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Article(id=1322924147633954995, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.06.036, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339295538, onlineDateStr=2026-10-30, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339295538, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339295538, creator=13701087609, updateTime=1793339295538, updator=13701087609, issue=Issue{id=1322923782029062261, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='6', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1749484800000', pubDateStr='2025-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339208371, creator='13701087609', updateTime=1793340556755, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929437859258468, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929437859258469, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=179, endPage=182, ext={EN=ArticleExt(id=1322924147894001844, articleId=1322924147633954995, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Acupuncture Therapy Based on Theory of Five Movements and Six Qi on Glaucoma Intraocular Pressure Control and Optic Nerve Function Repair, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To study the effect of acupuncture therapy based on the theory of five movements and six Qi on glaucoma intraocular pressure control and optic nerve function repair.

Methods

A total of 140 patients with glaucoma who were treated in the hospital from January to December 2022 were randomly divided into two groups，with 70 patients in each group.The patients in the control group were treated with conventional western medicine.On the basis of the control group，the patients in the observation group were treated with acupuncture therapy based on the theory of five movements and six Qi.After 4 weeks of treatment，the treatment efficiency，intraocular pressure，visual field index［mean defect（MD），mean light sensitivity（MS），loss variance（LV）］，optic nerve index［amplitude and latency of pattern visual evoked potential（P-VEP）］and adverse reactions were compared between the two groups.

Results

The total effective rate of the observation group was97.14%，which was significantly higher than that of the control group（87.14%），and the difference between the groups was statistically significant（P<0.05）.After treatment，the intraocular pressure of the two groups decreased significantly（P<0.05），and the intraocular pressure of the observation group was lower than that of the control group（P<0.05）.After treatment，the value of MSin the two groups was signifi-cantly increased，while the values of MD and LV were significantly decreased，and the difference was statistically significant compared with those before treatment（P<0.05）.After treatment，the value of MSin the observation group was significantly higher than that in the control group，the values of MD and LV were significantly lower than those in the control group，and the difference between the two groups was statistically significant（P<0.05）.After treatment，the amplitude of P-VEPin the two groups was increased，and the latency of P-VEP was shortened，and the difference was statistically significant compared with that before treatment（P<0.05）.After treatment，the amplitude of P-VEPin the observation group was significantly higher than that in the control group，and the latency of P-VEPwas significantly shorter than that in the control group，the differences were statistically significant（P<0.05）.The incidences of adverse reactions in the observation group and the control group were 8.57% and 5.71%，respectively and the difference was not statistically significant（P>0.05）.The symptoms of adverse reactions could be relieved by themselves.

Conclusion

The acupuncture therapy based on the theory of five movements and six Qi is applied to glaucoma patients with satisfactory results.It can better control intraocular pressure and repair optic nerve function.It is a safe and effective treatment plan and is worthy of reference and application.

, authors=Lifeng ZHENG, Haiping LI, Sisi WU, Jianying ZHAO, Ying ZHAO, Yinxin LI, Yuan XING, authorsList=Lifeng ZHENG, Haiping LI, Sisi WU, Jianying ZHAO, Ying ZHAO, Yinxin LI, Yuan XING, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322924149219401917, articleId=1322924147633954995, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=基于五运六气理论的针疗法对青光眼眼压控制及视神经功能修复的效果评估, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

研究基于五运六气理论的针疗法对青光眼眼压控制及视神经功能修复的效果。

方法

选取2022年1月—2022年12月于医院治疗的青光眼患者140例，随机均分为两组、每组70例，对照组患者应用常规西医治疗，观察组患者在对照组基础上，进行基于五运六气理论的针疗法，治疗4周后比较两组患者的治疗有效率、眼压、视野指标［平均光敏感度（Mean sensitivity，MS）、平均缺损（Mean deviation，MD）、丢失方差（Loss variance，LV）］、视神经指标［图形视觉诱发电位（pat-tern visual evoked potential，P-VEP）振幅及潜伏期］及不良反应情况。

