益气活血通络法对NAION视功能保护的研究

Research on Visual Function Protection for Nonarteritic Anterior Ischemia Optic Neuropathy in Nourishing qi,Activating Blood Circulation and Collaterals Method

目的通过分析益气活血通络法对非动脉炎性前部缺血性视神经病变（NAION）患者的视力、视野及视神经纤维层的影响，评价本综合疗法对NAION的临床疗效。方法NAION患者39例49眼为观察对象，其中20例（26眼）接受黄芪注射液20mL、川芎嗪注射液160mg、醒脑静注射液20mL及地塞米松10mg分别加入0．9％NS250mL中静脉点滴治疗（观察组），每日1次，同时服用益气活血通络汤；另外19例（23眼）接受地塞米松3～5d后逐渐减量。均以2周为1个疗程。结果①在经过2周治疗后，观察组与对照组视野缺损对比，2组视野缺损度都有改善，2组比较差异无统计学意义（P〉0．05）。在经过4周治疗后，观察组与对照组视野缺损对比，观察组好转明显，2组比较，P〈0．05。②在本组病例中，治疗前及治疗后2周进行OCT检查分析，2组患者神经纤维层水肿治疗后都有所减轻，2组比较，P〈0．05。结论本综合疗法能使急性期NAION的病情得到较快控制，对NAION有保护视神经功能的作用。

OBJECTIVE To evaluate clinical efficacy on NAION by analyzing effect of nourishing qi, activating blood circula- tion and collaterals method on vision, visual field and optic nerve fiber layer in patients with nonarteritic anterior ischemic optic neuropathy（NAION）. METHODS 39 patients with 49 eyes were treated as observed object. 20 cases （26 eyes） accepted intravehous drip treatment with 20 mL Astragalus injection, 160mg TMP injection, 20 mL XNJI and 10 mg dexamethasone（ observation group ）, all of which were added with 250 mL 0.9% N. S, as well Yiqihuoxuetongluo decoction, one time a day. The other 19 cases （23 eyes） took dexamethasone for 3-5 days and then gradually did less. Both groups took 2 weeks as a course. RESULTS （1）In terms of vision lesion, after two weeks of treatment, both groups had improvement and showed no significant difference （P〈0. 05）. After four weeks, observation group had more significant effect （P〈0. 05）. （2）The nerve fiber layer edema in two groups were mitigated after OCT examination analysis of 2 weeks before and after treatment（P〈0.05）. CONCLUSION The therapy can make NAION acute phase under faster control and protect optic nerve function.