疏肝健脾法对活动期甲状腺相关眼病的疗效观察及球后血流动力学影响

Clinical observation of smoothing liver and strengthening spleen method on active thyroid associated ophthalmopathy and its influence on retrobulbar hemodynamics

目的探讨疏肝健脾法治疗活动期甲状腺相关眼病的疗效及对球后血流动力学影响。方法选择60例活动期甲状腺相关眼病患者随机分为两组,其中治疗组30例给予口服疏肝健脾方联合甲基强的松龙针治疗,对照组30例给予甲基强的松龙针治疗,两组疗程均为12 w。观察两组治疗前后CAS评分、眼球突出度及球后血流动力学变化情况。结果两组临床疗效比较差异无统计学意义(P>0.05),眼动脉血流动力学比较,治疗组的PSV、EDV明显高于对照组(P<0.05),而RI比较差异无统计学意义(P>0.05)。视网膜中央动脉血流动力学参数比较,治疗组的EDV明显高于对照组,差异有统计学意义(P<0.05),而PSV、RI比较差异无统计学意义(P>0.05)。治疗后两组突眼度、CAS评分均降低(P均<0.05)。结论疏肝健脾法能有效改善TAO患者CAS评分、眼球突出度症状。

Objective To investigate the therapeutic effect of smoothing liver and strengthening spleen on active thyroid associated ophthalmopathy and its influence on retrobulbar hemodynamics.Methods Sixty eligible patients with thyroid-associated ophthalmopathy were randomly divided into two groups,30 cases in the treatment group(60 eyes)were treated with oral Chinese medicine“Shugan Jianpi Decoction”combined with methylprednisolone impact therapy,and 30 cases in the control group(60 eyes)were treated with methylprednisolone impact therapy.Both groups were treated for 12 weeks.CAS score,exophthalmos and retrobulbar hemodynamics were observed before and after treatment in both groups.Results There was no significant difference in clinical efficacy between the two groups(P>0.05).Compared with the hemodynamic parameters of ophthalmic artery,PSV and EDV in the treatment group were significantly higher than those in the control group(P<0.05),while RI had no significant difference(P>0.05).Compared with the hemodynamic parameters of the central retinal artery,the EDV of the treatment group was significantly higher than that of the control group(P<0.05),while the difference of PSV and RI was not significant(P>0.05).After treatment,CAS score and exophthalmos in both groups were significantly decreased(P<0.05).Conclusion The method of smoothing liver and strengthening spleen can effectively improve CAS score and symptoms of exophthalmos in TAO patients.