蒙药古日古木-13治疗青光眼的临床疗效研究

Clinical effect of the Mongolian medicine Gurigumu-13 on glaucoma

目的探讨蒙药古日古木-13对青光眼患者视神经的保护作用。方法选择2009?2015年我科收治的青光眼患者236例(392眼),包括男159眼,女233眼。其中开角型青光眼145眼,慢性闭角型青光眼247眼。按患者入组顺序随机分成两组,蒙药古日古木-13治疗组(216眼),每日早晚各口服15粒古日古木-13;甲钴铵对照组(176眼),每日早中晚各1粒口服,两种药物均使用2个疗程(2月1疗程,共4个月)。入组患者分别于治疗前、治疗后1w、2w、4w、16w记录视力、眼压、视野和眼部电生理等情况并进行统计学分析。结果治疗前两组患者视力、眼压、视野和眼部电生理等检查结果无统计学差异(P>0.05);两组治疗后情况较治疗前均有所改善,而古日古木组(蒙药组)在0.6?1.0视力段较治疗前的改善比甲钴胺组效果更明显,差异有统计学意义(P<0.05);两组治疗前后眼压变化明显,古日古木组眼压随着治疗时间的延长与治疗前相比差异具有统计学意义(P<0.01);两组治疗后视野平均敏感度(MS)、视野平均缺损(MD)检查改善明显,治疗16w时两组视野MS和MD较治疗前具有统计学差异(P<0.05),而治疗16w时古日古木组与同时间段甲钴铵组的MS和MD比较,具有统计学差异(P<0.05);两组治疗后F-ERG b波和P-VEP P100波较治疗前均有改善,潜伏期减少(P<0.05),振幅增加(P<0.05);治疗16w时,两组眼电生理比较,潜伏期无统计学意义(P>0.05),而振幅增加明显,具有统计学差异(P<0.05),古日古木组优于对照组。结论古日古木-13这一蒙药经典验方具有降低眼压、改善青光眼视神经损伤的效果。

Objective To explore optic nerve protection effect of the Gurigumu-13 on glaucoma patients.Methods Selected 236 cases(392 eyes)glaucoma patients in our hospital from 2009 to 2015,including 159 eyes of male and 233 eyes of female.145 eyes were open angle glaucoma and 247 eyes were chronic angle closure glaucoma.The patients were divided into two groups according to entry sequence.Patients in Gurigumu group had oral administration of 15 capsules of the Gurigumu-13 at day and night each day.The patients in the control group had oral administration of 1 capsule of Methylcobalamin three times a day,all the patients were treated for two courses(4 months).Visual acuity,intraocular pressure,visual field and electrophysiologic examination of the eyes before treatment,lw,2w,4w and 16w after treatment were recorded.Results There was no statistical significance in all indexes of two groups before treatment(P>0.05),The visual acuity of two groups were higher than before treatment;while there were significant differences between the Gurigumu-13 group and control group in the 0.6~1.0 visual acuity.The changes of intraocular pressure in two groups before and after treatment were obvious.With the extension of time,there was significant difference in the Gurigumu-13 group compared with that before treatment(P<0.01).The average sensitivity of visual field(MS)and visual field average defect(MD)of two groups were obviously improved after treatment.Compared with control group,the Gurigumu-13 group had signifcant difference in MS and MD at 16w after treatment(P<0.05).The incubation period in F-ERG b and P-YEP P100 at 16w after treatment of two groups improved and the amplitude increased.The decreased incubation period had no statistic significance while the increased amplitude had statistic significance.As to the ocular electrophysiological changes after treatment of two groups,the Gurigumu-13 group was superior to the control group.Conclusion The classical ancient Mongolian medicine Gurigumu-13 can decrease intraocular pressure and improve glaucoma optic nerve injury.