纳气针法治疗干眼症的临床疗效观察

发布时间：2018-04-27 08:19

本文选题：纳气针法 + 风池穴　；参考：《大连医科大学》2016年硕士论文

【摘要】：目的:比较运用纳气针法与常规针法治疗干眼症的临床疗效差异,以期验证纳气针法针刺风池穴为主治疗干眼症的可行性。方法:选取2014年2月至2016年1月大连医科大学附属第二医院针灸科门诊和眼科门诊确诊为干眼症的患者共60例(120只眼),根据治疗方法的不同,随机分为纳气针法组、常规针刺组、人工泪液组三组进行治疗,每组均为20例,其中纳气针法组(A)入组20例,脱落2例,共18例(36只眼);常规针刺组(B)入组20例,脱落1例,共19例(38只眼);人工泪液组(C)入组20例,脱落4例,共16例(32只眼)。纳气针法组在风池穴应用纳气针法;足三里、三阴交、太溪施迎随补法;光明、太冲施迎随泻法;太阳、攒竹、四白施捻转平补平泻法。常规针刺组取穴同纳气针法组,采用捻转平补平泻法。纳气针法组和常规针刺组每日一次,7天为一疗程,连续治疗4个疗程;人工泪液组应用人工泪液每天一次,每日4次点眼,根据患者的具体症状酌情增减,连续使用30天。随访观察三组治疗前后泪液分泌实验(Schirmer I test,SIt)、泪膜破裂时间(breakup time of tear film,BUT)、角膜荧光素染色(fluorescien,FL)、视觉模拟评分法(Visual Analogue Scale/Score,VAS)评分、临床总症状积分和干涩积分指标的变化。所有患者均符合入组标准,可耐受所有检查和针灸治疗并知情同意。将收集的数据建立数据库,采用SPSS 20.0统计学软件进行数据分析,对计量资料以均数±标准差((?)±S)表示。计数资料采用x2检验;三组间治疗前计量资料的比较采用单因素方差分析,两两比较采用LSD-t检验;各组治疗前后变量差异采用配对t检验;对比三组治疗疗效采用非参数秩和检验;均以P0.05为差异具有统计学意义,评价各参数变化。结果:1.三组治疗后SIt、BUT值均较治疗前增加,其中A、B组较治疗前增加明显,差异有统计学意义(P0.05)。A、B组均高于C组,差异有统计学意义(P0.05);A组SIt值高于B组,有统计学差异(P0.05)。2.三组治疗后临床症状总评分、VAS评分均较治疗前降低,其中A、B组较治疗前降低明显,差异有统计学意义(P0.05)。A、B组均低于C组,差异有统计学意义(P0.05);A组总评分、VAS评分低于B组,有统计学差异(P0.05)。3.三组治疗后FL评分、眼干涩积分均较治疗前降低,其中A、B组较治疗前降低明显,差异有统计学意义(P0.05)。A、B组均低于C组,差异有统计学意义(P0.05);A组FL评分、干涩积分低于B组,无统计学差异(P0.05)。4.纳气针法组总有效率为91.7%;常规针刺组总有效率84.3%;人工泪液组总有效率68.7%,纳气针法组总有效率高于常规针刺组和人工泪液组,差异有统计学意义。结论:1.纳气针法治疗干眼症疗效明显优于常规针刺,显著改善了眼睛局部的干涩、不适等症状,改善泪液的分泌,对角膜上皮有修复作用。2.纳气针法针刺风池穴可使局部产生针感以及沿足少阳胆经的循行感传,使眼睑、眼球产生酸胀热感,疗效显著,充分证明“气至病所”的临床意义。
[Abstract]:Objective: to compare the clinical curative effect of Qi-invigorating acupuncture and routine acupuncture in the treatment of xerophthalmia in order to verify the feasibility of treating xerophthalmia by acupuncture of Qi-acupuncture and Fengchi acupoint. Methods: from February 2014 to January 2016, 60 patients with xerophthalmia were selected from Department of Acupuncture, Department of Acupuncture and Ophthalmology, second affiliated Hospital of Dalian Medical University. The routine acupuncture group and artificial tear group were treated with 20 cases in each group, including 20 cases in group A), 2 cases in group A and 18 cases in group A, and 20 cases in group B in routine acupuncture group, 1 case in group A, and 1 case in group B in routine acupuncture group, and 2 cases in group A, 2 cases in group A, and 20 cases in group B in routine acupuncture group, and 1 case in group A in routine acupuncture group. There were 19 cases with 38 eyes and 20 cases with artificial tear group (C), and 4 cases with shedding, 16 cases with 32 eyes. Na-Qi acupuncture group in Fengchi acupoint, Zusanli, Sanyinjiao, Taixi Yingying with the complement method, bright, Taichongying with diarrhea method, the sun, Zanzhu, four Beshi twirling flat tonifying and reducing method. Routine acupuncture group took points with Qi acupuncture group, using twirling and tonifying and reducing method. The artificial tear group was treated with artificial tear once a day, 4 times a day, according to the specific symptoms of the patients, it was used continuously for 30 days. The changes of tear secretion test (Schirmer I test), tear film break up time of tear film, corneal fluorescein staining, visual analogue score (VAS), total clinical symptom score and dry score were observed before and after treatment. All patients meet the admission criteria, can tolerate all examinations and acupuncture treatment and informed consent. The collected data were set up and analyzed by SPSS 20.0 statistical software. The measurement data were expressed as mean 卤standard deviation (卤S). The counting data were analyzed by x2 test, single factor analysis of variance (ANOVA), LSD-t test were used to compare the measured data before and after treatment, and the difference of variables before and after treatment was matched t test. Comparison of three groups of therapeutic efficacy using non-parametric rank sum test; P0.05 as the difference was statistically significant to evaluate the changes of the parameters. The result is 1: 1. After treatment, the value of SItbut in group A was significantly higher than that before treatment, and the difference was statistically significant. The SIt value of group A was significantly higher than that of group C, and the difference was statistically significant (P 0.05. 05. 2). After treatment, the total clinical symptom scores and VAS scores of the three groups were all lower than those before treatment, and the VAS scores in group A were significantly lower than those in group B (P 0.05), and the VAS scores in group A were lower than those in group B (P 0.05), and the scores of VAS in group A were significantly lower than those in group B. There was statistical difference (P 0.05). The scores of FL and dry astringency in the eyes of the three groups were lower than those before treatment, and the scores of FL and dry astringency in group A were significantly lower than those in group B (P 0.05) and the scores of dry astringency in group A were lower than those in group B (P < 0.05), and the scores of FL and dry astringency in group A were significantly lower than those in group B. There was no statistical difference (P 0.05). The total effective rate was 91.7 in the acupuncture group, 84.3 in the routine acupuncture group, 68.7 in the artificial tear group, and 68.7 in the artificial tear group, which was higher than that in the conventional acupuncture group and the artificial tear group, and the difference was statistically significant. Conclusion 1. The treatment of dry eye with Qi acupuncture was better than that with routine acupuncture. It could significantly improve the dry and uncomfortable symptoms of the eyes, improve the secretion of tears, and repair corneal epithelium. Acupuncture at Fengchi point with the method of Na-Qi acupuncture can make the local sense of acupuncture and the sense of moving along the foot Shaoyang gallbladder meridian transmit, and make the eyelid and eyeball produce a sense of acid-swelling and heat. The curative effect is remarkable, which fully proves the clinical significance of "Qi to the place of disease".
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.82

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