揿针对翼状胬肉切除术后患者疼痛及泪膜稳定性的影响

Effect on the pain and tear film stability in patients after pterygium excision treated with intradermal needling

目的:分析揿针对翼状胬肉切除术后患者疼痛及泪膜稳定性的影响。方法:选择原发性翼状胬肉患者76例(共98只患眼)随机分为观察组38例(53只患眼)、对照组38例(45只患眼)。对照组患者仅行翼状胬肉切除术,观察组行翼状胬肉切除后给予揿针治疗,穴取攒竹、鱼腰、太阳、四白、合谷,留置24 h后取出,每周3次。比较两组患者术后3 d疼痛程度,术前、术后2周、术后4周干眼症状、基础泪液分泌试验(Schirmer-Ⅰ)以及泪膜破裂时间(break-up time,BUT)变化情况,并评定临床疗效。结果:观察组患者术后3 d疼痛程度显著轻于对照组(P<0.05)。术后2周、术后4周两组患者干眼症状评分较术前显著降低(均P<0.05),且观察组显著低于对照组(均P<0.05)。术后2周、术后4周两组患者Schirmer-Ⅰ试验渗湿长度较术前显著延长(均P<0.05),且观察组显著长于对照组(均P<0.05)。术后2周、术后4周两组患者BUT试验时间较术前显著延长(均P<0.05),且观察组显著长于对照组(均P<0.05)。观察组总有效率为89.5%(34/38),高于对照组71.1%(27/38,P<0.05)。结论:揿针可有效降低翼状胬肉切除术后患者疼痛程度,改善患者干眼症状,促进泪液基础分泌量并改善患者术后泪膜稳定性。

Objective To analyze the effects of intradermal needling for pain and tear film stability in patients after pterygium excision. Methods A total of 76 patients(98 affected eyes) with primary pterygium were randomly divided into an observation group(38 cases, 53 affected eyes) and a control group(38 cases, 45 affected eyes).In the control group,only pterygium resection was performed, in the observation group, intradermal needling after pterygium resection was applied at Cuanzhu(BL 2), Yuyao(EX-HN 4), Taiyang(EX-HN 5), Sibai(ST 2), Hegu(LI 4), removed after 24 h and changed three times a week. The pain level of 3 days after surgery, dry eye symptoms, the basic tear secretion test(Schirmer-Ⅰ), and the tear-break time(BUT) changes before surgery, 2 weeks after surgery and 4 weeks after surgery were compared between the two groups, and the clinical efficacy was evaluated. Results The pain level of 3 days after surgery in the observation group was significantly lower than that in the control group(P<0.05). The dry eye symptom scores at 2 weeks and 4 weeks after surgery in the two groups were significantly lower than those before surgery(all P<0.05),and the dry eye symptom scores in the observation group were significantly lower than those in the control group(both P<0.05).The Schirmer-Ⅰ test at 2 weeks and 4 weeks after surgery was significantly prolonged than that before surgery(all P<0.05),and the Schirmer-Ⅰ test in the observation group was significantly longer than that in the control group(both P<0.05). The BUT at 2 weeks and 4 weeks after surgery in the two groups was significantly longer than that before surgery(all P<0.05),and the BUT in the observation group was significantly longer than that in the control group(both P<0.05). The total effective rate in the observation group was 89.5%(34/38), which was higher than 71.1%(27/38) in the control group(P<0.05).Conclusion Intradermal needling can effectively reduce the pain level of patients after pterygium resection, improve dry eye symptoms, promote the secretion of tears and improve the tear film stability.