头体针联合玻璃酸钠眼液治疗中重度干眼症的临床研究

Clinical study of head and body acupuncture combined with sodium hyaluronate eye solution in the treatment of moderate and severe dry eye

摘要:

目的 探讨头体针联合玻璃酸钠眼液治疗中重度干眼症的效果。方法 前瞻性选取2021年11月—2023年3月甘肃省人民医院收治的62例中重度干眼症患者，随机数表法分为研究组、对照组，各31例。对照组给予玻璃酸钠眼液治疗，研究组在对照组基础上给予头体针治疗，两组治疗4周观察效果。比较两组中医证候评分、眼部症状评分、泪膜稳定性相关指标、临床疗效、睑板腺分泌能力、泪液中细胞因子及不良反应情况。结果 研究组治疗前后主症、次症中医证候评分的差值均高于对照组（P <0.05）。研究组治疗前后眼表疾病指数、眼表荧光染色评分的差值均高于对照组（P <0.05）。研究组治疗前后泪眼分泌实验、泪河高度、非侵入性泪膜破裂时间、脂质层厚度的差值均高于对照组（P <0.05）。研究组总有效率高于对照组（P <0.05）。研究组睑板腺分泌能力高于对照组（P <0.05）。研究组治疗前后溶菌酶、表皮生长因子、乳铁蛋白的差值均高于对照组（P <0.05）。两组治疗期间无明显不良反应。结论 头体针联合玻璃酸钠眼液治疗中重度干眼症疗效显著，可明显改善患者眼部症状及泪膜稳定性相关指标，增强睑板腺分泌能力，促进溶菌酶、表皮生长因子、乳铁蛋白分泌，安全可靠。

关键词:干眼症;头体针;玻璃酸钠眼液;中医;疗效

Abstract:

Objective To investigate the effect of head and body acupuncture combined with sodium hyaluronate eye solution on moderate and severe dry eye.Methods Sixty-two patients with moderate and severe dry eye treated from November 2021 to March 2023 were prospectively selected and randomly divided into study group and control group, with 31 cases in each group. The control group was treated with sodium hyaluronate eye solution, and the study group was treated with head and body acupuncture on the basis of the control group. TCM syndrome score, ocular symptom score, relevant indexes of tear film stability, clinical efficacy, meibomian gland secretion capacity, tear cytokines and adverse reactions were compared between the two groups.Results The difference of TCM syndrome scores of primary and secondary symptoms in the study group before and after treatment was higher than that in the control group (P < 0.05). The difference of ocular surface disease index and ocular surface fluorescence score before and after treatment in the study group were higher than those in the control group (P < 0.05). The differences of lacrimal secretion test, lacrimal river height, non-invasive tear film rupture time and lipid layer thickness before and after treatment in the study group were higher than those in the control group (P < 0.05). The total effective rate of the study group was higher than that of the control group (P < 0.05). The secretion capacity of meibomian gland in the study group was higher than that in the control group (P < 0.05). The differences of lysozyme, epidermal growth factor and lactoferrin in the study group before and after treatment were higher than those in the control group (P < 0.05). There were no obvious adverse reactions in the two groups during treatment.Conclusion Head and body acupuncture combined with sodium hyaluronate eye solution is effective in the treatment of moderate and severe dry eye, which can significantly improve ocular symptoms and related indexes of tear film stability, enhance the secretion capacity of meibomian gland, and promote the secretion of lysozyme, epidermal growth factor and lactoferrin, which is safe and reliable.

Key words:dry eyes;head body acupuncture;sodium hyaluronate eye solution;traditional Chinese medicine;curative effect