本文選題：青光眼 + 視神經(jīng)萎縮　； 參考：《中國中醫(yī)科學(xué)院》2017年碩士論文

【摘要】：目的:1采用針刺療法治療青光眼性視神經(jīng)萎縮,聯(lián)合現(xiàn)代醫(yī)學(xué)檢測手段,客觀評價(jià)針刺的臨床療效;2初步闡釋青光眼性視神經(jīng)萎縮的中醫(yī)證型分布特點(diǎn),為臨床提供新的治療思路和方法。方法:將2016年1月1日至2016年12月31日期間中國中醫(yī)科學(xué)院西苑醫(yī)院眼科門診收治的符合入組診斷標(biāo)準(zhǔn)的青光眼性視神經(jīng)萎縮患者16人30只眼,采用自身對照優(yōu)效性試驗(yàn),隨機(jī)先后進(jìn)行方案A(青光眼基礎(chǔ)治療)和方案B(青光眼基礎(chǔ)治療配合針刺治療)治療。方案A予降眼壓眼藥水如拉坦前列腺素滴眼液、卡替洛爾滴眼液,注射鼠神經(jīng)生長因子抗青光眼治療。方案B予基礎(chǔ)治療聯(lián)合針刺治療:選穴:主穴:百會、上睛明、球后、攢竹、風(fēng)池、光明、足三里。配穴:肝氣郁結(jié)證:太沖、合谷、肝俞;氣血瘀滯證:內(nèi)關(guān)、血海、膈俞;肝腎陰虛證:肝俞、腎俞、太溪、三陰交;氣血兩虛證:脾俞、三陰交、血海、養(yǎng)老。每一個(gè)受試對象先后接受對照(方案A)和試驗(yàn)(方案B)兩種不同方案進(jìn)行治療。對照組方案A療程1個(gè)月,洗脫期為1個(gè)月,試驗(yàn)組方案B療程為針刺30次,進(jìn)行自身對照研究。兩組觀察指標(biāo)為:視力、眼壓、視野平均光敏度(MS)和平均缺損(MD)、中醫(yī)癥候積分。根據(jù)以上各項(xiàng)指標(biāo)變化分析針刺治療青光眼性視神經(jīng)萎縮的臨床療效和中醫(yī)證型分布特點(diǎn)。結(jié)果:1、30次針刺治療結(jié)束后,患者視力、視野平均光敏度(MS)、視野平均缺損度(MD)均有改善,治療前后比較有統(tǒng)計(jì)學(xué)意義(p0.05)。2、青光眼性視神經(jīng)萎縮中醫(yī)證型分布以肝腎陰虛為主,占53%,肝氣郁結(jié)證次之,占36%。3、針刺治療能有效降低中醫(yī)癥候積分,治療前后比較有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論:針刺療法可不同程度提高青光眼性視神經(jīng)萎縮患者視力,改善部分患者視野,明顯降低中醫(yī)癥候積分,改善患者全身癥狀;針刺治療是青光眼性視神經(jīng)萎縮治療的有效輔助治療手段,可在臨床推廣。
[Abstract]:Objective to evaluate the clinical efficacy of acupuncture in the treatment of glaucoma optic atrophy by using acupuncture therapy and modern medical examination methods. [WT5HZ] to preliminarily explain the distribution of TCM syndromes of glaucoma optic atrophy.To provide new ideas and methods for clinical treatment.Methods: from January 1, 2016 to December 31, 2016, 30 eyes of 16 patients with glaucoma optic nerve atrophy, who were admitted to Xiyuan Hospital, Xiyuan Hospital, Chinese Academy of traditional Chinese Medicine, were selected and treated.Regimen A (basic glaucoma therapy) and scheme B (glaucoma basic therapy combined with acupuncture therapy) were given randomly.Scheme A was given intraocular pressure lowering eye drops, such as lattan prostaglandin eye drops and katilol eye drops, and injection of nerve growth factor (NGF) to treat glaucoma.Scheme B basic treatment combined with acupuncture treatment: selection: main point: Baihui, Qianming, behind the ball, Zanzhu, Fengchi, Guangming, Zusanli.Points: liver qi stagnation syndrome: Taichong, Hegu, Ganshu; Qi and blood stasis syndrome: Neiguan, blood sea, Geshu; liver and kidney yin deficiency syndrome: Ganshu, Shenshu, Taixi, Sanyinjiao; Qi and blood deficiency syndrome: spleen Yu, Sanyinjiao, blood sea, endowment.Each of the subjects was treated with two different regimens: control (Scheme A) and trial (Scheme B).Control group A treatment course 1 month, elution period 1 month, experimental group B course of treatment was acupuncture 30 times, self-control study.The two groups were visual acuity, intraocular pressure, visual field mean Guang Min and MSM) and average defect.According to the above indexes, the clinical effect of acupuncture on glaucoma optic atrophy and the distribution of TCM syndromes were analyzed.Results after 30 times of acupuncture treatment, the visual acuity, the average degree of vision of Guang Min and the average degree of visual field defect (MDM) were all improved. There was significant difference between before and after treatment (P 0.05). The distribution of traditional Chinese medicine syndrome of glaucoma optic atrophy was mainly liver and kidney yin deficiency.Acupuncture treatment can effectively reduce the integral of TCM symptoms, before and after treatment, there is statistical significance between before and after treatment.Conclusion: acupuncture therapy can improve the visual acuity of patients with glaucoma optic atrophy, improve the visual field of some patients, reduce the integral of TCM symptoms, and improve the patients' systemic symptoms.Acupuncture is an effective adjuvant treatment for glaucoma optic atrophy and can be popularized in clinic.
【學(xué)位授予單位】：中國中醫(yī)科學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.82

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