中藥結(jié)合針灸對(duì)動(dòng)眼神經(jīng)麻痹患者的治療效果

李壽慶 張海濤 黃旭東 王繼兵

[摘要] 目的 分析中藥聯(lián)合針灸對(duì)動(dòng)眼神經(jīng)麻痹患者的治療效果及安全性。 方法 以2012年1月～2016年6月在濰坊眼科醫(yī)院接受救治的動(dòng)眼神經(jīng)麻痹患者80例作為研究對(duì)象，按隨機(jī)數(shù)字表法分為兩組，分別行單純針灸治療（對(duì)照組，40例）和中藥聯(lián)合針灸治療（觀察組，40例）。以10 d為1個(gè)療程，兩組患者均治療3個(gè)療程。比較兩組患者的總有效率、不良反應(yīng)發(fā)生率、中醫(yī)癥候積分及生活質(zhì)量評(píng)分。 結(jié)果 治療后觀察組治療總有效率和生活質(zhì)量評(píng)分明顯高于對(duì)照組，中醫(yī)癥候積分明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。兩組不良反應(yīng)發(fā)生率比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P > 0.05）。 結(jié)論 為動(dòng)眼神經(jīng)麻痹患者行針灸聯(lián)合中藥治療，能有效改善患者臨床癥狀，提高生活質(zhì)量，值得推廣。

[關(guān)鍵詞] 動(dòng)眼神經(jīng)麻痹；中藥；針灸；生活質(zhì)量

[中圖分類(lèi)號(hào)] R276.7 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1673-7210（2018）03（a）-0115-05

[Abstract] Objective To analyze the therapeutic effect and safety of traditional Chinese medicine combined with acupuncture on patients with oculomotor nerve palsy. Methods From January 2012 to June 2016， 80 patients with oculomotor nerve palsy treated in Weifang Eye hospital were divided into two groups by random number table， with 40 cases in each group. The control group was treated by administered acupuncture treatment， and the observation group was treated by traditional Chinese medicine combined with acupuncture treatment. With 10 days as a course of treatment， both groups were treated with 3 courses of treatment. The total effective rate， the incidence of adverse reactions as well as scores of TCM syndrome integral and quality of life were compared. Results After treatment， the total effective rate and quality of life score in the observation group were higher than those in the control group， while the TCM syndrome integral in the observation group was lower than that in the control group， with statistically significant difference （P < 0.05）. There was no significant difference in the incidence of adverse reactions between the two group （P > 0.05）. Conclusion Acupuncture combined with Chinese medicine can effectively improve the clinical symptoms and quality of life of patients with oculomotor paralysis， so it is worthy of promotion.

[Key words] Oculomotor palsy； Chinese medicine； Acupuncture； Quality of life

動(dòng)眼神經(jīng)麻痹病因復(fù)雜，主要有高度外斜視表現(xiàn)、上瞼下垂、瞳孔散大且對(duì)光調(diào)節(jié)反應(yīng)及反射消失、復(fù)視，可伴隨麻痹眼下斜視或頭痛[1]，且眼球除外旋外的其他方向運(yùn)動(dòng)也會(huì)受到影響，因此需積極采取有效措施展開(kāi)治療。現(xiàn)代醫(yī)學(xué)認(rèn)為，動(dòng)眼神經(jīng)麻痹的病因十分復(fù)雜，包括糖尿病、腫瘤、外傷、炎癥或血管性疾病等，多通過(guò)營(yíng)養(yǎng)神經(jīng)藥物及針對(duì)病因的治療來(lái)改善患者的神經(jīng)功能，促使其神經(jīng)功能得到修復(fù)，但單用西藥治療的效果并不理想。有時(shí)患者需實(shí)施手術(shù)治療[2]，而手術(shù)必然會(huì)給患者造成損傷及痛苦。近年來(lái)，以針灸為主要方法的中醫(yī)療法在動(dòng)眼神經(jīng)麻痹臨床治療中逐漸得到推廣[3]。中醫(yī)對(duì)該病的研究歷史悠久，根據(jù)疾病的臨床表現(xiàn)可將之納入“萎病”“上胞下垂”等范疇。針灸有疏通靜脈之功，兼有活血通絡(luò)之效，且副作用少、依賴性小，治療安全性高，是一種廣泛為大眾接受的綠色療法；中藥療法取材天然，切中病機(jī)用藥下可改善患者臨床癥狀，減輕患者痛苦。本研究選取80例動(dòng)眼神經(jīng)麻痹患者，探討單純針灸治療與針?biāo)幝?lián)合治療在其中的應(yīng)用價(jià)值，現(xiàn)報(bào)道如下：

1 資料與方法

1.1 一般資料

選取2012年1月～2016年6月在濰坊眼科醫(yī)院（以下簡(jiǎn)稱(chēng)“我院”）接受診治的動(dòng)眼神經(jīng)麻痹患者80例為研究對(duì)象，在獲取我院醫(yī)學(xué)倫理委員會(huì)批準(zhǔn)后，以隨機(jī)數(shù)字表法將之分為兩組，每組各40例。對(duì)照組中，男28例，女12例；年齡25～74歲，平均（43.62±5.71）歲；病程1～64 d，平均（28.14±4.96）d；發(fā)病原因：腦血管病15例，炎癥因素7例，外傷造成8例，糖尿病6例，原因不明4例。觀察組中，男27例，女13例；年齡23～72歲，平均（43.51±5.62）歲；病程1～62 d，平均（28.09±4.75）d；發(fā)病原因：腦血管病14例，炎癥因素8例，外傷造成7例，糖尿病6例，原因不明5例。兩組患者基本資料比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P > 0.05），具有可比性。