针刺治疗青光眼性视神经萎缩的临床疗效分析

发布时间：2018-04-16 15:07

本文选题：青光眼 + 视神经萎缩　；参考：《中国中医科学院》2017年硕士论文

【摘要】：目的:1采用针刺疗法治疗青光眼性视神经萎缩,联合现代医学检测手段,客观评价针刺的临床疗效;2初步阐释青光眼性视神经萎缩的中医证型分布特点,为临床提供新的治疗思路和方法。方法:将2016年1月1日至2016年12月31日期间中国中医科学院西苑医院眼科门诊收治的符合入组诊断标准的青光眼性视神经萎缩患者16人30只眼,采用自身对照优效性试验,随机先后进行方案A(青光眼基础治疗)和方案B(青光眼基础治疗配合针刺治疗)治疗。方案A予降眼压眼药水如拉坦前列腺素滴眼液、卡替洛尔滴眼液,注射鼠神经生长因子抗青光眼治疗。方案B予基础治疗联合针刺治疗:选穴:主穴:百会、上睛明、球后、攒竹、风池、光明、足三里。配穴:肝气郁结证:太冲、合谷、肝俞;气血瘀滞证:内关、血海、膈俞;肝肾阴虚证:肝俞、肾俞、太溪、三阴交;气血两虚证:脾俞、三阴交、血海、养老。每一个受试对象先后接受对照(方案A)和试验(方案B)两种不同方案进行治疗。对照组方案A疗程1个月,洗脱期为1个月,试验组方案B疗程为针刺30次,进行自身对照研究。两组观察指标为:视力、眼压、视野平均光敏度(MS)和平均缺损(MD)、中医症候积分。根据以上各项指标变化分析针刺治疗青光眼性视神经萎缩的临床疗效和中医证型分布特点。结果:1、30次针刺治疗结束后,患者视力、视野平均光敏度(MS)、视野平均缺损度(MD)均有改善,治疗前后比较有统计学意义(p0.05)。2、青光眼性视神经萎缩中医证型分布以肝肾阴虚为主,占53%,肝气郁结证次之,占36%。3、针刺治疗能有效降低中医症候积分,治疗前后比较有统计学意义(p0.05)。结论:针刺疗法可不同程度提高青光眼性视神经萎缩患者视力,改善部分患者视野,明显降低中医症候积分,改善患者全身症状;针刺治疗是青光眼性视神经萎缩治疗的有效辅助治疗手段,可在临床推广。
[Abstract]:Objective to evaluate the clinical efficacy of acupuncture in the treatment of glaucoma optic atrophy by using acupuncture therapy and modern medical examination methods. [WT5HZ] to preliminarily explain the distribution of TCM syndromes of glaucoma optic atrophy.To provide new ideas and methods for clinical treatment.Methods: from January 1, 2016 to December 31, 2016, 30 eyes of 16 patients with glaucoma optic nerve atrophy, who were admitted to Xiyuan Hospital, Xiyuan Hospital, Chinese Academy of traditional Chinese Medicine, were selected and treated.Regimen A (basic glaucoma therapy) and scheme B (glaucoma basic therapy combined with acupuncture therapy) were given randomly.Scheme A was given intraocular pressure lowering eye drops, such as lattan prostaglandin eye drops and katilol eye drops, and injection of nerve growth factor (NGF) to treat glaucoma.Scheme B basic treatment combined with acupuncture treatment: selection: main point: Baihui, Qianming, behind the ball, Zanzhu, Fengchi, Guangming, Zusanli.Points: liver qi stagnation syndrome: Taichong, Hegu, Ganshu; Qi and blood stasis syndrome: Neiguan, blood sea, Geshu; liver and kidney yin deficiency syndrome: Ganshu, Shenshu, Taixi, Sanyinjiao; Qi and blood deficiency syndrome: spleen Yu, Sanyinjiao, blood sea, endowment.Each of the subjects was treated with two different regimens: control (Scheme A) and trial (Scheme B).Control group A treatment course 1 month, elution period 1 month, experimental group B course of treatment was acupuncture 30 times, self-control study.The two groups were visual acuity, intraocular pressure, visual field mean Guang Min and MSM) and average defect.According to the above indexes, the clinical effect of acupuncture on glaucoma optic atrophy and the distribution of TCM syndromes were analyzed.Results after 30 times of acupuncture treatment, the visual acuity, the average degree of vision of Guang Min and the average degree of visual field defect (MDM) were all improved. There was significant difference between before and after treatment (P 0.05). The distribution of traditional Chinese medicine syndrome of glaucoma optic atrophy was mainly liver and kidney yin deficiency.Acupuncture treatment can effectively reduce the integral of TCM symptoms, before and after treatment, there is statistical significance between before and after treatment.Conclusion: acupuncture therapy can improve the visual acuity of patients with glaucoma optic atrophy, improve the visual field of some patients, reduce the integral of TCM symptoms, and improve the patients' systemic symptoms.Acupuncture is an effective adjuvant treatment for glaucoma optic atrophy and can be popularized in clinic.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.82

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