Department of Acupuncture and Moxibustion, Guanganmen Hospital, Academy of Traditional Chinese Medicine
A total of 123 cases involving 194 eyes of recurrent hemorrhage into the retina and vitreous humour among adolescents were treated with acupuncture and moxibustion during recent years and the effective rate was found to be 87.62%. A satisfactory outcome was also shown by the results of follow-up in a portion of the patients. Our observations are summarized as follows:
Methods of Observations:
Two systems of diagnostic criteria according to the traditional Chinese and western medicine were adopted, and both the treatment and the observations were done in the out-patient-department.
1. Therapeutic principles based on the theories of the traditional Chinese medicine "in case of 'Xu' ('' deficient activity) regulate with 'Bu' ('' reenforcing), and in case of 'Shi' ('' excessive activity) 'Xie' ('' reducing) is applied", we have adopted the method Qingtou Mingmu ( clearing the mind and enligtening the sight vision) and Huoxie Huayu ( improving the blood circulation and eliminating the stasis).
2. Point selection and manipulation: Acupuncture by the method of reenforcing with heat was done over the points Fengchi, Yiming and Qubin and promising results were to be expected with the thermal sensation transmitted to the ocular region. Except over the points Taiyang, Zanzhu and Yangbai, where the needle may be retained for 15-30 minutes, in general, needle-retaining acupuncture is not necessary. The needles were inserted slowly with slight pressure over the Neijingming and Qiuhou points for 1-1.5 inches, and pressure was applied to the points with a sterilized cotton ball for 1-2 minutes after withdrawal of the needles. For renal deficient activity cases add Shenshu, Dazhui, and Taixi; for splenic deficient activity add Pishu, Sanyingjiao or Zhongwan and Qihai; for hepatic hyperfunction add Ganshu, Ligou and Guangming; for insomnia add Shengmen; for headache add Hegu; for hemorrhage into the fundus add Erbai. Indirect moxibustion over walnut shell is applied in cases of "retinitis proliferans" over the ocular region. One course of treatment consists of twelve times of acupuncture and moxibustion which is given in successive or alternate days.
Results of treatment:
Criteria of therapeutic effect: Cure -- stoppage of the hemorrhage and disappearance of the symptoms, vision recovered to 1.0 or above and essentially normal fundoscopic findings. Remarkable effect-- hemorrhage checked, symptoms subsided, vision increased to above 0.3 and marked improvement of the disc pathology. Improvement -- symptoms alleviated with hemorrhage checked both in frequency and amount, improvement of vision above 0.1. Failure -- hemorrhage continued and vision not improved.
Therapeutic effect: short-term follow-up in 194 eyes revealed cure in 52 eyes (26.8%), remarkable improvement in 43 (22.17%) and improvement in 75 (38.66%). In all, treatment was effective in 170 (87.63%). Failure occurred in 24 (12.57%). 44 eyes had long-term follow-up among them 32 (77.28%) had no recurrence and in 10 (22.72%) the lesion recurred. A remarkably low recurrent rate is seen in the cured cases.
Discussion:
1. The therapeutic effect is closely related with the pretreatment level of eye vision. As a rule excellent results are expected in cases with higher acuity of vision, and this is also true vice versa. Among the 94 eyes with a vision level below 0.1, only five eyes claimed cure (5.32%) and 17 (18.00%) were failures. In the 100 eyes with the pre-treatment vision above 0.1, 47 (47.0%) cured and no effect in 7 7%). The difference of cure rate among these two groups is statistically significant (P=0.001).
2. The therapeutic effect is influenced by the amount of hemorrhage into the fundus as well as the extent of the disc lesion. Poor results are often seen in those cases with profuse hemorrhage and severe pathological changes in the disc, and the outcome is as a rule promising when both hemorrhage and the disc lesion are not severe. Among the 194 eyes with profuse bleeding and dense vitreous opacities, the fundi could not be visualized in 103; and in the latter group only 8 claimed cure (7.76%), and failure in 16 (15.53%). In 47 eyes of traumatic choroidal heomarrhage, 22 cured (46.8%), failure in two (4.26%). The difference is statistically highly significant (P<0.001).