结果

观察组总有效率97.14%，显著高于对照组87.14%，组间差异有统计学意义（P<0.05）。治疗后两组患者眼压均显著降低（P<0.05），且观察组低于对照组（P<0.05）。治疗后两组患者视野指标MS显著增高，MD、LV显著降低，与同组治疗前比较差异有统计学意义（P<0.05）；治疗后观察组MS显著高于对照组，MD、LV显著低于对照组，组间差异有统计学意义（P<0.05）。治疗后两组P-VEP振幅增高，P-VEP潜伏期缩短，与同组治疗前比较差异有统计学意义（P<0.05）；治疗后观察组P-VEP振幅显著高于对照组，P-VEP潜伏期显著短于对照组，差异有统计学意义（P<0.05）。观察组、对照组不良反应发生率分别为8.57%、5.71%，差异无统计学意义（P>0.05），不良反应症状均可自行缓解。

结论

基于五运六气理论的针疗法应用于青光眼患者效果满意，能够更好地控制眼压、修复视神经功能，是安全、有效地治疗方案，值得借鉴应用。

, authors=郑丽凤, 黎海平, 吴西西, 赵建英, 赵颖, 李银鑫, 邢远, authorsList=郑丽凤, 黎海平, 吴西西, 赵建英, 赵颖, 李银鑫, 邢远, authorCompany=null, correspAuthors=null, authorNote=

郑丽凤（1981-），女，河北唐山人，副主任医师，硕士，研究方向：白内障，青光眼，眼底病。

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郑丽凤（1981-），女，河北唐山人，副主任医师，硕士，研究方向：白内障，青光眼，眼底病。

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郑丽凤（1981-），女，河北唐山人，副主任医师，硕士，研究方向：白内障，青光眼，眼底病。

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year=2022, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［24］, rfOrder=23, authorNames=于坷鑫, journalName=null, refType=null, unstructuredReference=于坷鑫. 疏肝通窍法对肝郁质原发性青光眼生存质量的影响及POAG体质与跨筛板压力的相关性分析［D］. 哈尔滨：黑龙江中医药大学，2022., articleTitle=疏肝通窍法对肝郁质原发性青光眼生存质量的影响及POAG体质与跨筛板压力的相关性分析, refAbstract=null), Reference(id=1322924158513979671, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924147633954995, doi=null, pmid=null, pmcid=null, year=2021, volume=31, issue=10, pageStart=725, pageEnd=729, url=null, language=null, rfNumber=［25］, rfOrder=24, authorNames=倘孟莹, 陈文黎, 陈爽, journalName=中国中医眼科杂志, refType=null, unstructuredReference=倘孟莹，陈文黎，陈爽，等. 基于“厥阴病欲解时”治疗眼科病证［J］. 中国中医眼科杂志，2021，31（10）：725-729., articleTitle=基于“厥阴病欲解时”治疗眼科病证, refAbstract=null), Reference(id=1322924158581088536, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924147633954995, doi=null, pmid=null, pmcid=null, year=2021, volume=36, issue=9, 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组别例数显效有效无效总有效
观察组7027（38.57）41（58.57）2（2.86）68（97.14）
对照组7022（31.43）39（55.71）9（12.86）61（87.14）
χ2值4.834
P值0.028
), ArticleFig(id=1322924153954771188, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924147633954995, language=CN, label=表1, caption=

两组青光眼患者疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
观察组7027（38.57）41（58.57）2（2.86）68（97.14）
对照组7022（31.43）39（55.71）9（12.86）61（87.14）
χ2值4.834
P值0.028
), ArticleFig(id=1322924154026074357, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924147633954995, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
观察组7018.79±1.9212.71±1.0523.245<0.001
对照组7019.03±2.1113.40±1.2619.167<0.001
t值0.7043.520--
P值0.4830.001--
), ArticleFig(id=1322924154114154742, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924147633954995, language=CN, label=表2, caption=

