| 摘要: | 青光眼是一個綜合性徵候群，患者因眼壓上升導致視野狹窄和失明。許多的研究認為眼部周圍血液循環障礙和眼壓升高二者在青光眼扮演著重要的角色。針灸能調整眼壓和改善中樞視神經活性（activity of optic nerve）及增加眼底血流（blood ?ow of eye fundus）。睛明（BL1）能交通陰陽，滋養明目；球後（EX-HN7）能行氣活血、通經明目。因此，本研究的目的探討針刺睛明穴及球後穴對青光眼患者眼壓的療效評估。我們設計一個隨機、單盲、對照的臨床試驗，總共45位青光眼患者隨機分為以下三組，每組15位如下：1) 對照組：僅用中藥王不留行子敷貼於兩側睛明和球後穴位上皮膚，每週二次，一次20分鐘，連續二週； 2）針刺組：方法如同對照組，但使用專利型球面眼針刺入睛明和球後兩穴並得氣；3）電針組：方法同針刺組，但得氣後將睛明穴（BL1）與球後穴（EX-HN7）的針連接於電針機，刺激頻率為6 Hz，刺激強度以肉眼可微見肌肉微抽搐為主。主要評估（primary outcome measure）是眼壓的變化，而次要評估（secondary outcome measure）是WHOQOL-REF(Taiwan version)量表的分數變化。結果顯示在右眼和左眼，針刺組和電針組第一次、第二次、第三次和第四次於針刺或電針後60分鐘眼壓下降程度都大於對照組（all p < 0.01）；針刺或電針介入前與介入四次後相比，眼壓下降也是針刺組和電針組大於對照組（all p < 0.001）。
針刺或電針施予睛明和球後能使青光眼患者眼壓降低，基於這個結果，推論針刺和電針施予睛明和球後有利於人類青光眼患者的治療。
Glaucoma is a syndrome, and that is results from intraocular pressure increases cause visual field narrow and blindness. Many studies report that both blood circulation in the eye surroundings and the increase of intraocular pressure play an important role in glaucoma. Acupuncture can modulate intraocular pressure and improve activity of optic nerve , and also increase blood flow of eye fundus. Jingming (BL1) can communicate yi and yang, and nourish and clear eyes, Qiuhou (EX-HN7) can transport qi and activate blood, and freely flowing meridian and clear eyes. Therefore, the purpose of the present study was to investigate the therapeutic effect of acupuncture at Jingming and Qiuhou on intraocular pressure in patients with glaucoma. We designed a single-blinded, randomized, controlled clinical trial, a total of 45 patients with glaucoma divided into three groups, each group was 15 subjects as follows: 1) contrast group, using the seeds of wang-bu-liu-xing applied on the surface of Jingming and Qiuhou acupoints, one times/day, and each time was 20 min, twice/week for 2 weeks continuously; 2) acupuncture group, the methods were identical to the contrast group, but used acupuncture applied to Jingming and Qiuhou with Der-qi; 3) Electroacupuncture (EA) group, the methods were identical to acupuncture, but the needles of Jingming and Qiuhou connected to the EA machine after Der-qi, the frequencies of stimulus were 6 Hz, the intensity of stimulus was minimal visible muscle twitch. Primary outcome measure was the changes of intraocular pressure, and the second outcome measure was the score changes of WHOQOL-REF (Taiwan version). The results indicated that in the right and left eyes, the intraocular pressure in the acupuncture and EA group was lower than these in the contrast group 60 min after first, second, third and fourth acupuncture or EA treatment (all p < 0.01); The difference of intraocular pressure between before intervention and after intervention finish four times was greater lower in the acupuncture and EA groups than these in the contrast group (all p < 0.001).
Acupuncture or EA at Jingming and Qiuhou could reduce intraocular pressure in the patients with glaucoma, based on the results suggesting acupuncture or EA apply to the Jingming and Qiuhou is beneficial for the treatment of patients with glaucoma. |
