六味地黄丸联合综合训练治疗大龄儿童弱视的临床研究

Clinical Study on the Effect of Liuwei Dihuang Wan Combined with Comprehensive Training of Amblyopia in Elder Children

[目的]研究六味地黄丸联合综合训练治疗大龄儿童弱视的临床疗效。[方法]将40例大龄弱视患儿采用随机数字表法分为治疗组和对照组,每组各20例。对照组采用遮盖疗法和弱视综合训练的常规治疗方法;治疗组在对照组基础上加服补益肝肾中药六味地黄丸,比较两组患儿的最佳矫正视力、眼位、双眼立体视、注视性质、图形视觉诱发电位。两组均每隔5个月复查,共复查3次。[结果]与初诊比较,两组患儿视力均明显提高,差异有统计学意义(P<0.05);治疗后5个月,两组组间比较,视力提高无统计学差异(P>0.05),治疗后10、15个月,治疗组患儿最佳矫正视力提高明显快于对照组,组间差异具有统计学意义(P<0.05)。与初诊比较,治疗后治疗组和对照组患儿立体视锐度均有改善,差异均有统计学意义(P<0.05),但两组间差异无统计学意义(P>0.05)。两组患儿治疗前、后P-100波振幅比较,组间差异无统计学意义(P>0.05),时间效应和交互效应均具有统计学意义(P<0.05)。两组组内比较显示,治疗后第5、10、15个月与治疗前比较,差异均具有统计学意义(P<0.05)。两组患儿治疗前、后P-100波潜伏期比较,组间效应和交互效应不明显(P>0.05),时间效应具有统计学意义(P<0.05)。组内比较显示,治疗组治疗后第5、10、15个月P-100波潜伏期与治疗前比较,差异具有统计学意义(P<0.05);对照组治疗后第5、10、15个月与治疗前比较,均无统计学差异(P>0.05)。[结论]两种治疗方法均能不同程度地提高大龄弱视儿童的视力,但六味地黄丸联合综合训练的疗效明显优于单用综合训练。

[Objective]To evaluate the effect of Liuwei Dihuang Wan combined with comprehensive training on amblyopia in elder children.[Methods]Forty cases of elder children suffered from amblyopia were randomly divided into control and treatment groups,20 cases in each.The patients in control group received the conventional treatment including occlusion therapy and amblyopia comprehensive training.Additionally the patients in treatment group received Liuwei Dihuang Wan extract(4 pills per time,3 times a day).Five months was a therapeutic course,after three therapeutic courses,the best corrected visual acuity(BCVA),position of eye,stereopsis,fixation nature and pattern visual evoked patients(PVEP)were detected.[Results]The BCVA was increased significantly in both control and treatment group after treatment(P<0.05).There was no significantly difference in the BVCA between the two groups after one therapeutic course.While after two and three therapeutic courses,the BVCA in treatment group was much better than control group(P<0.05).The stereopsis was increased significantly in both groups after treatment(P﹤0.05),while there was no significant difference in the stereopsis between the two groups.There was no significant difference in the amplitude of P-100 wave between the two groups(P>0.05).Comparison within the two groups showed that the amplitude of P-100 wave were increased significantly after treatment of 5 months,10 months and 15 months,compared with before treatment(P<0.05).There were interaction effects and time factors between groups.There was no significant difference in the implicit time of P-100 wave between the two groups,while comparison within groups showed that in treatment group,the implicit time of P-100 wave were increased significantly after treatment of 5 months,10 months and 15 months,compared with before treatment(P<0.05);but in control group,there was no significant difference in the implicit time of P-100 wave between after treatment and before treatment(P>0.05).There are no interaction effects between groups and time factors.[Conclusion]Both therapies can variously improve the visual acuity of elder children with amblyopia,while the effect of Liuwei Dihuang Wan combined with comprehensive training of amblyopia works better.