针刺对集合功能不足性视疲劳的疗效观察

　　中国中医眼科杂志 2000年第1期第10卷 临床研究

　　作者：庞雅菊　宋坤英　陈志生　马宝来

　　单位：天津眼科医院天津 300020

　　关键词：针刺；集合功能；视疲劳

　　摘要　目的　观察针刺对集合功能不足性视疲劳的疗效。

　　方法　77例集合功能不足性视疲劳患者分为针剌组和对照组。针剌组51例接受针刺治疗10天；对照组26例进行笔尖训练10天。对两组患者治疗前后临床症状、同视机融合范围、AC/A值进行比较。

　　结果　针剌组症状完全改善16例，部分改善30例，无改善5例。对照组部分改善11例，无改善15例。两组疗效比较差异有显著性(P＜0.01)。两组治疗前融合范围、AC/A值比较差异无显著性(P＞0.05)。治疗后针剌组融合范围、AC/A值较治疗前差异有显著性(P＜0.01)；对照组融合范围较治疗前差异无显著性(P＞0.05),AC/A值较治疗前差异有显著性(P＜0.05)。针剌组治疗后融合范围和AC/C值的扩大均大于对照组。

　　结论　针刺对集合不足性视疲劳有治疗作用。

　　The effect of acupuncture on the asthenopia caused by the convergence insufficiency

Pang Yiaju Song Kunying Cheng Zhisheng

　　（Tianjin Eye Hospital. Tianjin 300020, China）

　　Abstract OBJECTIVE To observe the efficiency of the acupuncture on the asthenopia caused by the convergence insufficiency.METHODS　Seventy seven patients with asthenopia caused by the convergence insufficiency were divided into the acupuncture group and the control group. Fifty one patients were treated for 10 days with the acupuncture in the acupuncture group, and 26 patients were treated for 10 days with pencil-tip training in the control group.The symptoms, fusion extent and AC/A ratio were compared between two groups.RESULTS　The symptoms of 16 patients disappeared, 30 patients were improved partially and 5 patients were not changed in the acupuncture group. The symptoms of eleven patients were partially relieved and 15 patients were not changed in control group. There was a significant difference between two groups(P＜0.01) when their effective rate was compared. There was not a significant difference in the fusion extent and AC/A ratio of two groups before treatment (P＞0.05). After the treatment there was a significant difference for fusion extent and AC/A ratio compared with pretreatment in acupuncture group (P＜0.01). There was not significant difference for fusion extent (P＞0.05 ), and the difference had a statistic signification (P＜0.05 ) for AC/A ratio in the control group. The improvement of fusion extent and AC/A ratio were more obvious in acupuncture group than the control group.CONCLUSIONS　The results confirmed that the acupuncture was one of effective methods in treatment of asthenopia caused by the convergence insufficiency.

　　Key words acupuncture convergence function asthenopia　

　　集合功能不足是肌性视疲劳的主要原因之一，其特点为看远时眼位正常，看近时为外隐斜，AC/A的比值低于正常，在接近于集合近点时集合储备力不足，是一种眼科常见病。 由于集合功能不足，难以从事远近距离不同的双眼单视，而出现视物模糊，阅读困难、眼胀眼痛，头痛或头晕等一系列视疲劳症状，给患者生活和工作带来不便。现有集合训练方法常不能收到满意效果，我们采用针刺治疗本病，疗效显著，报导如下。

　　1　资料与方法

　　1.1 临床资料

　　观察病例为1998年9月至1999年6月眼科门诊集合功能不足视疲劳患者77例。男17例，女60例。年龄最小17岁，最大60岁，平均年龄36岁。病程1周至15年，平均1年。随机分为针刺组和对照组(表1)，针刺组平均年龄36.08岁，对照组平均年龄35.31岁，经统计学检验t=0.62，P＞0.05，两组之间平均年龄差异无显著性，表示两组之间有可比性。

　　诊断标准：两组患者均无屈光不正及显斜。远近视力正常。眼前节及眼底检查未见异常。有正常双眼视。患者均有严重视疲劳症状，近距离学习工作困难。当注视近目标时，仅一眼注视，另一眼不能注视。同视机检查融合范围＜25°，AC/A值＜3。

　　1.2　治疗方法

　　针刺组患者用针刺治疗。取穴：攒竹、丝竹空、睛明、健明、承泣、球后、风池、风府、百会、内关、合谷等。每日1次，每次选穴8个，留针30分钟，10天为1个疗程。

　　对照组采用笔尖训练法，每日3次，每次5分钟，10天为1个疗程。

　　两组均治疗1个疗程，治疗前后由同一名专职医生进行同视机检查，详细记录临床症状。

　　2　结果

　　2.1　疗效判断标准

　　参阅有关资料，我们制定了症状改善判断标准。①完全改善：视物模糊、阅读困难、眼胀眼痛、头晕或头痛等症状完全消失，近距离用眼无视疲劳症状。②部分改善：部分症状消失或减轻，近距离用眼偶有不适。③无改善：治疗前后临床症状相同，自觉无好转。

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