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1.甘肃中医药大学附属医院眼科,兰州730000
2.南京中医药大学第一临床学院,江苏南京210023
3.南京中医药大学附属医院眼科
4.甘肃兰州普瑞眼科医院
5.南京中医药大学附属医院针灸康复科
颉瑞萍,主任医师。E-mail:13919914952@163.com
收稿:2023-04-07,
网络首发:2023-09-19,
纸质出版:2023-11-12
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刘雪,高卫萍,赵楠等.针刺治疗水液缺乏型干眼:随机对照试验[J].中国针灸,2023,43(11):1235-1238.
LIU Xue,GAO Wei-ping,ZHAO Nan,et al.Acupuncture for aqueous deficiency dry eye: a randomized controlled trial[J].Chinese Acupuncture & Moxibustion,2023,43(11):1235-1238.
刘雪,高卫萍,赵楠等.针刺治疗水液缺乏型干眼:随机对照试验[J].中国针灸,2023,43(11):1235-1238. DOI: 10.13703/j.0255-2930.20230407-k0006.
LIU Xue,GAO Wei-ping,ZHAO Nan,et al.Acupuncture for aqueous deficiency dry eye: a randomized controlled trial[J].Chinese Acupuncture & Moxibustion,2023,43(11):1235-1238. DOI: 10.13703/j.0255-2930.20230407-k0006.
目的
2
比较针刺和玻璃酸钠滴眼液治疗水液缺乏型干眼的临床疗效及安全性。
方法
2
将60例(120只眼)水液缺乏型干眼患者随机分为观察组(30例,脱落1例)和对照组(30例,脱落1例)。对照组予玻璃酸钠滴眼液滴眼,一次1滴,一天4次,连续14 d;观察组予针刺治疗,穴取双侧上睛明、攒竹、丝竹空、太阳、瞳子髎,一天1次,每6 d休息1 d,连续14 d。比较两组患者治疗前后泪河高度(TMH)、基础泪液分泌试验(SⅠT)、眼表疾病指数量表(OSDI)评分、非接触式泪膜破裂时间(NIBUT)、角膜荧光素钠染色(FLS)评分,并观察两组治疗的安全性。
结果
2
与治疗前比较,两组患者治疗后TMH、SⅠT和NIBUT均增高(
P
<
0.01,
P
<
0.05),FLS评分降低(
P
<
0.01);观察组患者治疗后OSDI评分降低(
P
<
0.01)。治疗后观察组TMH、SⅠT高于对照组(
P
<
0.01),OSDI评分低于对照组(
P
<
0.01)。两组均未出现不良反应及不良事件。
结论
2
针刺和玻璃酸钠滴眼液均能有效治疗水液缺乏型干眼,在增加TMH、促进基础泪液分泌及减轻患者主观症状方面,针刺治疗有明显优势;针刺治疗干眼操作安全。
Objective
2
To compare the clinical efficacy and safety of acupuncture and sodium hyaluronate eye drop in the treatment of aqueous deficiency dry eye.
Methods
2
A total of 60 patients (120 eyes) with aqueous deficiency dry eye were randomly divided into an observation group (30 cases
1 case dropped out) and a control group (30 cases
1 case dropped out). In the control group
sodium hyaluronate eye drop were used
one drop at a time
4 times a day
for 14 consecutive days. In the observation group
acupuncture was applied at bilateral Shangjingming (Extra)
Cuanzhu (BL 2)
Sizhukong (TE 23)
Taiyang (EX-HN 5)
and Tongziliao (GB 1)
once a day
treatment for 6 days with the interval of 1 day was required
for 14 consecutive days. The tear meniscus height (TMH)
Schirmer Ⅰ test (SⅠT)
ocular surface disease index (OSDI) score
non-invasive tear break-up time (NIBUT)
and corneal fluorescein sodium staining (FLS) score were compared between the two groups before and after treatment
and the safety of the treatment of the two groups was observed.
Results
2
Compared with those before treatment
after treatment
TMH
SⅠT and NIBUT were increased (
P
<
0.01
P
<
0.05)
and FLS scores were decreased (
P
<
0.01) in the two groups; the score of OSDI was reduced (
P
<
0.01) in the observation group. After treatment
in the observation group
TMH and SⅠT were higher than those in the control group (
P
<
0.01)
and the score of OSDI was lower than that in the control group (
P
<
0.01). No adverse reactions and adverse events were observed in the two groups.
Conclusion
2
Acupuncture and sodium hyaluronate eye drop can both effectively treat aqueous deficiency dry eye
acupuncture has obvious advantages in improving TMH and basic tear secretion
and reducing the subjective symptoms of patients. Acupuncture for dry eye is safe.
Tsubota K , Yokoi N , Watanabe H , et al . A new perspective on dry eye classification: proposal by the Asia dry eye society [J ] . Eye Contact Lens , 2020 , 46 Suppl( 1 ): S2 - S13 .
魏静玲 . 玻璃酸钠与重组人表皮生长因子滴眼液治疗干眼症患者的临床疗效观察 [J ] . 山西医药杂志 , 2022 , 51 ( 5 ): 556 - 557 .
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中华医学会眼科学分会角膜病学组 . 干眼临床诊疗专家共识(2013年) [J ] . 中华眼科杂志 , 2013 , 49 ( 1 ): 73 - 75 .
邵毅 , 陈鲁嘉 , 邹洁 . 干眼的诊断评估与治疗规范: 2021年专家共识解读 [J ] . 眼科新进展 , 2022 , 42 ( 10 ): 757 - 762 .
林忠嗣 , 于冬松 , 赵金龙 , 等 . 针刺治疗干眼及对泪液炎性因子的影响 [J ] . 中国针灸 , 2022 , 42 ( 12 ): 1379 - 1383 .
Tong L , Zhou L , Koh SK , et al . Changes in tear proteome after acupuncture treatment in dry eye [J ] . Clin Ophthalmol , 2021 , 15 : 4585 - 4590 .
郑晓骏 , 高卫萍 . 针刺治疗干眼的研究进展 [J ] . 中国中医眼科杂志 , 2022 , 32 ( 5 ): 389 - 391 .
姬慧杰 , 孙心怡 , 高卫萍 . 针刺治疗干眼的取穴规律与辨证论治的研究进展 [J ] . 中国中医眼科杂志 , 2022 , 32 ( 12 ): 978 - 981 .
徐雯 , 刘雪 , 高卫萍 . 针药结合对兔干眼模型角膜及泪腺形态学的影响 [J ] . 南京中医药大学学报 , 2015 , 31 ( 6 ): 541 - 545 .
Zhang X , Zhang B , Peng SY , et al . Effectiveness of acupuncture at acupoint BL1 (Jingming) in comparison with artificial tears for moderate to severe dry eye disease: a randomized controlled trial [J ] . Trials , 2022 , 23 ( 1 ): 605 .
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