Yang Weijie, Liu Wenting, Cui Ruolin, Liu Jian, Gan Dekang, Xu Hong
Ruijin Hospital of Jiaotong University, Shanghai 200025, China.
Shanghai University of TCM.
Zhongguo Zhen Jiu. 2018 Aug 12;38(8):841-6. doi: 10.13703/j.0255-2930.2018.08.012.
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.
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 (LO), gan (CO), shen (CO) and other points; ④plum-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.
①At all the observation time points of the treatment, the macular thickness was lower than that before treatment in the two groups (all <0.05), and there was no significant difference between the acupuncture group and the ranibizumab group (all >0.05). ②Visual acuity was higher than that before treatment at all the time points in the two groups (all <0.05). After 3-months treatment, there was no statistical significance between the two groups (>0.05). After 6, 9, and 12 months treatment, the visual acuity in the acupuncture group was better than that in the ranibizumab group (<0.05, <0.01). ③At all the time points, the quality of life scores were lower than those before treatment in the two groups (all <0.05). There was no statistical significance in the ranibizumab group compared with those before treatment (all >0.05). In 3, 6, 9 and 12 months of treatment, the quality of life scores in the acupuncture group was better than those in the ranibizumab group (<0.05, <0.01). ④The total effective rate of the acupuncture group was 79.2% (19/24), which was better than 30.4% (7/23) in the ranibizumab group (<0.05). ⑤The improvement of visual acuity before and after treatment was negatively correlated with the course of disease (<0.05), ie, the longer the disease course of the eyes, the worse the visual acuity and the worse the effect.
Acupuncture comprehensive treatment can effectively treat macular edema, significantly improve the patient's vision, improve the subjective experience and the quality of life, and the shorter the course of the disease the more significant effect. Acupuncture comprehensive treatment is better than intramuscular injection of ranibizumab.
比较相同针刺综合疗法与玻璃体内注射雷珠单抗治疗不同疾病所致黄斑水肿的临床疗效，探索有效治疗方法。
采用回顾性研究，①针刺联合眼明Ⅰ穴（奇穴）、丝竹空（TE 23）、瞳子髎（GB 1）电针，隔日1次；②穴位注射，球后（EX-HN 7）、太阳（EX-HN 5）交替注射复方樟柳碱与甲钴胺注射液，隔日1次；③耳穴压丸，取眼（LO）、肝（CO）、肾（CO）等穴；④梅花针叩刺正光1穴（奇穴）、正光2穴（奇穴），隔日1次。针刺组20例（24眼）采用上述治疗。雷珠单抗组22例（23眼）给予玻璃体内注射雷珠单抗0.5 mg。观察治疗前、治疗3、6、9及12个月时黄斑中心凹厚度、早期糖尿病视网膜病变研究（ETDRS）视力表视力、视功能损害眼病患者生活质量量表自评得分，并评价临床疗效。
①治疗各观察时间点，两组黄斑厚度均低于治疗前（均P<0.05），针刺组与雷珠单抗组比较差异无统计学意义（均P>0.05）。②两组各时间点视力均高于治疗前（均P<0.05）。治疗3个月时，两组比较差异无统计学意义（P>0.05）。治疗6、9、12个月时，针刺组视力优于雷珠单抗组（P<0.05，P<0.01）。③各时间点，两组生活质量得分均低于治疗前（均P<0.05）。雷珠单抗组与治疗前比较差异无统计学意义（均P>0.05）。治疗3、6、9及12个月时，针刺组生活质量得分优于雷珠单抗组（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治疗前后视力改善情况与病程呈负相关（P<0.05），即眼病病程越长，视力越差，疗效越差。
针刺综合治疗能有效治疗黄斑水肿，显著提高患者视力，改善主观感受及生活质量，病程越短效果越显著，针刺综合治疗效果优于玻璃体内注射雷珠单抗。