两组青光眼患者治疗前后眼压比较（±s）

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组别例数治疗前治疗后t值P值
观察组7018.79±1.9212.71±1.0523.245<0.001
对照组7019.03±2.1113.40±1.2619.167<0.001
t值0.7043.520--
P值0.4830.001--
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组别例数测定时间MS（dB）MD（Db）LV（dB2）
观察组70治疗前16.10±2.0911.43±1.4124.06±3.15
治疗后20.48±2.808.07±0.9216.95±2.17
t1值10.47315.28619.401
P1值<0.001<0.001<0.001
对照组70治疗前16.03±1.9710.85±1.2024.12±3.04
治疗后19.16±2.058.93±0.7418.17±2.56
t2值9.21111.39415.928
P2值<0.001<0.001<0.001
两组治疗前比较t3值0.2042.6210.115
P3值0.8390.8100.909
两组治疗2周后t4值3.1835.1053.042
比较P4值0.002<0.0010.003
), ArticleFig(id=1322924154252566776, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924147633954995, language=CN, label=表3, caption=

两组青光眼患者治疗前后视野指标比较（±s）

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组别例数测定时间MS（dB）MD（Db）LV（dB2）
观察组70治疗前16.10±2.0911.43±1.4124.06±3.15
治疗后20.48±2.808.07±0.9216.95±2.17
t1值10.47315.28619.401
P1值<0.001<0.001<0.001
对照组70治疗前16.03±1.9710.85±1.2024.12±3.04
治疗后19.16±2.058.93±0.7418.17±2.56
t2值9.21111.39415.928
P2值<0.001<0.001<0.001
两组治疗前比较t3值0.2042.6210.115
P3值0.8390.8100.909
两组治疗2周后t4值3.1835.1053.042
比较P4值0.002<0.0010.003
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组别例数测定时间P-VEP振幅/（μV）P-VEP潜伏期/（ms）
观察组70治疗前4.89±0.91107.25±8.13
治疗后6.13±1.1098.70±5.68
t1值5.9208.389
P1值<0.001<0.001
对照组70治疗前4.96±0.87106.91±9.03
治疗后5.59±1.04102.54±6.36
t2值3.8873.310
P2值<0.0010.001
两组治疗前比较t3值0.4650.234
P3值0.6430.815
两组治疗后比较t4值3.0953.768
P4值0.0020.001
), ArticleFig(id=1322924155980620026, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924147633954995, language=CN, label=表4, caption=

两组青光眼患者治疗后视功能指标比较（±s）

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组别例数测定时间P-VEP振幅/（μV）P-VEP潜伏期/（ms）
观察组70治疗前4.89±0.91107.25±8.13
治疗后6.13±1.1098.70±5.68
t1值5.9208.389
P1值<0.001<0.001
对照组70治疗前4.96±0.87106.91±9.03
治疗后5.59±1.04102.54±6.36
t2值3.8873.310
P2值<0.0010.001
两组治疗前比较t3值0.4650.234
P3值0.6430.815
两组治疗后比较t4值3.0953.768
P4值0.0020.001
), ArticleFig(id=1322924156051923195, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924147633954995, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数皮疹食欲减退头晕结膜充血合计
观察组702（2.86）1（1.43）1（1.43）2（2.86）6（8.57）
对照组701（1.43）2（2.86）1（1.43）0（0.00）4（5.71）
χ2值0.431
P值0.512
), ArticleFig(id=1322924156144197884, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924147633954995, language=CN, label=表5, caption=

两组青光眼患者不良反应情况比较

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组别例数皮疹食欲减退头晕结膜充血合计
观察组702（2.86）1（1.43）1（1.43）2（2.86）6（8.57）
对照组701（1.43）2（2.86）1（1.43）0（0.00）4（5.71）
χ2值0.431
P值0.512
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基于五运六气理论的针疗法对青光眼眼压控制及视神经功能修复的效果评估
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郑丽凤 , 黎海平 , 吴西西 , 赵建英 , 赵颖 , 李银鑫 , 邢远
中华中医药学刊 | 国家项目点击 2025,43(6): 179-182
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中华中医药学刊 |国家项目点击 2025 , 43 (6) : 179 -182
基于五运六气理论的针疗法对青光眼眼压控制及视神经功能修复的效果评估
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郑丽凤（1981-），女，河北唐山人，副主任医师，硕士，研究方向：白内障，青光眼，眼底病。

