针刺对青光眼患者视功能影响的临床观察

Clinical observation on the effect of acupuncture on visual function of patients with glaucoma

关键词:  青光眼  针刺  视力  眼压  视野光敏度  视野平均缺损

Key words:  glaucoma  acupuncture  vision  intraocular pressure  mean sensitivity to light  mean defect

摘要:

[目的]探讨针刺治疗对眼压稳定的青光眼患者视功能影响。[方法]选取青光眼患者68例，采用前瞻性随机对照研究，将68例青光眼性视神经病变者随机治疗组及对照组。对照组继续接受原来的降眼压基础治疗；治疗组在基础治疗外予以针刺治疗，取穴如下：主穴风池、太阳、睛明、合谷，配穴：球后、四白、承泣、童子髎、丝竹空，百会等，每日1次，每周治疗6 d，4周为1个疗程，连续治疗3个疗程（12周），观察患眼视力、眼压、视野、视觉诱发电位的变化。[结果]1）治疗后，治疗组视力均数较治疗前提高（P<0.05）；2）两组患者治疗前后眼压未见明显改变及差异（P<0.05）；3）治疗后，与治疗前比较，治疗组视野平均敏感度（MS）值提高（P<0.05），视野平均缺损值（MD）降低（P<0.05）；4）治疗12周后两组的P100波峰均提高，潜伏期时间缩短。[结论]针刺治疗青光眼虽不能明显提高患者视力、降低眼压，但可以改善视野光敏度、降低平均缺损值，值得临床作为青光眼的辅助治疗以保护视神经、改善视功能。

Abstract:

[Objective] To explore the effect of acupuncture on the visual function of glaucoma patients with stable intraocular pressure.[Methods] The 68 patients with glaucoma were selected,and randomly divided into two groups:control group and acupuncture group. The control group continued to receive the original treatment for reducing intraocular pressure. The acupuncture group was also given acupuncture treatment on the premise of basic treatment. And the basic point prescription is as follows:the main point,Taiyang (EX-HN5),Fengchi (GB20), Jingming(BL1),Hegu(LI4);with acupuncture point:Qiuhou(EX-HN7),Sibai(ST2),Chengqi(ST1),Tongziliao(TE23),Sizhukong (SJ23),Baihui(DU20),once per day,to treat for 6 days a week,with one month as the course of treatment,Treatment was continued for about 3 months (12 weeks),then to observe the patients' visual acuity,intraocular pressure,vision field and the changes of visual evoked potential.[Results] 1) The visual acuity was improved after acupuncture treatment,and the difference was significant (P<0.05). 2) In intraocular pressure,there was no significant improvement before and after treatment (P>0.05). 3) After treatment of acupuncture group vision mean sensitivity (MS) value increase,the mean visual defect value (MD) reduce (P<0.05),the differences were significant compared with before treatment. 4) After 12 weeks of treatment,the P100 wave peak of the two groups was increased,and the diving time was shortened.[Conclusion] Acupuncture therapy in patients with glaucoma cannot improve eyesight or reduce intraocular ressure,but it can improve the average photosensitivity of the vision field,reduce the average defect value,Is worthy of clinical application as an adjuvant treatment of glaucoma to protect the optic nerve and improve the visual function.