2016年美国眼科学会原发性闭角型青光眼临床指南的中西医治疗探索

Exploration on preferred practice patterns of American Academy of Ophthalmology for primary angle closure glaucoma of traditional Chinese and western medicine in 2016

借助循证医学的方法,根据临床上3例患者的治疗方案,对美国眼科学会于2016年发布的临床指南中原发性闭角型青光眼及其疑似患者的管理进行回顾性总结和探讨。针对临床上最为常见的两种干预方式激光虹膜切开术和白内障超声乳化术,集中讨论两种处理方式的优势和潜在风险,意在灵活运用新版指南。初步探讨原发性闭角型青光眼的早期中药干预,尽早保护视神经及视功能。原发性闭角型青光眼的早期干预应充分评估患者情况,结合全身状态辨证论治,选择精准化、个性化的中西医结合治疗方案。

Based on evidence-based medicine, according to the clinical treatment cases of 3 patients, preferred practice patterns （PPP） of American Academy of Ophthalmology （AAO） issued in 2016, the management of primary angle closure glaucoma and its suspected patients were reviewed and discussed. According to the two most common clinical intervention methods, laser peripheral iridotomy （LPI） and cataract phacoemulsification, we focused on the advantages and potential risks of the two treatments, which was intended to be flexible in the use of guidelines and guide the clinical treatment of such patients. The early intervention of traditional Chinese medicine in primary angle closure glaucoma was investigated to protect the optic nerve and visual function as early as possible. The early intervention of primary angle closure glaucoma should fully assess the patient＇s condition. Combined with the whole body＇s syndrome differentiation and treatment, we should choose a precise and personalized integrated traditional Chinese and Western medicine treatment plan.