治疗前比较,差异无统计学意义(P>0.05);治疗4周后,2组泪河高度均提高,差异均有统计学意义(t头针组=-9.685,P=0.000;t对照组=-2.337,P=0.026),2组间比较,头针组高于对照组,差异有统计学意义(t=4.709,P=0.000)。(4)OSDI评分:2组间治疗前比较,差异无统计学意义(P>0.05);治疗4周后,2组OSDI评分均减少,差异均有统计学意义(t头针组=18.100,t对照组=8.792,均P=0.000),2组间比较,头针组低于对照组,差异有统计学意义(t=-4.086,P=0.000)。(5)临床疗效:头针组总有效率(91.18%)优于对照组(70.58%),差异有统计学意义(χ2=4.660,P=0.031)。结论方氏头皮针飞针疗法能快速促进泪液分泌,稳定泪膜状态,改善眼部干眼症状,治疗干眼的疗效更显著。

OBJECTIVE To evaluate the clinical efficacy of flying needle therapy of Fang's scalp acupuncture in the treatment of dry eye.METHODS Sixty-eight patients(136 eyes)with dry eye admitted to the Foshan Hospital of Traditional Chinese Medicine between June 2021 and January 2022 were randomly divided into scalp acupuncture group(SAG)and control group(CG),with 34 cases(68 eyes)in each group.The control group was treated with only 0.1%Sodium Hyaluronate eye drops,while the scalp acupuncture group received Fang's scalp needle flying needle therapy in addition to the eye drops.Changes in the Ocular Surface Disease Index(OSDI)scores,tear film break up time(BUT),SchirmerⅠtest(SⅠT),and tear meniscus height were observed and compared between the two groups before treatment and four weeks after treatment.RESULTS(1)BUT:There was no significant difference between the two groups before treatment(P>0.05).BUT was significantly prolonged in both groups after treatment(tSAG=-21.628,tCG=-7.322,both P=0.000).The BUT of the scalp acupuncture group was longer than that of the control group after four weeks treatment,and the difference was statistically significant(t=11.173,P=0.000).(2)SⅠT:There was no significant difference between the two groups before treatment(P>0.05).SⅠT increased significantly in both groups after four weeks treatment(tSAG=-13.514,tCG=-4.927,both P=0.000).The SⅠT of the scalp acupuncture group was higher than that of the control group after treatment,and the difference was statistically significant(t=6.783,P=0.000).(3)Tear meniscus height:There was no significant difference between the two groups before treatment(P>0.05).Tear meniscus height increased significantly in both groups after treatment(tSAG=-9.685,P=0.000;tCG=-2.337,P=0.026).The tear meniscus height of the scalp acupuncture group was higher than that of the control group after four weeks treatment,and the difference was statistically significant(t=4.709,P=0.000).(4)OSDI:There was no significant difference between the two groups before treatment(P>0.05).The OSDI scores decreased significantly in both groups after four weeks treatment(tSAG=18.100,tCG=8.792,both P=0.000).The OSDI scores of the scalp acupuncture group were lower than those of the control group after treatment,and the difference was statistically significant(t=-4.086,P=0.000).(5)Clinical efficacy:The total effective rate of the scalp acupuncture group(91.18%)was better than that of the control group(70.58%),and the difference was statistically significant(χ2=4.660,P=0.031).CONCLUSIONS Fang´s scalp needle flying needle therapy can quickly promote tear secretion,stabilize tear film state and improve dry eye symptoms.Compared with sodium hyaluronate eye drops alone,Fang's scalp needle flying needle therapy combined with sodium hyaluronate eye drops is more effective in the treatment of dry eye.