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郑丽凤（1981-），女，河北唐山人，副主任医师，硕士，研究方向：白内障，青光眼，眼底病。

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郑丽凤, 黎海平, 吴西西, 赵建英, 赵颖, 李银鑫, 邢远
作者信息
  • 广西中医药大学第一附属医院，广西 南宁 530023
作者简介:

郑丽凤（1981-），女，河北唐山人，副主任医师，硕士，研究方向：白内障，青光眼，眼底病。

Effect of Acupuncture Therapy Based on Theory of Five Movements and Six Qi on Glaucoma Intraocular Pressure Control and Optic Nerve Function Repair
Lifeng ZHENG, Haiping LI, Sisi WU, Jianying ZHAO, Ying ZHAO, Yinxin LI, Yuan XING
Affiliations
  • First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine，Nanning 530023，Guangxi，China
出版时间: 2025-06-10 doi: 10.13193/j.issn.1673-7717.2025.06.036
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摘要
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目的

研究基于五运六气理论的针疗法对青光眼眼压控制及视神经功能修复的效果。

方法

选取2022年1月—2022年12月于医院治疗的青光眼患者140例，随机均分为两组、每组70例，对照组患者应用常规西医治疗，观察组患者在对照组基础上，进行基于五运六气理论的针疗法，治疗4周后比较两组患者的治疗有效率、眼压、视野指标［平均光敏感度（Mean sensitivity，MS）、平均缺损（Mean deviation，MD）、丢失方差（Loss variance，LV）］、视神经指标［图形视觉诱发电位（pat-tern visual evoked potential，P-VEP）振幅及潜伏期］及不良反应情况。

结果

观察组总有效率97.14%，显著高于对照组87.14%，组间差异有统计学意义（P<0.05）。治疗后两组患者眼压均显著降低（P<0.05），且观察组低于对照组（P<0.05）。治疗后两组患者视野指标MS显著增高，MD、LV显著降低，与同组治疗前比较差异有统计学意义（P<0.05）；治疗后观察组MS显著高于对照组，MD、LV显著低于对照组，组间差异有统计学意义（P<0.05）。治疗后两组P-VEP振幅增高，P-VEP潜伏期缩短，与同组治疗前比较差异有统计学意义（P<0.05）；治疗后观察组P-VEP振幅显著高于对照组，P-VEP潜伏期显著短于对照组，差异有统计学意义（P<0.05）。观察组、对照组不良反应发生率分别为8.57%、5.71%，差异无统计学意义（P>0.05），不良反应症状均可自行缓解。

结论

基于五运六气理论的针疗法应用于青光眼患者效果满意，能够更好地控制眼压、修复视神经功能，是安全、有效地治疗方案，值得借鉴应用。

青光眼  /  针疗法  /  五运六气理论  /  眼压  /  视神经
Objective

To study the effect of acupuncture therapy based on the theory of five movements and six Qi on glaucoma intraocular pressure control and optic nerve function repair.

Methods

A total of 140 patients with glaucoma who were treated in the hospital from January to December 2022 were randomly divided into two groups，with 70 patients in each group.The patients in the control group were treated with conventional western medicine.On the basis of the control group，the patients in the observation group were treated with acupuncture therapy based on the theory of five movements and six Qi.After 4 weeks of treatment，the treatment efficiency，intraocular pressure，visual field index［mean defect（MD），mean light sensitivity（MS），loss variance（LV）］，optic nerve index［amplitude and latency of pattern visual evoked potential（P-VEP）］and adverse reactions were compared between the two groups.

