丹栀逍遥散治疗青光眼视神经损害的疗效观察

Observation of curative effect of Danzhi Xiaoyao powder on glaucomatous optic atrophy

目的评价中西药对青光眼术后患者视神经的保护作用。方法前瞻性研究我院青光眼术后眼压控制良好的闭角型青光眼患者65例,随机分为中药组和西药组,中药组予以丹栀逍遥散加减治疗,西药组予以甲钴胺片治疗,治疗3个月。比较治疗前、治疗3个月和6个月2组最佳矫正视力(BCVA)、眼压、视网膜神经纤维(RNFL)平均厚度、视野的变化。结果 2组治疗前、治疗3个月和6个月BCVA和眼压变化均无显著差异(P>0.05)。6个月时,2组RNFL平均厚度均低于治疗前,中药组RNFL平均厚度高于西药组(P<0.05)。治疗后,中药组平均光敏度值增高,2组平均缺损值均降低(P<0.05);中药组平均光敏度值高于西药组,平均缺损值低于西药组(P<0.05)。结论丹栀逍遥散和甲钴胺片有保护青光眼术后患者视神经功能的作用,且丹栀逍遥散效果优于甲钴胺片。青光眼术后的视神经保护治疗对维持残存视功能具有重要意义。

Objective To evaluate the protective effect of traditional Chinese medicine and western medicine on optic nerve after glaucoma surgery.Methods Totally 65 cases of angle closure glaucoma with good intraocular pressure after glaucoma surgery in our hospital were randomly divided into traditional Chinese medicine group and western medicine group for prospective study.The traditional Chinese medicine group was treated with modified Danzhi Xiaoyao powder and the western medicine group was treated with mecobalamin tablets for 3months.The changes of best corrected visual acuity（BCVA）,intraocular pressure,average thickness of retinal nerve fiber（RNFL）and visual field were compared between two groups at pre-treatment,3months and6 months after treatment.Results There was no significant difference in BCVA and intraocular pressure between the two groups at pre-treatment and post-treatment（P0.05）.At 6months,the average thickness of RNFL in two groups were lower than that before treatment,and the average thickness of RNFL in traditional Chinese medicine group was higher than that in western medicine group（P0.05）.After treatment,the mean sensitivity in traditional Chinese medicine group was increased,and the mean defect in two groups were decreased（P0.05）.The mean sensitivity in traditional Chinese medicine group was higher than that in western medicine group,and the mean defect was lower than that in western medicine group（P0.05）.Conclusion Both Danzhi Xiaoyao powder and mecobalamin tablets have optic nerve protecting function for patients after glaucoma surgery,and the effect of Danzhi Xiaoyao powder is better than mecobalamin tablets.