明目四物汤配合针刺治疗肝血不足型干眼的临床观察

发布时间：2018-05-20 18:22

本文选题：干眼 + 针刺　；参考：《山西中医学院》2016年硕士论文

【摘要】：目的干眼为最常见的眼表疾病,流行病学调查及临床检查发现干眼的发病率骤增,并逐渐趋于年轻化。本实验拟以观察明目四物汤配合针刺对肝血不足型干眼的临床疗效,寻找中医治疗干眼的有效方法。方法本临床研究病例来源于2014年6月1日至2015年12月30日,在大同市矿区中医院眼科门诊纳入符合标准的患者,共48例(96眼),剔除4例,脱落3例。通过随机数字表法随机分为实验组和对照组。实验组给予明目四物汤结合针刺干预,1次/日,6次/周,治疗4周。对照组采用玻璃酸钠滴眼液干预,4次/日,1滴/次,治疗4周。观察并记录两组患者治疗前后的干眼问卷评分、中医临床症状评分、泪液分泌量(SIT)、泪膜破裂时间(BUT)及角膜上皮荧光染色(FL),并对两组治疗后组间比较,选取适当的检验方法对观察结果进行统计学分析。结果治疗前两组患者的性别、年龄及病程的统计学结果(P0.05)均无统计学意义,两组患者治疗前组间比较统计学结果(P0.05)无差异。实验组与对照组比较具有均衡性和可比性。实验组治疗前后比较:经统计学检查在干眼问卷评分、中医临床症状评分、泪液分泌量及角膜荧光染色上(P0.01)有显著差异,在泪膜破裂时间上(P0.05)无差异。对照组治疗前后比较:经统计学检查在干眼问卷评分、泪液分泌量及角膜染色上有显著差异(P0.01),中医临床症状评分(P0.05)有统计学意义,泪膜破裂时间(P0.05),差异无统计学意义。治疗后组间相比:中医临床症状评分和角膜染色(P0.01)有明显差异,干眼问卷评分及泪液分泌量(P0.05)差异有统计学意义,泪膜破裂时间(P0.05)差异无统计学意义。实验组总有效率91.67%明显高于对照组总有效率75%,差异有统计学意义。结论明目四物汤配合针刺能够有效缓解肝血不足型干眼患者的临床症状,通过调整脏腑气血津液及局部刺激达到促进泪液分泌和延长泪膜破裂时间的目的。从干眼问卷评分看,治疗组总有效率明显高于对照组总有效率,说明在缓解眼部症状上,明目四物汤配合针刺疗效优于玻璃酸钠滴眼液。
[Abstract]:Objective dry eye is the most common ocular surface disease. The aim of this experiment was to observe the clinical effect of Mingmu Siwu decoction combined with acupuncture on dry eyes of liver and blood deficiency and to find an effective method of treating dry eyes with traditional Chinese medicine. Methods from June 1, 2014 to December 30, 2015, 48 patients (96 eyes) were included in the ophthalmological outpatient department of Datong Mining area Hospital of traditional Chinese Medicine. 4 cases were removed and 3 cases dropped out. The experimental group and the control group were randomly divided into two groups by random digital table. The experimental group was treated with Mingmu Siwu decoction combined with acupuncture intervention once a day and 6 times a week for 4 weeks. The control group was treated with sodium hyaluronate eye drops for 4 weeks. To observe and record the scores of dry eye questionnaire, clinical symptoms of TCM, tear secretion, tear film rupture time and corneal epithelial fluorescent staining before and after treatment in both groups, and to compare the two groups after treatment. Select the appropriate test method to analyze the observation results statistically. Results there was no significant difference in sex, age and course of disease between the two groups before treatment (P 0.05), but there was no significant difference between the two groups before treatment (P 0.05). Compared with the control group, the experimental group was balanced and comparable. Comparison before and after treatment: there were significant differences in dry eye questionnaire score, TCM clinical symptom score, tear secretion and corneal fluorescence staining (P0.01), but there was no difference in tear film rupture time (P0.05). Comparison before and after treatment in the control group: there were significant differences in dry eye questionnaire score, tear discharge volume and corneal staining (P 0.01), and clinical symptom score (P 0.05) in traditional Chinese medicine. There was no significant difference in tear film rupture time (P 0.05). After treatment, there were significant differences in clinical symptom score and corneal staining (P0.01), dry eye questionnaire score and tear secretion (P0.05), but there was no significant difference in tear film rupture time (P0.05). The total effective rate of the experimental group was 91.67%, which was significantly higher than that of the control group (75%). Conclusion Mingmu Siwu decoction combined with acupuncture can effectively relieve the clinical symptoms of dry eye patients with deficiency of liver and blood, and promote the secretion of tear and prolong the time of tear film rupture by adjusting viscera qi and blood body fluid and local stimulation. According to the score of dry eye questionnaire, the total effective rate of the treatment group was significantly higher than that of the control group, which indicated that Mingmu Siwu decoction combined with acupuncture was superior to sodium hyaluronate eye drops in relieving ocular symptoms.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.82

【参考文献】