本文選題：干眼 + 針刺��； 參考：《山西中醫(yī)學(xué)院》2016年碩士論文

【摘要】：目的干眼為最常見的眼表疾病,流行病學(xué)調(diào)查及臨床檢查發(fā)現(xiàn)干眼的發(fā)病率驟增,并逐漸趨于年輕化。本實(shí)驗(yàn)擬以觀察明目四物湯配合針刺對肝血不足型干眼的臨床療效,尋找中醫(yī)治療干眼的有效方法。方法本臨床研究病例來源于2014年6月1日至2015年12月30日,在大同市礦區(qū)中醫(yī)院眼科門診納入符合標(biāo)準(zhǔn)的患者,共48例(96眼),剔除4例,脫落3例。通過隨機(jī)數(shù)字表法隨機(jī)分為實(shí)驗(yàn)組和對照組。實(shí)驗(yàn)組給予明目四物湯結(jié)合針刺干預(yù),1次/日,6次/周,治療4周。對照組采用玻璃酸鈉滴眼液干預(yù),4次/日,1滴/次,治療4周。觀察并記錄兩組患者治療前后的干眼問卷評分、中醫(yī)臨床癥狀評分、淚液分泌量(SIT)、淚膜破裂時(shí)間(BUT)及角膜上皮熒光染色(FL),并對兩組治療后組間比較,選取適當(dāng)?shù)臋z驗(yàn)方法對觀察結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果治療前兩組患者的性別、年齡及病程的統(tǒng)計(jì)學(xué)結(jié)果(P0.05)均無統(tǒng)計(jì)學(xué)意義,兩組患者治療前組間比較統(tǒng)計(jì)學(xué)結(jié)果(P0.05)無差異。實(shí)驗(yàn)組與對照組比較具有均衡性和可比性。實(shí)驗(yàn)組治療前后比較:經(jīng)統(tǒng)計(jì)學(xué)檢查在干眼問卷評分、中醫(yī)臨床癥狀評分、淚液分泌量及角膜熒光染色上(P0.01)有顯著差異,在淚膜破裂時(shí)間上(P0.05)無差異。對照組治療前后比較:經(jīng)統(tǒng)計(jì)學(xué)檢查在干眼問卷評分、淚液分泌量及角膜染色上有顯著差異(P0.01),中醫(yī)臨床癥狀評分(P0.05)有統(tǒng)計(jì)學(xué)意義,淚膜破裂時(shí)間(P0.05),差異無統(tǒng)計(jì)學(xué)意義。治療后組間相比:中醫(yī)臨床癥狀評分和角膜染色(P0.01)有明顯差異,干眼問卷評分及淚液分泌量(P0.05)差異有統(tǒng)計(jì)學(xué)意義,淚膜破裂時(shí)間(P0.05)差異無統(tǒng)計(jì)學(xué)意義。實(shí)驗(yàn)組總有效率91.67%明顯高于對照組總有效率75%,差異有統(tǒng)計(jì)學(xué)意義。結(jié)論明目四物湯配合針刺能夠有效緩解肝血不足型干眼患者的臨床癥狀,通過調(diào)整臟腑氣血津液及局部刺激達(dá)到促進(jìn)淚液分泌和延長淚膜破裂時(shí)間的目的。從干眼問卷評分看,治療組總有效率明顯高于對照組總有效率,說明在緩解眼部癥狀上,明目四物湯配合針刺療效優(yōu)于玻璃酸鈉滴眼液。
[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.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.82

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