高维滨电眼针治疗视网膜静脉阻塞伴黄斑水肿医案1则

高维滨教授是黑龙江省名中医,国家级名老中医药专家,全国名老中医药专家学术经验继承工作指导老师,博士研究生导师,享受国务院特殊津贴。从事针灸临床、科研、教学工作五十余年,医术精湛,学术上主张以中西医理论为基础,辨病辨证相结合,提倡针灸取穴少而精,异病同治,擅长用针刺治疗神经系统疾病及各类疑难病症。笔者有幸跟随高教授学习,现介绍高教授运用眶内电眼针疗法治疗视网膜静脉阻塞黄斑水肿医案1则,以飨同道。

高维滨教授基于“筋、经、脑共治”理论运用电针治疗眼肌麻痹的经验撷菁

眼肌麻痹病因复杂,临床表现各不相同,多以眼球突然偏斜、转动受限、视一为二等为临床特征,属中医“目偏视”的范畴,临证观察此病多与“脑神经核—周围神经—眼外肌”视觉环路病变有关,而这分属于中医“筋、经、脑”的范畴。高维滨教授认为“脑窍受邪”为病机之本,“经筋病变”为病机之标,故此创新性的提出“筋、经、脑同治”的治疗观点,对于“筋”的治疗提出“电眼针法”,对于“经”的治疗提出“电针太阳组穴法”,对于“脑”的治疗提出“电项针法”,三法合用共同治疗“筋—经—脑”视觉环路,临床疗效满意。

Electroacupuncture therapy for ophthalmoplegia:a case series

Objective To probe the effective therapy for electroacupuncture treatment of ophthalmoplegia.Methods Twelve patients diagnosed with ophthalmoplegia were treated with acupuncture for 6–14 weeks,three times per week,until recovery was complete.Results Eleven patients recovered completely after 2–3 months,and one patient recovered after 6 months.No recurrence was obser ved among all patients within 6–12 months.Conclusions Electroacupuncture treatment improved eye movement and the quality of life of 12 patients with ophthalmoplegia.However,randomised controlled studies are needed to verify the efficacy of electroacupuncture treatment.

Influence of electroacupuncture on histomorphology of lacrimal glands and ocular surface in experimental dry eye syndrome

Objective： To observe the influence of electroacupuncture （EA） on histomorphologies of lacrimal glands, cornea and conjunctiva in experimental dry eye syndrome, and to explore the repair effects of EA on lacrimal glands and ocular surface damage. Methods： Twenty-four healthy male New Zealand rabbits were randomly divided into a normal group, a model group, an EA group and a medication group, 6 rabbits in each group. Experimental dry eye syndrome models were prepared in rabbits by using 0.1% benzalkonium chloride for eye drops. Tear secretion volume, break-up time of tear film （BUT） and corneal fluorescein staining score were observed before and after the treatment. Periodic acid Schiff （PAS） staining method was used to observe the changes of conjunctival goblet cells in rabbits. After hematoxylin eosin （HE） staining, morphological changes of rabbit cornea, conjunctiva and lacrimal gland tissues were observed under light microscope. Results： Compared with the normal group, tear secretion volume and BUT were significantly reduced （both P^0.01）, while the corneal fluorescein staining score was significantly increased （P〈O.01） in the model group. Compared with the model group, tear secretion volume and BUT were significantly increased, while the corneal fluorescein staining score was significantly decreased in the EA group and the medication group （all P〈0.01）. Compared with the normal group, the number of conjunctival goblet cells in the model group was significantly reduced; compared with the model group, the numbers of conjunctival goblet cells were all relatively higher in the EA group and the medication group. Pathological lesions of cornea, conjunctiva and lacrimal glands all showed improvement by HE staining in the EA group and the medication group after the intervention. Conclusion： EA can improve tear secretion and tear film stability of rabbit dry eye syndrome, and repair the pathologic lesions of conjunctival goblet cells, corneal epithelia, cornea, conjunctiva and lacrimal glands.

