季娴 温积权 陈益丹 楼继先 徐洁慧

[摘要] 目的 探讨针刺联合药物治疗中老年人眼外肌麻痹的有效性和安全性。 方法 选取2012年9月～2016年12月我科收治的43例眼外肌麻痹患者，按随机数字表法分为两组，针刺联合药物治疗为观察组，药物治疗为对照组，比较治疗后患者复试症状、眼位及眼球运动的变化。 结果 治疗后两组大部分患者复试症状减轻、眼位偏斜改善、眼球运动好转。组间比较，观察组总有效率90.91%，对照组总有效率61.90%，差异具有统计学意义（P<0.05）。治疗过程中未发现与针刺穴位相关的不良反应。 结论 针刺联合药物可以有效治疗中老年人眼外肌麻痹，相比单纯药物治疗效果更稳定可靠，且安全性较高。

[关键词] 眼外肌麻痹；针刺；药物治疗；中老年人

[中图分类号] R246.8 [文献标识码] B [文章编号] 1673-9701（2018）02-0073-04

[Abstract] Objective To observe the efficacy and safety of acupuncture combined with drug therapy in middle aged and older people with extraocular muscles paralysis. Methods 43 patients with extraocular muscles paralysis from September 2012 to December 2016 admitted in our department were divided into two groups， according to the random number table method. The observation group was treated with acupuncture combined with drug therapy， and the control group was given drug treatment. The changes of diplopia symptoms， eye position and eye movement of patients after treatment were compared. Results After treatment， the diplopia symptoms in the majority of patients in the two groups were relieved， the eye position deviation was improved and the eye movement was better. The total effective rate was 90.91% in the observation group and 61.90% in the control group. There was significant difference in the efficacy between the two groups（P<0.05）. No adverse reactions associated with acupuncture points were found during the course of treatment. Conclusion Acupuncture combined with drugs can effectively treat the extraocular muscles paralysis in middle aged and older people， and its treatment effect is more stable and reliable than that of the drug alone， with high safety.

[Key words] Extraocular muscles paralysis； Acupuncture； Drug therapy； Middle aged and older people

眼外肌麻痹患者在臨床中较为常见，其病因复杂，支配眼球运动的神经核、神经或肌肉自身的病变均可引起[1]。随着我国人口老龄化的加剧，中老年人眼外肌麻痹病例日益增多[2]。患者多以突然发现视物重影为主诉，临床表现为眼位偏斜、眼球运动受限等，严重者甚至可引起头晕、恶心呕吐。现阶段该病尚无特效方法[3]，西医除了病因治疗以外，主要通过应用营养神经、扩张血管等药物治疗，但传统方法治疗周期较长，疗效欠理想。患者长期视物重影影响日常生活，十分痛苦。经典中医著作《证治准绳·杂病·七窍门》对眼肌麻痹早有认识，称之为“神珠将反”，乃风热攻脑，筋络被其牵缩紧急，吊斜目珠子，是以不能运转[4]。中医擅长标本兼治，恢复机体的正常生理功能[5，6]。为此，我们选择针刺联合药物对中老年眼外肌麻痹患者进行治疗，并与单用药物治疗患者进行对照观察，现报道如下。……