A total of 123 cases involving 194 eyes of recurrent hemorrhage into the retina and vitreous humour among adolescents were treated with acupuncture and moxibustion during recent years and the effective rate was found to be 87.62%. A satisfactory outcome was also shown by the results of follow-up in a portion of the patients. Our observations are summarized as follows:
Methods of Observations:
Two systems of diagnostic criteria according to the traditional Chinese and western medicine were adopted, and both the treatment and the observations were done in the out-patient-department.
1. Therapeutic principles based on the theories of the traditional Chinese medicine "in case of 'Xu' ('' deficient activity) regulate with 'Bu' ('' reenforcing), and in case of 'Shi' ('' excessive activity) 'Xie' ('' reducing) is applied", we have adopted the method Qingtou Mingmu ( clearing the mind and enligtening the sight vision) and Huoxie Huayu ( improving the blood circulation and eliminating the stasis).
2. Point selection and manipulation: Acupuncture by the method of reenforcing with heat was done over the points Fengchi, Yiming and Qubin and promising results were to be expected with the thermal sensation transmitted to the ocular region. Except over the points Taiyang, Zanzhu and Yangbai, where the needle may be retained for 15-30 minutes, in general, needle-retaining acupuncture is not necessary. The needles were inserted slowly with slight pressure over the Neijingming and Qiuhou points for 1-1.5 inches, and pressure was applied to the points with a sterilized cotton ball for 1-2 minutes after withdrawal of the needles. For renal deficient activity cases add Shenshu, Dazhui, and Taixi; for splenic deficient activity add Pishu, Sanyingjiao or Zhongwan and Qihai; for hepatic hyperfunction add Ganshu, Ligou and Guangming; for insomnia add Shengmen; for headache add Hegu; for hemorrhage into the fundus add Erbai. Indirect moxibustion over walnut shell is applied in cases of "retinitis proliferans" over the ocular region. One course of treatment consists of twelve times of acupuncture and moxibustion which is given in successive or alternate days.
Results of treatment:
Criteria of therapeutic effect: Cure -- stoppage of the hemorrhage and disappearance of the symptoms, vision recovered to 1.0 or above and essentially normal fundoscopic findings. Remarkable effect-- hemorrhage checked, symptoms subsided, vision increased to above 0.3 and marked improvement of the disc pathology. Improvement -- symptoms alleviated with hemorrhage checked both in frequency and amount, improvement of vision above 0.1. Failure -- hemorrhage continued and vision not improved.
Therapeutic effect: short-term follow-up in 194 eyes revealed cure in 52 eyes (26.8%), remarkable improvement in 43 (22.17%) and improvement in 75 (38.66%). In all, treatment was effective in 170 (87.63%). Failure occurred in 24 (12.57%). 44 eyes had long-term follow-up among them 32 (77.28%) had no recurrence and in 10 (22.72%) the lesion recurred. A remarkably low recurrent rate is seen in the cured cases.
Discussion:
1. The therapeutic effect is closely related with the pretreatment level of eye vision. As a rule excellent results are expected in cases with higher acuity of vision, and this is also true vice versa. Among the 94 eyes with a vision level below 0.1, only five eyes claimed cure (5.32%) and 17 (18.00%) were failures. In the 100 eyes with the pre-treatment vision above 0.1, 47 (47.0%) cured and no effect in 7 7%). The difference of cure rate among these two groups is statistically significant (P=0.001).
2. The therapeutic effect is influenced by the amount of hemorrhage into the fundus as well as the extent of the disc lesion. Poor results are often seen in those cases with profuse hemorrhage and severe pathological changes in the disc, and the outcome is as a rule promising when both hemorrhage and the disc lesion are not severe. Among the 194 eyes with profuse bleeding and dense vitreous opacities, the fundi could not be visualized in 103; and in the latter group only 8 claimed cure (7.76%), and failure in 16 (15.53%). In 47 eyes of traumatic choroidal heomarrhage, 22 cured (46.8%), failure in two (4.26%). The difference is statistically highly significant (P<0.001).
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