针刺配耳穴贴压治疗中老年中重度干眼疗效及视觉生存质量的分析

摘要

ObjectiveTo evaluate the effects of acupuncture add ear acupoint chirismus and vision related quality of life in moderate or severe dry eye of the elderly.Methods100 cases of moderate or severe dry eye of the elderly were collected and divided into 2 groups randomly by computer,which were treated by artificial tears therapy(control group)or acupuncture(the main point of the Taixi,Taichong,Sanyinjiao, Zusanli,Jingming,Chengqi,Zanzhu,Sizhukong penetrating Yuyao),add ear acupoint chirismus(ear acupoint select liver,kidney,spleen, eye,endocrine,Mu1,Mu2)&artificial tears therapy(treatment group)respectively.The tear break-up time(BUT),lacrimal secration volume test(Schirmer I),corneal fluorescein staining(FL),the symptomg score and OSDI scores of patients were detected and marked before treatment, 2 weeks after treatment,and 2 weeks after treatment discontinued.ResultsThe BUT,Schirmer I,FL,subjective symptoms score and OSDI score in the two groups were better after 2 weeks treatment than that before treatment(P<0.05).The BUT and SchirmerI score in the test group were better than the control group after 14 days of treatment(P<0.05).While,the BUT,Schirmer I,subjective symptoms score and OSDI score in the test group were better than the control group after 14 days of treatment discontinued(P<0.05).ConclusionsTear replacement therapy and acupuncture add ear acupoint chirismus therapy both could improve symptoms and signs in moderate or severe dry eye of the elderly. Furthermore,improvement of lacrimal secration volume and vision related quality of life could be found in patients when acupuncture add ear acupoint chirismus therapy added to tear replacement therapy.The effects of therapy is more duration. This research suggested that acupuncture add ear acupoint chirismus therapy was an effective method for dry eye treatment in moderate or severe dry eye of the elderly.%目的：评价针刺配耳穴贴压治疗中老年中重度干眼患者的疗效及其对视觉相关生存质量的影响。方法收集门诊就诊的中老年中重度干眼患者100例，采用计算机随机法分为两组，分别给予人工泪液治疗（对照组）或针刺（主穴为太溪、太冲、三阴交、足三里、睛明、承泣、攒竹、丝竹空透鱼腰）配耳穴贴压（耳穴选肝、肾、脾、眼、内分泌，目1目2）+人工泪液治疗（观察组）治疗2周，治疗前后及停止治疗2周后分别观察患者的泪膜破裂时间（BUT）、基础泪液分泌量（SchirmerI）、角膜荧光素染色（FL），并对患者的主观症状及眼表疾病指数（OSDI）进行分析。结果两组治疗2周后BUT、SchirmerI、FL、主观症状评分、OSDI评分等均优于治疗前（P<0.05）。观察组在BUT、SchirmerI方面，疗效优于对照组（P<0.05）。治疗停止2周后，观察组在BUT、SchirmerI、主观症状评分、OSDI评分等方面，疗效优于对照组（P<0.05）。结论针刺配耳穴贴压和泪液替代治疗可改善中老年中重度干眼患者的症状和体征。与单纯泪液替代治疗比较，增加针刺配耳穴贴压治疗可进一步改善患者泪液分泌及视觉相关生存质量，治疗效果更加持久和稳定。提示针刺配耳穴贴压配合泪液替代治疗是治疗中老年中重度干眼的有效方法。