Shi Jing-lin, Miao Wan-hong
Department of Ophthalmology, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Zhong Xi Yi Jie He Xue Bao. 2012 Sep;10(9):1003-8. doi: 10.3736/jcim20120909.
With the understanding of the immune inflammatory response in the pathogenesis of dry eyes, and the limitations of widely used artificial tears and numerous pharmaceuticals and methods to promote tear secretion, clinicians pay more attention to the therapies that can promote tear secretion actively. Acupuncture treatment for dry eye may meet this requirement.
To observe the clinical efficacy of acupuncture treatment on dry eye and the effects on duration, and to examine the mechanisms of acupuncture in treating patients with dye eyes.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: The study was performed at Department of Ophthalmology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine from August 2010 to May 2011. Patients with the primary diagnosis of dry eye were enrolled. Sixty-five patients were randomly divided into treatment group and control group, and were given 3 weeks of acupuncture treatment or artificial tear therapy respectively.
The enzyme-linked immunosorbent assay was used to detect the lactoferrin content of the tears before and after treatment. In order to evaluate the efficacy of the treatment methods, the Schirmer I test and break-up time were also measured.
Compared with before treatment, the lactoferrin content in the tears of patients in the treatment group increased, break-up time was prolonged and the result of the Schirmer I test showed improvement after 3 weeks of treatment. The indexes mentioned above did not change in the control group after treatment. There were no significant differences in tear lactoferrin and Schirmer I test between one week after treatment and after 3-week treatment in the treatment group, but break-up time was significantly shortened. The result of Schirmer I test in the treatment group was significantly higher than that in the control group one week after treatment.
Acupuncture can increase tear lactoferrin level, extend tear film break-up time and promote tear secretion in patients with dry eye in a time-limited trial. With the end of treatment, the effect decreased.
随着对干眼发病机制中免疫炎症反应的认识,以及广泛使用的人工泪液和众多促进泪液分泌的药物及方法存在的局限性,临床医生更加关注能够积极促进泪液分泌的治疗方法。针刺治疗干眼可能符合这一要求。
观察针刺治疗干眼的临床疗效及其对病程的影响,并探讨针刺治疗干眼的作用机制。
设计、地点、参与者和干预措施:本研究于2010年8月至2011年5月在上海中医药大学附属曙光医院眼科进行。纳入原发性干眼患者。65例患者随机分为治疗组和对照组,分别给予3周的针刺治疗或人工泪液治疗。
采用酶联免疫吸附测定法检测治疗前后泪液中乳铁蛋白含量。为评估治疗方法的疗效,还测量了泪液分泌试验(Schirmer I试验)和泪膜破裂时间。
与治疗前相比,治疗组患者治疗3周后泪液中乳铁蛋白含量增加,泪膜破裂时间延长,泪液分泌试验结果改善。对照组治疗后上述指标无变化。治疗组治疗1周后与治疗3周后的泪液乳铁蛋白及泪液分泌试验结果无显著差异,但泪膜破裂时间显著缩短。治疗组治疗1周后泪液分泌试验结果显著高于对照组。
在一项限时试验中,针刺可提高干眼患者泪液乳铁蛋白水平,延长泪膜破裂时间,促进泪液分泌。随着治疗结束,疗效下降。