不同病因视神经萎缩中西医结合治疗的临床疗效

Clinical Effect of Integrated Medicine in the Treatment of Optic Nerve Atrophy induced by Different Pathogeny

目的对不同病因视神经萎缩中西医结合治疗的临床疗效的差异性进行分析和探讨,为后来临床治疗提供有效的参考数据。方法根据不同病因视神经萎缩对患者进行分类,选取2012年11月—2013年11月收治的视神经萎缩患者100人,共147眼,其中外伤10眼,缺血性视神经病变13眼,炎症31眼,遗传性34眼,青光眼21眼,占位性病变20眼,不明原因18眼,对所有患者采用中西医结合疗法进行治疗,治疗后观察并记录所有患者视力、视野的好转情况,以及不良反应的发生率。结果采用中西医结合的治疗方法对不同病因的视神经萎缩进行治疗后,患者的视力好转率为:外伤6眼(60.0%),缺血性9眼(69.2%),遗传性20眼(58.8%),炎症19眼(61.3%),青光眼7眼(33.3%),不明原因11眼(61.1%),占位性病变8眼(40.0%)。视野好转率:炎症23眼(74.2%),外伤7眼(70.0%),缺血性8眼(61.5%),青光眼6眼(28.6%),遗传性11眼(32.4%),占位性病变12眼(60.0%),不明原因10眼(55.5%)。不同病因视神经萎缩患者视力、视野好转并不完全同步,疗程越长,疗效越好。且治疗前后患者视力、视野情况差异具有统计学意义(P<0.05)。结论中西医结合治疗不同病因视神经萎缩的治疗效果较为理想,可有效改善患者视神经的电生理功能,保护视神经。其中炎症、外伤、缺血临床疗效较好,治疗成本更低,此法值得在临床大力推广。

Objective To analyze and discuss the difference of the clinical effect of integrated medicine in the treatment of optic nerve at-rophy induced by different pathogeny, and to provide effective reference data for the clinical treatment. Methods Selecting 100 cases of patients with optic nerve atrophy from November 2011 to November 2013, they were divided according to the different pathogeny of optic nerve atrophy. 147 eyes, 10 eyes were trauma, 13 eyes were ischemic optic neuropathy, 31 eyes were inflammation, 34 eyes were heredi-tary, 21 eyes were glaucoma, 20 eyes were occupying lesions, 18 eyes had unknown reason. All patients were treated with therapy of inte-grated medicine. After treatment, the improvement of visual acuity and visual field and the incidence of adverse reactions were observed and recorded. Results After treatment, the improvement rate of visual acuity were as follows： 6 eyes were trauma（60 %）, 9 eyes were ischemic optic neuropathy（69.2%）, 20 eyes were hereditary（58.8%）, 19 cases were inflammation（61.3）, 7 eyes were glaucoma（33.3%）, 8eyes were occupying lesions（40%）, 11 eyes had unknown reason（61.1%）. The improvement rate of visual field were as follows： 23 eyes were inflammation（74.2%）, 7 eyes were trauma（70%）, 8 eyes were ischemic optic neuropathy（61.5%）, 6 eyes were glaucoma（28.6%）,11 eyes were hereditary（32.4%）, 12 eyes were occupying lesions（55.5%）, 10 eyes had unknown reason（60%）. Visual acuity and visual field in patients with optic nerve atrophy were not completely synchronized, the longer the course of treatment, the better the curative ef-fect. And the difference of visual acuity and visual field was statistically significant（ P〈0.05）. Conclusion Therapy of integrated medicine in the treatment of optic nerve atrophy induced by different pathogeny had more ideal effect, can effectively improve the visual function of patients with electric physiological function, and protect optic nerve. All of them, the therapeutic effect of inflammation, trauma and is-chemia are better. The treatment cost is lower, and this method is worthy of promotion in clinical practice.