平目汤合针刺治疗非活动期Graves眼病临床观察

目的 观察针刺联合平目汤治疗阳气亏虚、痰瘀阻滞型非活动期Graves病浸润性突眼的临床疗效。方法 采用随机对照的研究方法，将44例患者随机分为针药结合组（22例40眼）、中药组（22例39眼），中药组予平目汤颗粒口服，针药结合组在中药组的基础上联合远近配穴针刺治疗，两组疗程均为12周。观察两组突眼度、突眼临床有效率、眼部症状积分、中医证候积分等变化。结果 治疗后，两组突眼度较治疗前均降低（P＜0.05），针药结合组突眼度降低程度显著大于中药组（P＜0.05）；针药结合组突眼疗效显著优于中药组（P＜0.05）；与治疗前比较，两组眼部症状积分均显著降低（P＜0.05），针药结合组眼部症状积分降低程度大于中药组（P＜0.05）；与治疗前比较，两组治疗后除“面色晦暗”“自汗”外，其余各项证候积分均显著降低（P＜0.05），其中针药结合组在降低眼球疼痛积分方面优于中药组（P<0.05）。结论 平目汤联合针刺能更好地降低阳气亏虚、痰瘀阻滞型非活动期Graves眼病患者的突眼度，改善其眼部症状，缓解眼球疼痛。

Clinical Effect of Pingmu Decoction Combined with Acupuncture in Treatment of Inactive Graves' Orbitopathy

Objective To investigate the clinical effect of acupuncture combined with Pingmu Decoction in the treatment of infiltrative exophthalmos in inactive Graves'' orbitopathy with Yang deficiency and phlegm stasis. Methods A randomized controlled study was performed. A total of 44 patients were randomly divided into acupuncture-medicine group (22 patients with 40 eyes) and traditional Chinese medicine (TCM) group (22 patients with 39 eyes). The patients in the TCM group were given oral Pingmu Decoction, and those in the acupuncture-medicine group were given acupuncture with distal-proximal acupoint combinations in addition to the treatment in the TCM group. The course of treatment was 12 weeks for both groups. The two groups were compared in terms of the changes in the degree of exophthalmos, clinical response rate of exophthalmos, eye symptom score, and TCM syndrome score. Results After treatment, both groups had a significant reduction in the degree of exophthalmos (P<0.05), and the acupuncture-medicine group had a significantly greater reduction than the TCM group (P<0.05). The acupuncture-medicine group had a significantly better outcome of exophthalmos than the TCM group after treatment (P<0.05). Both groups had a significant reduction in eye symptom score after treatment (P<0.05), and the acupuncture-medicine group had a significantly greater reduction than the TCM group (P<0.05). After treatment, both groups had significant reductions in the scores of all symptoms except dim complexion and spontaneous sweating (P<0.05), and the acupuncture-medicine group had a significantly better reduction in the score of eye pain than the TCM group (P<0.05). Conclusion In patients with inactive Graves'' orbitopathy with Yang deficiency and phlegm stasis, Pingmu Decoction combined with acupuncture can reduce the degree of exophthalmos, improve eye symptoms, and alleviate eye pain.