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针刺治疗青光眼的前瞻性评估

Prospective Evaluation of Acupuncture as Treatment for Glaucoma.

作者信息

Law Simon K, Lowe Starrie, Law Samuel M, Giaconi JoAnn A, Coleman Anne L, Caprioli Joseph

机构信息

Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.

Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.

出版信息

Am J Ophthalmol. 2015 Aug;160(2):256-65. doi: 10.1016/j.ajo.2015.04.033. Epub 2015 Apr 30.

Abstract

PURPOSE

To evaluate acupuncture as treatment for glaucoma.

DESIGN

Prospective double-masked randomized crossover study.

METHODS

setting: Clinical practice.

POPULATION

One eye per patient with primary open-angle glaucoma and stable intraocular pressure (IOP).

INTERVENTION

Patients were randomized to receive 1 acupuncture series (12 sessions with either eye-related [eye-points] or non-eye-related [non-eye-points] acupoints) and then crossed over to receive the other series.

OUTCOME MEASURES

IOP, blood pressure (BP), heart rate (HR), best-corrected visual acuity (BCVA), visual field (VF), optic disc and peripapillary retinal nerve fiber layer (RNFL) measurements, compliance, and adverse reactions. Probability to detect 3 mm Hg IOP difference between series was 90%.

RESULTS

Twenty-two patients volunteered and 11 (50.0%) completed the study; 8 (36.4%) did not complete treatment owing to changes of health, moving away, lack of transportation, or family crisis; and 3(13.6%) were withdrawn owing to needle sensitivity or IOP elevation (8 mm Hg) in the contralateral eye. After an acupuncture session, mean IOP increased slightly with both eye-points (from 12.9 ± 1.8 mm Hg to 13.6 ± 2.0 mm Hg, P = .019) and non-eye-points (from 13.0 ± 1.5 mm Hg to 13.5 ± 1.7 mm Hg, P = .073) series. HR, diurnal IOP, and BCVA showed no statistically significant changes after 12 sessions of either series. Systolic and diastolic BP were reduced after 12 sessions of non-eye-points series (P = .040, P = .002, respectively). Optic disc, RNFL, and VF showed no statistically significant changes.

CONCLUSIONS

Acupuncture has no overall effect on diurnal IOP or BCVA but may temporally increase the IOP immediately after a treatment session. BP is lowered by acupuncture with non-eye-points, but not with eye-points. Compliance and adverse event rates were low.

摘要

目的

评估针灸治疗青光眼的效果。

设计

前瞻性双盲随机交叉研究。

方法

设置:临床实践。

研究对象

每位原发性开角型青光眼患者且眼压稳定者的一只眼睛。

干预措施

患者被随机分为接受1个针灸疗程(12次,使用与眼睛相关的[眼穴]或与眼睛无关的[非眼穴]穴位),然后交叉接受另一个疗程。

观察指标

眼压(IOP)、血压(BP)、心率(HR)、最佳矫正视力(BCVA)、视野(VF)、视盘和视乳头周围视网膜神经纤维层(RNFL)测量、依从性和不良反应。检测两个疗程之间眼压相差3 mmHg的概率为90%。

结果

22名患者自愿参与,11名(50.0%)完成研究;8名(36.4%)因健康状况改变、搬家、交通不便或家庭危机而未完成治疗;3名(13.6%)因针刺敏感或对侧眼压升高(8 mmHg)而退出。一次针灸治疗后,使用眼穴(从12.9±1.8 mmHg升至13.6±2.0 mmHg,P = 0.019)和非眼穴(从13.0±1.5 mmHg升至13.5±1.7 mmHg,P = 0.073)疗程时,平均眼压均略有升高。两个疗程各进行12次后,心率、昼夜眼压和最佳矫正视力均无统计学显著变化。非眼穴疗程进行12次后,收缩压和舒张压降低(分别为P = 0.040,P = 0.002)。视盘、视网膜神经纤维层和视野无统计学显著变化。

结论

针灸对昼夜眼压或最佳矫正视力无总体影响,但可能在治疗后立即暂时升高眼压。非眼穴针灸可降低血压,眼穴则不能。依从性和不良事件发生率较低。

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