目的：研讨雷火灸联合A型肉毒毒素治疗难治性眼睑痉挛的疗效。

方法：前瞻性研究，选取2022年1月至2025年1月经我院确诊为难治性眼睑痉挛的患者，随机分为2组，对照组单纯行A型肉毒毒素注射，雷火灸治疗组基于对照组在注射A型肉毒毒素前使用雷火灸治疗，比较两组方案疗效、治疗前后的眼睑痉挛状况、残疾程度\〖眼睑痉挛残疾指数(BSDI)\〗及不良反应。

结果：纳入难治性眼睑痉挛的患者60例，雷火灸治疗组30例，男13例，女17例，平均年龄62.39±6.82岁； 对照组30例，男12例，女18例，平均年龄62.72±6.95岁。疗效统计显示，雷火灸治疗组总起效率93%(28/30)相比对照组70%(21/30)疗效更高(P<0.05)。治疗后，雷火灸治疗组眼睑痉挛严重程度、频率分级相比对照组均明显改善(P<0.05)。治疗后，两组BSDI量表得分较治疗前均下降，且雷火灸治疗组降幅明显大于对照组(均P<0.05)。雷火灸治疗组不良反应出现占比与对照组相近(P>0.05)。

结论：雷火灸与A型肉毒毒素联合使用能够提升对难治性眼睑痉挛患者的治疗效果，有效改善眼睑痉挛状况及残疾程度。

METHODS:Prospective study. Patients diagnosed with refractory blepharospasm in the hospital from January 2022 to January 2025 were randomly divided into two groups. The control group received botulinum toxin type A injection alone, while the thunder-fire moxibustion group received thunder-fire moxibustion prior to the botulinum toxin type A injection,with the control group as the baseline intervention. The clinical efficacy, blepharospasm severity before and after treatment, disability degree \〖blepharospasm disability index(BSDI)score\〗, and adverse reactions were compared between the two groups.

RESULTS:Sixty patients(120 eyes)with refractory blepharospasm were enrolled. The thunder-fire moxibustion group consisted of 30 patients, including 13 males and 17 females, with a mean age of 62.39±6.82 y. The control group consisted of 30 patients, including 12 males and 18 females, with a mean age of 62.72±6.95 y. The total effective rate was 93%(28/30)in the thunder-fire moxibustion group, which was significantly higher than 70%(21/30)in the control group(P<0.05). After treatment, the severity and frequency grade of blepharospasm in the thunder-fire moxibustion group were significantly better than those in the control group(P<0.05). The BSDI scores in both groups decreased after treatment, with a significantly greater reduction in the thunder-fire moxibustion group(both P<0.05). The incidence of adverse reactions was similar between the two groups(P>0.05).

CONCLUSION: The combination of thunder-fire moxibustion and botulinum toxin type A can significantly enhance the therapeutic efficacy for refractory blepharospasm, effectively alleviate the severity of symptoms and degree of disability.