【摘 要】
：
目的：通过应用针刀联合中药治疗中重度干眼症,观察泪液分泌变化、眼表细胞改变,以及患者症状的改善,客观评价针刀联合中药治疗干眼症的疗效,为干眼症的治疗开辟新的有效治疗方法.方法：符合中重度干眼症诊断标准的患者20例(40只眼),进行裂隙灯结膜、角膜、睑板腺检查,以及SchirmerⅠ试验、荧光素染色检测、BUT检测.采取眼周局部穴位(攒竹、鱼腰、丝竹空、太阳、四白、睛明、内精明)针刀治疗,以及周身针
【出 处】
：
2017世界中医药学会联合会针刀年会
论文部分内容阅读
目的：通过应用针刀联合中药治疗中重度干眼症,观察泪液分泌变化、眼表细胞改变,以及患者症状的改善,客观评价针刀联合中药治疗干眼症的疗效,为干眼症的治疗开辟新的有效治疗方法.
方法：符合中重度干眼症诊断标准的患者20例(40只眼),进行裂隙灯结膜、角膜、睑板腺检查,以及SchirmerⅠ试验、荧光素染色检测、BUT检测.采取眼周局部穴位(攒竹、鱼腰、丝竹空、太阳、四白、睛明、内精明)针刀治疗,以及周身针刀穴位(左内关、右鱼际、左太溪、右太冲、曲池、合谷)调理,辅以枕寰枢复合体紊乱针刀松解.5～7天治疗一次,每次治疗前进行裂隙灯检查、SchirmerⅠ试验、荧光素染色检测,BUT检测,治疗5次.3次治疗后根据辩证论治给予中药巩固治(黄连羊肝丸、明目地黄丸、六味地黄丸或杞菊地黄丸、桑白皮汤、百合固金汤等).
结果：(1)SchirmerⅠ试验：治疗前0～2mm,治疗第1次后5～10mm,第2次后5～12mm,第3次≥7～15mm,第4次后＞7～20mm,第5次后7～19mm.随访半年均＞10mm.(2)角膜荧光素染色结果：治疗前角膜上皮着色,重度呈片状着色,评分6-10分.随着治疗好转,染色点逐渐减少,第1次治疗后3-6分,第2次后1-6分,第3次后0-4分,第4次后0-4分,第5次后0-2分.(3)角膜血管化及结膜充血逐渐减轻.(4)泪膜破裂时(BUT)结果：治疗前0-2s;治疗后BUT延长,第1次治疗后2-6s,第2次后4-6s,第3次后4-8s,第4次后5-10s,第5次后6-12min.(5)患者自觉症状(畏光、晨起睁眼困难、视物模糊、干涩睁不开眼、眼痛等)明显好转,甚至随着病情的好转眼神从异常变为正常.治疗5次后,治愈21眼,好转17眼,未愈2眼,有效率95％.与治疗前相比,差异具有统计学意义.
结论：针刀联合中药治疗中、重度干眼症,运用针刀学的闭合性手术理论、慢性软组织损伤病理学新理论以及经络实质理论等三大理论,采取局部穴位疏通、全身调理、神经网络调控等方式,使泪腺、副泪腺恢复分泌功能,泪液分泌增加,改善了泪液质和量,恢复眼表的内环境,修复受损的结膜、角膜上皮细胞,是治疗干眼症的有效方法.
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