眼部离子导入激素配合丹栀逍遥散内服治疗青少年急性视神经炎临床研究

Clinical Observation on Ocular Iontophoresis of Hormone Combined with Oral Use of Dan Zhi Xiaoyao Powder for Adolescent Acute Optic Neuritis

目的:观察眼部离子导入激素配合丹栀逍遥散内服治疗青少年急性视神经炎的临床疗效。方法:选择青少年急性视神经炎患者38例(44眼),随机分为对照组20眼和治疗组24眼。对照组采用大剂量甲基强的松龙冲击疗法,静脉滴注;治疗组采用眼部直流电离子导入甲基强的松龙配合丹栀逍遥散加减。观察治疗前后视力、裂隙灯、眼底、图像视觉诱发电位(P-VEP)、电脑视野(视力允许患者行此项检查)检查结果变化,并进行激素副作用观察。结果:总有效率治疗组为83.3%,对照组为60.0%,2组总有效率比较,差异有显著性意义(P<0.05)。2组治疗前及对照组治疗前后最佳矫正视力分布情况比较,差异均无显著性意义(P>0.05);治疗组治疗前后比较,差异有显著性意义(P<0.05)。2组治疗前P-VEP检查振幅及潜伏期比较,差异均无显著性意义(P>0.05),2组治疗1月、6月后P-VEP检查振幅及潜伏期比较,差异均有显著性意义(P<0.05),提示治疗组明显优于对照组。治疗组副作用明显少于对照组。结论:应用眼部离子导入激素配合丹栀逍遥散内服治疗青少年急性视神经炎,治疗效果良好,能减轻全身激素应用的副作用,是值得推广的治疗方法。

Objective:To observe the therapeutic effect of ocular iontophoresis of hormone combined with oral use of Dan Zhi Xiaoyao Powder(DZXP) for adolescent acute optic neuritis(AON).Methods:Thirty-eight AON adolescents with 44 affected eyes were ran-domized into 2 groups:20 eyes were in the control group and 24 eyes were in the treatment group.The control group was given intravenous drip of large-dosage methylprednisolone for stosstherapy,and the treatment group was given ocular iontophoresis of methylprednisolone combined with modified DZXP.The changes of eyesight,slit lamp,eyeground,vision-evoked potential and computerized visual field(if the eyesight of the patients is suitable for the detection) were observed before and after treatment.The side effects of prednisolone were also monitored Results:The total effective rate was 83.3% in the treatment group and was 60.0% in the control group,the difference being significant between the two groups(P<0.05).The differences of the best corrected vision were insignificant between the two groups before treatment,and in the control group before and after treatment(P>0.05).The difference of the best corrected vision was significant in the treatment before and after treatment(P<0.05).The differences of the amplitude and latency of vision-evoked potential were insignificant between the two groups before treatment(P>0.05),but were significant between the two groups after treatment for one and six months(P<0.05).The side effects were less in the treatment group than those in the control group.Conclusion:Ocular iontophoresis of hormone combined with oral use of DZXP is effective for adolescent acute optic neuritis,with fewer side effects.