Results

The total effective rate of the observation group was97.14%，which was significantly higher than that of the control group（87.14%），and the difference between the groups was statistically significant（P<0.05）.After treatment，the intraocular pressure of the two groups decreased significantly（P<0.05），and the intraocular pressure of the observation group was lower than that of the control group（P<0.05）.After treatment，the value of MSin the two groups was signifi-cantly increased，while the values of MD and LV were significantly decreased，and the difference was statistically significant compared with those before treatment（P<0.05）.After treatment，the value of MSin the observation group was significantly higher than that in the control group，the values of MD and LV were significantly lower than those in the control group，and the difference between the two groups was statistically significant（P<0.05）.After treatment，the amplitude of P-VEPin the two groups was increased，and the latency of P-VEP was shortened，and the difference was statistically significant compared with that before treatment（P<0.05）.After treatment，the amplitude of P-VEPin the observation group was significantly higher than that in the control group，and the latency of P-VEPwas significantly shorter than that in the control group，the differences were statistically significant（P<0.05）.The incidences of adverse reactions in the observation group and the control group were 8.57% and 5.71%，respectively and the difference was not statistically significant（P>0.05）.The symptoms of adverse reactions could be relieved by themselves.

Conclusion

The acupuncture therapy based on the theory of five movements and six Qi is applied to glaucoma patients with satisfactory results.It can better control intraocular pressure and repair optic nerve function.It is a safe and effective treatment plan and is worthy of reference and application.