Effects of electroacupuncture on conjunctival cell apoptosis and the expressions of apoptosis-related proteins Caspase-3,Fas and Bcl-2 in rabbits with dry eye syndrome

Objective:By observing the effects of electroacupuncture(EA)on the apoptosis of conjunctival cells of rabbits with dry eye syndrome(DES)and the expressions of apoptosis-related proteins Caspase-3,Fas and Bcl-2,to discuss the mechanism of EA in the treatment of DES from the perspective of cell apoptosis.Methods:Male New Zealand rabbits were randomly divided into a normal group(NG),a model group(MG),an EA group(EAG)and a sham EA group(SEAG).DES rabbit model was developed by eye drop of 0.1%benzalkonium chloride.The rabbit tear secretion and tear film break-up time(BUT)were measured;terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)assay was used to detect the apoptosis of conjunctival cells;the expressions of Caspase-3,Fas and Bcl-2 proteins in conjunctival cells were detected by immunohistochemistry.Results:Compared with the NG,the rabbit tear secretion decreased and the BUT was shortened in the MG(both P<0.01);compared with the MG and the SEAG,the rabbit tear secretion increased and the BUT was prolonged in the EAG(all P<0.05).Compared with the NG,the apoptosis of rabbit conjunctival cells increased(P<0.01),the expressions of Caspase-3 and Fas proteins increased(both P<0.05),and the expression of Bcl-2 protein decreased(P<0.01)in the MG;compared with the MG and the SEAG,the apoptosis of rabbit conjunctival cells decreased(both P<0.01),the expressions of Caspase-3 and Fas proteins decreased(all P<0.05),and the expression of Bcl-2 protein increased(both P<0.01)in the EAG.Conclusion:EA can inhibit the apoptosis of rabbit conjunctival cells,down-regulate the expressions of apoptosis-related proteins Caspase-3 and Fas,and up-regulate the expression of Bcl-2 protein,which may be one of the mechanisms of EA in treatment of DES.

Efficacy of electroacupuncture for patients with dry eye syndromes:a randomized controlled trial

Objective To observe the efficacy of electroacupuncture(EA)in treating dry eye syndromes(DES)and its regulatory effects on patient’s quality of life(QOL),anxiety,and depression.MethodsBy following a randomized controlled study design,eligible DES patients were allocated to an EA group(EAG)or an acupuncture group(AG).Patients in the AG were intervened by acupuncture alone,while in the EAG,electrical stimulation was applied to Cuanzhu(BL2)and Taiyang(EX-HN5)in addition to the same treatment in the AG.Changes in clinical manifestations,ocular surface disease index(OSDI),Schirmer tear test-1(STT-1),tear-film break-up time(TF-BUT),cornea fluorescein staining(CFS),and corneal sensitivity(CS)were observed,as well as changes in the short-form 36-item health survey(SF-36)and hospital anxiety and depression scale(HADS)scores.ResultsThe scores of clinical symptoms,OSDI,and CFS decreased significantly in both EAG and AG when compared with the baseline values(P<0.05),respectively,while the TF-BUT and CS increased significantly(P<0.05),and the tear secretion of patients in the EAG increased(P<0.05).Compared with those before treatment,the scores of physical role functioning,general health perception,emotional role functioning,and mental health of patients in both EAG and AG showed significant increases after treatment(P<0.05),together with a marked decrease in the score of anxiety(P<0.05).Compared with the AG,the EAG obtained a more significant increase in STT-1(P<0.05).ConclusionDES patients respond well to both EA and acupuncture treatments,manifested by prolonged TF-BUT and improvement of CS.Meanwhile,the two approaches can improve QOL and reduce anxiety.Furthermore,EA appears more effective in increasing tear secretion than acupuncture alone.

Clinical efficacy of electroacupuncture in controlling myopia in children and its influence on retinal blood flow

Objective:To observe the clinical efficacy of electroacupuncture(EA)in controlling myopia in children and its effect on retinal blood flow.Methods:Sixty-eight myopic children were randomly divided into an observation group and a control group,with 34 cases in each group.The control group was given auricular acupressure treatment alone,and the observation group was treated with EA once a week in addition to the treatment used in the control group.The spherical equivalent refraction(SER)and axial length(AL)were measured at baseline,and after 3 months and 6 months of treatment.Optical coherence tomography angiography was used to measure the vessel density(VD)and perfusion density(PD)in the surface layer of the retina.Results:After 3 months and 6 months of treatment,the changes in SER between the two groups were not statistically significant(P>0.05).After 3 months of treatment,the changes in AL between the two groups were not statistically significant(P>0.05);after 6 months of treatment,the change amount of AL in the observation group was smaller than that in the control group(P<0.05);after 3 months and 6 months of treatment,the changes in VD and PD in the surface layer of the retina in the observation group were significantly greater than those in the control group(P<0.01).Conclusion:EA treatment once a week for 6 months can delay the increase of AL and improve the retinal surface blood flow in myopic children.