摘要
目的观察补气活血化瘀通络方对气虚血瘀型非动脉炎性前部缺血性视神经病变(NAION)患者视力、视野、血流动力学及视网膜电图(ERG)的影响。方法将104例(109眼)气虚血瘀型NAION患者按照随机数字表法分为2组。对照组52例(54眼)予复方樟柳碱注射液治疗,治疗组52例(55眼)在对照组治疗基础上加补气活血化瘀通络方治疗。2组均2周为1个疗程,治疗4个疗程,疗程结束后随访8周。治疗后比较2组疗效;观察2组治疗前、随访时视力、视野平均敏感度(MS)、视野平均缺损(MD)变化;观察2组治疗前、随访时眼动脉和视网膜中央动脉血流动力学指标搏动指数(PI)、血管阻力指数(RI)、收缩期峰值血流速度(PSV)变化;观察2组治疗前、随访时ERG变化;观察2组治疗前、随访时中医证候评分变化。结果治疗组总有效率94.23%(49/52),对照组总有效率78.85%(41/52),治疗组疗效优于对照组(P<0.05)。2组随访时视力、MS均较本组治疗前升高(P<0.05),MD降低(P<0.05),且随访时治疗组视力、MS均高于对照组(P<0.05),MD低于对照组(P<0.05)。2组随访时眼动脉及视网膜中央动脉PI、PSV均较本组治疗前升高(P<0.05),RI降低(P<0.05),且随访时治疗组眼动脉及视网膜中央动脉PI、PSV均高于对照组(P<0.05),RI低于对照组(P<0.05)。2组随访时ERG振荡电位(OPs)总和振幅均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05);a、b波振幅及潜伏期比较差异均无统计学意义(P>0.05)。2组随访时中医证候评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论补气活血化瘀通络方治疗气虚血瘀型NAION临床疗效显著,能提高患者视力,改善视野,改善眼动脉和视网膜中央动脉血流动力学,减轻视神经盘水肿。
Objective To observe the effect of Buqi Huoxue Huayu Tongluo recipe on visual acuity,visual field,hemodynamics and flash electroretinogram(ERG)in patients with non-arteritis anterior ischemic optic neuropathy(NAION)of qi deficiency and blood stasis type.Methods 104 patients(109 eyes)with NAION of qi deficiency and blood stasis type were divided into two groups according to the random number table method.52 cases(54 eyes)in control group were treated with compound anisodine injection.52 cases(55 eyes)in treatment group were treated by Buqi Huoxue Huayu Tongluo recipe on the basis of the treatment in the control group.The two groups were treated for 2 weeks as a course of treatment,a total of 4 courses of treatment.Both groups were followed up for 8 weeks The efficacy of two groups were compared.The changes of visual acuity,visual field average sensitivity(MS)and visual field average defect(MD)before and after treatment were observed.The changes of pulsation index(PI),vascular resistance index(RI)and peak systolic velocity(PSV)of ophthalmic artery and central retinal artery hemodynamics before and after treatment were observed in the two groups.The changes of ERG and TCM syndrome score before and after treatment in the two groups were observed.Results The total effective rate was 94.23%(49/52)in the treatment group and 78.85%(41/52)in the control group.The effect of the treatment group was better than that of the control group(P<0.05).After treatment,the visual acuity and MS of the two groups were increased(P<0.05),MD was decreased(P<0.05),and the visual acuity and MS of the treatment group were higher than those of the control group(P<0.05),MD was lower than that of the control group(P<0.05).After treatment,PI and PSV of ophthalmic artery and central retinal artery in the two groups increased(P<0.05),RI was decreased(P<0.05),and PI and PSV of ophthalmic artery and central retinal artery in the treatment group were higher than those in the control group(P<0.05),RI was lower than that in the control group(P<0.05).Th
作者
刘雁
谭海锋
万方
LIU Yan;TAN Haifeng;RAN Jun;WAN Fang(Department of Ophthalmology,Chongqing Three Gorges Central Hospital 404000)
出处
《河北中医》
2020年第3期370-374,386,共6页
Hebei Journal of Traditional Chinese Medicine
基金
四川省医学科研青年创新课题(编号:2018132623)。
关键词
动脉炎
并发症
缺血
视神经疾病
中药疗法
Arteritis
Complications
Ischemia
Optic nerve diseases
Chinese medicine therapy
