眶内电针治疗糖尿病性动眼神经麻痹的疗效及相关因素分析OA
Analysis of the Efficacy and Related Factors of Intraorbital Electroacupuncture in the Treatment of Diabetic Oculomotor Nerve Palsy
目的:探讨眶内电针治疗糖尿病性动眼神经麻痹的疗效及其影响因素.方法:回顾性分析2020 年1 月—2024 年11 月于哈尔滨医科大学附属第一医院接受眶内电针疗法治疗的糖尿病性动眼神经麻痹患者临床资料.通过电子病历系统提取人口学特征、眼运动神经麻痹评分、糖化血红蛋白、动眼神经麻痹病程、糖尿病病程、治疗次数、复视像在水平和垂直方向上的最大偏转角度等.采用 t 检验/Mann-Whitney U 检验比较痊愈组与非痊愈组差异,运用二元 Logistic 回归分析疗效影响因素.结果:167 例患者中67 例痊愈,96 例有效,4 例无效,总痊愈率40.1%(67/167),总有效率97.6%(163/167).患者治疗后复视症状减轻,治疗前后最大水平(α)及最大垂直(β)复视角度值中位数差异有统计学意义(P<0.001).67 例痊愈患者治疗后 α 最大值 6°,最小值 0°,置信区间 1.289～2.598;β 最大值 5°,最小值0°,置信区间1.113～2.462.单因素分析显示痊愈组与非痊愈组患者在眼运动神经麻痹评分、糖化血红蛋白、治疗次数、治疗天数方面差异均有统计学意义(P<0.001).回归分析显示治疗次数为针灸有效的保护因素(β=0.050,P<0.001);糖化血红蛋白为危险因素(β=-0.248,P=0.026).结论:眶内电针有效改善糖尿病性动眼神经麻痹患者的眼睑下垂、复视、眼球运动障碍症状,其疗效与动眼神经麻痹程度轻、血糖控制稳定及足够疗程呈正相关.
Objective:To explore the efficacy and influencing factors of intraorbital electroacupuncture in the treatment of diabetic oculomotor nerve palsy.Methods:The clinical data of patients with diabetic oculomotor nerve palsy who received intraorbital electroacupuncture therapy in the First Affiliated Hospital of Harbin Medical University from January 2020 to November 2024 were retrospectively analyzed.Demographic characteristics,ocular motor nerve palsy score,glycosylated hemoglobin,course of oculomotor nerve palsy,course of diabetes,number of treatments,and maximum deflection angle of diplopia in horizontal and vertical directions were extracted from the electronic medical record system.The T test/Mann-Whitney U test was used to compare the difference between the cured group and the non-cured group,and the binary logistic regression was used to analyze the influencing factors of the curative effect.Results:Of the 167 patients,67 were cured,96 were effective,and 4 were ineffective.The overall cure rate was 40.1%,and the total effective rate was 97.6%.The symptoms of diplopia were alleviated after treatment.There was a statistically significant difference in the median value of the maximum horizontal(α)and maximum vertical(β)diplopia angle before and after treatment(P<0.001).After treatment,the maximum value of α in67 cured patients was6°,and the minimum value was 0°,with a confidence interval of 1.289-2.598.The maximum value of β is 5°,the minimum value is 0°,and the confidence interval is 1.113～2.462.Univariate analysis showed that there were significant differences in ocular motor nerve palsy score,glycosylated hemoglobin,treatment times and treatment days between the cured group and the non-cured group(P<0.05).Regression analysis showed that the number of treatments was an effective protective factor for acupuncture(β=0.050,P<0.001).Glycosylated hemoglobin was a risk factor(β=-0.248,P=0.026).Conclusion:Intraorbital electroacupuncture can effectively improve the symptoms of ptosis,diplopia and eye movement disorder in patients with diabetic oculomotor nerve palsy.The curative effect is positively correlated with the mild degree of oculomotor nerve palsy,stable blood glucose control and sufficient course of treatment.
刘宇菲;何兵兵;李元;栗雪梅;刘铁镌;周凌云
哈尔滨医科大学附属第一医院,黑龙江 哈尔滨 150001哈尔滨医科大学附属第一医院,黑龙江 哈尔滨 150001哈尔滨医科大学附属第一医院,黑龙江 哈尔滨 150001哈尔滨医科大学附属第一医院,黑龙江 哈尔滨 150001哈尔滨医科大学附属第一医院,黑龙江 哈尔滨 150001哈尔滨医科大学附属第一医院,黑龙江 哈尔滨 150001
医药卫生
糖尿病动眼神经麻痹复视电针康复
DiabetesOculomotor nerve palsyDiplopiaElectroacupunctureRehabilitation
《中医药学报》 2026 (4)
45-50,6
国家自然科学基金项目(82074524)
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