glaucoma  /  acupuncture therapy  /  theory of five movements and six Qi  /  intraocular pressure  /  optic nerve
郑丽凤, 黎海平, 吴西西, 赵建英, 赵颖, 李银鑫, 邢远. 基于五运六气理论的针疗法对青光眼眼压控制及视神经功能修复的效果评估. 中华中医药学刊, 2025 , 43 (6) : 179 -182 . DOI: 10.13193/j.issn.1673-7717.2025.06.036
Lifeng ZHENG, Haiping LI, Sisi WU, Jianying ZHAO, Ying ZHAO, Yinxin LI, Yuan XING. Effect of Acupuncture Therapy Based on Theory of Five Movements and Six Qi on Glaucoma Intraocular Pressure Control and Optic Nerve Function Repair[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (6) : 179 -182 . DOI: 10.13193/j.issn.1673-7717.2025.06.036
正文
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青光眼是由病理性眼压升高引起的一组具有特征性视神经损害和视野缺损的眼病，高眼压可以引起眼睛酸胀疼痛，虹视，视力急剧下降，严重者视力下降或者光感消失，眼睛充血发红，伴有恶心、呕吐、头疼，体温升高，脉搏加速，影响患者生活质量，据报道我国在人口老龄化和青光眼筛查诊断技术提高的背景下，青光眼患病率较前增加[1]。青光眼为不可逆性致盲眼病，需要早发现、早治疗、早控制挽救视力[2]。青光眼属在中医学归属“五风”内障，主要是由于肝肾阴虚、气血不足、痰火内盛、肝胆湿热等原因导致，近年来中医药逐渐应用于该疾病的诊疗并获得一定效果[3-4]。据报道针灸对于青光眼，尤其是急性发作时有显著止痛效果，同时也有一定程度的降眼压、提高视功能作用[5]。“五运六气”是中医在临床防治疾病中应用的理论，借助五运六气，及时定位患者的季节和环境特点，在此基础上应用针灸等中医疗法结合特殊穴位进行辨证治疗，能够取得显著效果[6]。本研究探讨基于五运六气理论的针疗法对青光眼眼压控制及视神经功能修复的效果，现对相关病例情况进行总结并报道如下。
1　资料与方法
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1.1　一般资料
选取2022年1月—2022年12月于医院治疗的青光眼患者140例，根据随机数表法均分为两组、每组70例。对照组中，男28例，女42例；年龄43～74岁，平均（61.2±5.9）岁；左眼34例，右眼29例，双眼7例；病程1～43个月，平均（12.9±4.3）个月。观察组中，男31例，女39例；年龄42～75岁，平均（61.7±5.2）岁；左眼35例，右眼27例，双眼8例；病程1～45个月，平均（13.2±4.0）个月。两组患者的性别、年龄、发病部位及病程方面资料差异均无统计学意义（P>0.05），均衡可比。所有患者及家属均知情同意本研究内容并自愿参与，研究内容经过医院医学伦理委员会审核批准进行。
1.2　纳入与排除标准
纳入标准：①西医诊断均符合《中国青光眼指南（2020年）》[7]及中疾病诊断标准，中医诊断符合《中医眼科学》[8]中疾病诊断标准；②性别不限，成年患者；③近一个月内未接受影响此次研究治疗方案的其他相关治疗；④生命体征正常，意识清楚。
排除标准：①先天性眼部疾病患者；②伴有黄斑裂孔、视网膜脱落、眼底出血等其他器质性眼部疾病患者；③此次研究药物过敏史或针刺禁忌证患者；④不能配合完成眼部检查者；⑤严重心肝肾功能异常患者；⑥妊娠或哺乳期女性。
1.3　方法
对照组患者应用常规西医治疗，马来酸噻吗洛尔滴眼液（湖北远大天天明制药有限公司，国药准字H20045947）滴入眼内给药，每天1～2次，每次1滴；醋甲唑胺片（杭州澳医保灵药业有限公司，国药准字H20000035）口服给药，每次用50 mg，1日2次，早、晚饭后各服1次。观察组患者在对照组基础上，进行基于五运六气理论的针疗法：患者仰卧位，取厥阴、阳明各3针，少阳、少阴各1针，针刺百会指向阳明，治疗前常规消毒针刺点及周边，取毫针顺时针方向沿皮平刺，进针0.5～0.8寸，行针时可稍作提插、捻转，留针20 min，每隔2 d治疗1次。两组患者均治疗4周。
1.4　观察项目
（1）治疗有效率：治疗后视力、视野显著改善及视野缩小症状消失为显效，视力、视野有所改善但仍伴有视野缩小症状为有效，视力、视野均无改善为无效[8]。治疗有效率＝（显效+有效）例数/总例数×100%。（2）眼压：采用NT-510型非接触式眼压计检测治疗前、后患者的平均眼压值，进食者需校正眼压测定。（3）视野指标：采用MEDA自动视野仪进行静态阈值的视野检查，获取平均光敏感度（Mean sensitivity，MS）、平均缺损（Mean deviation，MD）、丢失方差（Loss variance，LV）测量值。（4）视神经指标：治疗前、后采用视网膜电图检测患者的图形视觉诱发电位（pat-tern visual evoked potential，P-VEP）振幅及潜伏期。（5）不良反应：包括皮疹、食欲减退、头晕、结膜充血等，观察并记录患者不良反应的发生情况。
1.5　统计学分析
软件包SPSS21.0为本次研究数据分析工具，计数资料以［例（%）］表示，行χ2检验，计量资料呈正态分布、以（）表示，行t检验，P<0.05则表示差异有统计学意义。
2　结果
