CAJ | 학술논문

目的：根据国家中医管理局《中医医疗技术操作方案临床验证工作要求》，对雷火灸治疗干眼方案的疗效及安全性进行验证。方法前瞻性、多中心、自身对照临床研究设计。东方医院、北京中医医院、东直门医院的中医眼科组成协作组，各纳入干眼患者30例，共90例，采用重庆赵氏雷火灸治疗，每日1次，治疗4周。以临床症状评分、泪膜破裂时间（BUT）、角膜荧光素染色（FL）、Schirmer I试验（SIT）为观察指标，自身对照比较治疗前后变化，并对治疗方案的安全性进行观察。结果干眼患者治疗后各项主观症状评分均较前下降（P＜0.05），在观察的8项干眼症状中，干涩感、异物感、眼疲劳的效果最好，有效率分别为74.0%、65.6%、62.2%，烧灼感、眼红这两项症状的有效率最低，均为38.9%。治疗后的BUT、FL评分及SIT结果均较治疗前改善，前后差异有统计学意义（P＜0.05），三项检查的有效率分别为64.5%、42.2%、61.0%。无不良反应。结论雷火灸对于有干涩感，异物感，眼疲劳三项为主的干眼疗效明显，而对于以烧灼感，眼红为主证的蒸发过强型干眼疗效欠佳。未见不良反应。
목적：근거국가중의관리국《중의의료기술조작방안림상험증공작요구》，대뢰화구치료간안방안적료효급안전성진행험증。방법전첨성、다중심、자신대조림상연구설계。동방의원、북경중의의원、동직문의원적중의안과조성협작조，각납입간안환자30례，공90례，채용중경조씨뢰화구치료，매일1차，치료4주。이림상증상평분、루막파렬시간（BUT）、각막형광소염색（FL）、Schirmer I시험（SIT）위관찰지표，자신대조비교치료전후변화，병대치료방안적안전성진행관찰。결과간안환자치료후각항주관증상평분균교전하강（P＜0.05），재관찰적8항간안증상중，간삽감、이물감、안피로적효과최호，유효솔분별위74.0%、65.6%、62.2%，소작감、안홍저량항증상적유효솔최저，균위38.9%。치료후적BUT、FL평분급SIT결과균교치료전개선，전후차이유통계학의의（P＜0.05），삼항검사적유효솔분별위64.5%、42.2%、61.0%。무불량반응。결론뢰화구대우유간삽감，이물감，안피로삼항위주적간안료효명현，이대우이소작감，안홍위주증적증발과강형간안료효흠가。미견불량반응。
OBJECTIVE To verify the clinical efficacy and safety performance of the Thunder-fire moxibus-tion. according to medical technical operation scheme of traditional Chinese medicine clinical validation work re-quirements of Chinese Medicine Administration Bureau. METHODS A foresight, multicenter and self control clini-cal research project was designed, and a cooperative group was set up by Dongfang Hospital, Beijing Hospital of TCM and Dongzhimen Hospital. Each hospital with 30 dry eye cases was treated by Zhaoˊs thunder-fire moxibustion of Chongqing, once a day, 4 weeks treatment. Observed the objective indicators like the scores of clinical synptoms, tear film break-up time, schirmer test and cornea fluorescein staining, the statistical analysis was made at the end. ESULTS The effective rate of the thunder-fire moxibustion was 63%~75% in improving the dry feeling, foreign body sensation and asthenopia, while the effective rate was 38.9% in burning sensation and redness. CONCLU-SIONS To the dry-eye which was characterized by dry feeling, foreign body sensation and asthenopia, the therapeu-tic effect of thunder-fire moxibustion was obvious, while to the over evaporation dry-eye which was characterized by burning sensation and redness, the therapeutic effect was not significant.