中药“益视合剂”辅助治疗儿童弱视

Chinese materia medica Yishi mixture in treatment of amblyopia in children

目的客观评价"益视合剂"的疗效,以指导儿童弱视的临床治疗。方法根据病例选择标准共纳入36例61眼,随机分为对照组及治疗组。对照组(27眼)予以屈光矫正加精细目力训练,治疗组(34眼)在对照组治疗基础上加用"益视合剂",以4周为1个疗程,共3个疗程。于治疗前及每个疗程结束后检查视力,于治疗前和全部疗程结束后行光学相干断层扫描(OCT)检查。观察两组视力情况及黄斑区视网膜神经上皮层厚度。结果 1治疗后,治疗组总有效率为85.3%,基本治愈率为52.9%;对照组总有效率为59.3%,基本治愈率为29.6%。两组疗效差异有统计学意义(P<0.05),治疗组疗效明显优于对照组,其中屈光不正性弱视及中度弱视疗效较好;2治疗后黄斑区视网膜神经上皮层厚度变薄,尤其是黄斑内环区上方视网膜,外环区上方、鼻侧及下方视网膜厚度变化差异有统计学意义(P<0.05)。结论中药益视合剂作为辅助治疗方法可以显著提高儿童弱视的治愈率,缩短治疗时间,在改善黄斑区形态和功能方面起到一定的作用。

Objective To objectively and scientifically evaluate the efficacy of“Yishi mixture”,so as to guide clinical treatment of amblyopia in children.Methods A total of 6 1 eyes of 36 patients based on inclusion criteria were enrolled in this study.27 eyes in the control group received routine treatment including vision correction and training from fine work and 34 eyes in the treatment group were treated with “Yishi mixture”based on routine treatment,4 weeks as a course,and 3 course in total.At the beginning of treatment and at the end of 4,8 and 12 weeks after the treatment, vision was determined,before the treatment and at the end of 3 therapeutic courses optical coherence tomography （OCT）was used to determine the neurosensory retinal thickness in the macula.Results 1 .After 3 courses of thera-py,of the treatment group,the effective rate was 85.3%and the main cure rate was 52.9%;of the control group （27 eyes）,the effective rate was 59.3%and the main cure rate was 29.6%（P〈0.05）,especially for ametropic amblyo-pia and moderate amblyopia.2.After the treatment,the neurosensory retinal thickness in the macula and the retinal nerve fiber layer thickness had a decrease tendency in different degrees,especially in the inferior inner macula,superi-or,nasal and inferior outer macula.Conclusion As an adjuvant therapy,the “Yishi mixture”can significantly im-prove the cure rate of amblyopia in children,shorten the treatment time,and plays some role in improving the form and function of retina and visual cortex.