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2.1　两组治疗有效率比较
观察组总有效率97.14%，显著高于对照组87.14%，组间差异有统计学意义（P<0.05）。见表1。
2.2　两组治疗前后眼压比较
治疗前两组患者的眼压差异无统计学意义（P>0.05），治疗后两组患者眼压均显著降低（P<0.05），且观察组低于对照组（P<0.05）。见表2。
2.3　两组治疗前后视野指标比较
治疗前两组患者的各项视野指标差异均无统计学意义（P>0.05）；治疗后两组患者视野指标MS显著增高，MD、LV显著降低，与同组治疗前比较差异有统计学意义（P<0.05）；治疗后观察组MS显著高于对照组，MD、LV显著低于对照组，组间差异有统计学意义（P<0.05）。见表3。
2.4　两组治疗后视功能指标比较
治疗后两组P-VEP振幅增高，P-VEP潜伏期缩短，与同组治疗前比较差异有统计学意义（P<0.05）；治疗后观察组P-VEP振幅显著高于对照组，P-VEP潜伏期显著短于对照组，差异有统计学意义（P<0.05）。见表4。
2.5　两组不良反应情况比较
观察组、对照组不良反应发生率分别为8.57%、5.71%，差异无统计学意义（P>0.05），不良反应症状均可自行缓解。见表5。
3　讨论
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中医认为，青光眼多因悲郁暴怒等情志内伤所诱发，而劳倦，特别劳瞻竭视亦是重要原因之一，此外，尚与外感风寒之邪有关。青光眼辨证实者为肝郁、肝火、肝风、痰湿阻于目中玄府所致，出现眼珠胀痛、视物昏蒙、同侧头痛、鼻根发酸，伴有恶心呕吐等实证症状；虚者为肝肾亏虚、脾虚失运、气血不足所致，眼部疼痛症状不明显，但眼底出现视神经的损害[9-11]。针刺疗法是根据中医经络理论，采用毫针对人体的俞穴进行直接刺激，可增强身体机能、疏通经络、调和阴阳、补益气血，尤其适合眼压控制理想而视神经损害却持续加重的患者[12-13]。
本研究中观察组在常规西药治疗基础上，进行基于五运六气理论的针疗法获得更高的治疗有效率，并且在控制眼压和改善视功能方面均具有一定优势。“五运六气”理论源头深植于最早的医学典籍《黄帝内经》，其中有“不知加多少年，气之盛衰，虚实，故不能为君也”。“年”是历法术语，所谓历法，就是根据天文变化的自然规律，计量较长的时间间隔，判断气候的变化，预示季节来临的法则；所谓“气之盛衰”，是指各年份及其不同季节气候变化得太过与不及；所谓“虚实之所起”，是指不同季节气候变化给人体造成的虚实病理改变[14-15]。五运六气理论正是传承发挥了炎黄文明的五六之律，“五运”通过木、火、土、金、水五行的变化和天地阴阳的变化来理解人体疾病的相关变化；“六气”是自然界的六种气候变化：风、寒、热、湿、燥、火[16-17]。掌握五运六气，运用运气思维，根据天地阴阳变化规律，将自然气候变化与人体联系起来，从而使天、人、病三位一体，对疾病的诊治有重要的指导意义[18]。在具体应用上，借助五运六气，应时定位患者所处的季节、环境特点，施针用药，辨证治疗与专病专穴相结合，从而达到显著疗效[19]。针灸疗法主要通过刺激特定的穴位来调节身体的阴阳平衡，促进气血流通，达到缓解眼压的目的[20]。而基于五运六气理论的针疗法要综合天、人、病三位施治，并未固定穴位，而是针对个体具体情况取厥阴、阳明各3针，少阳、少阴各1针，针刺百会、指向阳明。厥阴经、阳明经均属手足六经，《素问·阴阳类论篇》唐代王冰注：“厥，犹尽也。……厥阴者，以阴尽为义也”“两阳合明，故曰二阳者阳明也。”魏宇娇等[21]有研究指出从厥阴病角度论治青光眼，认为病机主要责之于厥阴气化失司，即肝失疏泄则神水积滞、厥阴血虚则目系失养，同时厥阴病欲解时与青光眼患者多夜间病情加重相关。青光眼患者眼部及前额胀痛不适，属于阳明阖降失调，失制于肝经，肝气升发、浊气上泛头目[22-24]。手足阳明经巡行于面部，足厥阴肝经上连于目系，各予3针，左升右降，再引针刺百会向阳明加强疗效，此针疗法可抓住少阴、少阳两枢调理全身气化出入，治愈头目不适诸症，调节六经之气，得天气之助，促进疾病向愈[25-27]。
综合上述内容可见，基于五运六气理论的针疗法应用于青光眼患者效果满意，能够更好地控制眼压、修复视神经功能，是安全、有效地治疗方案，值得借鉴应用。
基金
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  • 国家自然科学基金项目(81874453)
  • 广西壮族自治区中医药管理局项目(GXZYZ20210357)
文献
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2025年第43卷第6期
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doi: 10.13193/j.issn.1673-7717.2025.06.036
  • 首发时间：2026-10-30
  • 出版时间：2025-06-10
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国家自然科学基金项目(81874453)
广西壮族自治区中医药管理局项目(GXZYZ20210357)
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    广西中医药大学第一附属医院，广西 南宁 530023
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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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