摘要
目的:比较异病同治针刺综合治疗法与西药雷珠单抗球内注射法治疗黄斑水肿的临床疗效,探寻治疗黄斑水肿的有效疗法。方法:采用回顾性研究法,针刺组(20例,24只患眼)予(1)针刺合电针:穴取新明1、丝竹空、瞳子髎等,隔日1次;(2)穴位注射:穴取患眼球后、太阳,予复方樟柳碱注射液、甲钴胺注射液交替注射,隔日1次;(3)耳穴贴压眼、肝、肾等穴;(4)梅花针叩刺正光1、正光2,隔日1次。雷珠单抗组(22例,23只患眼)采用雷珠单抗0.5 mg球内注射治疗。观察治疗前,治疗3、6、9、12个月后黄斑中心凹厚度、糖尿病视网膜病变早期治疗研究(ETDRS)视力表检测最佳矫正视力、视功能损害眼病患者生存质量量表患者自评得分,并进行临床疗效评定。结果:(1)黄斑中心凹厚度:两组各观察时间点较治疗前均有下降(均P<0.05),针刺组与雷珠单抗组组间比较差异均无统计学意义(均P>0.05)。(2)视力:两组各观察时间点较治疗前均有提高(均P<0.05),两组组间比较在治疗3个月后视力差异无统计学意义(P>0.05),治疗6、9、12个月后针刺组视力优于雷珠单抗组(P<0.05,P<0.01)。(3)针刺组治疗后各时点生存质量较治疗前提高(均P<0.05),雷珠单抗组治疗后与治疗前比较差异无统计学意义(均P>0.05);在治疗3、6、9、12个月后生存质量评分针刺组优于雷珠单抗组(P<0.05,P<0.01)。(4)针刺组总有效率为79.2%(19/24),优于雷珠单抗组的30.4%(7/23,P<0.05)。(5)治疗前后视力的提高程度与病程呈负相关(P<0.05),即患眼病程越长,视力越差,疗效越差。结论:针刺综合治疗方案能有效治疗黄斑水肿,明显提高患者视力,改善患者主观感受和提高生活质量,并且病程越短疗效越显著,针刺综合治疗法优于球内注射雷珠单抗。
Objective To compare the clinical efficacy of treating different diseases with the same acupuncture comprehensive therapy and intramuscular injection of ranibizumab in the treatment of macular edema, and to explore an effective treatment. Methods A retrospective study was conducted, ①Acupuncture combined with EA at Xinming one （Extra）, Sizhukong （TE 23）, Tongziliao （GB 1）, once every, other day; ②acupoint injection, alternation with compound anisodine and mecobalamine injection at Qiuhou （EX-HN 7）, Taiyang （EX-HN 5）, once every other day; ③auricular acupressure at yan （LO5）, gan （CO12）, shen （CO10） and other points; （plum-blossom needle at Zhengguang 1 （Extra）, Zhengguang 2 （Extra）, once every other day were given in the acupuncture group （20 cases, 24 affected eyes）. Intramuscular injection of 0.5 mg ranibizumab was given in the ranibizumab group （22 cases, 23 affected eyes）. The macular foveal thickness, early treatment diabetic retinopathy study of （ETDRS） visual acuity chart, self-evaluation scores of visual function impairment ophthalmopathy patient＇s quality of life scale were observed before treatment, after 3, 6, 9 and 12 months of treatment, and the clinical efficacy was evaluated. Results ①At all the observation time points of the treatment, the macular thickness was lower than that before treatment in the two groups （all P〈 0.05）, and there was no significant difference between the acupuncture group and the ranibizumab group （all P〉 0.05）. ②Visual acuity was higher than that before treatment at all the time points in the two groups （all P〈 0.05）. After 3-months treatment, there was no statistical significance between the two groups （P〉 0.05）. After 6, 9, and 12 months treatment, the visual acuity in the acupuncture group was better than that in the ranibizumab group （P〈 0.05, P〈 0.01）. ③At all the time points, the quality of life scores were lower than those before treatment in the two groups （all P〈
作者
杨伟杰
刘文婷
崔若林
刘坚
干德康
徐红
YANG Weijie;LIU Wenting;CUI Ruolin;LIU Jian;GAN Dekang;XU Hong(l Ruijin Hospital of Jiaotong University,Shanghai 200025,Chin;Shanghai University of TCM;Branch of Shanghai First People＇s Hospital;Eye and ENT Hospital of Fudan University;Longhua Hospital,Shanghai University of TCM,Shanghai 200032)
出处
《中国针灸》
CAS
CSCD
北大核心
2018年第8期841-846,共6页
Chinese Acupuncture & Moxibustion
基金
上海市科委研究项目:16401932500
关键词
黄斑水肿
针刺
穴位注射
梅花针
视力
黄斑中心凹厚度
雷珠单抗
张仁
macular edema
acupuncture
acupoint injection
plum-blossom needle
vision
macular foveal thickness
ranibizumab
ZHANG Ren
