“韦氏三联九针”联合青盲一号方治疗颅咽管瘤术后视神经萎缩的临床观察

Clinical observation on optic atrophy after craniopharyngioma operation treated by acupuncture prescription of“Wei’s triple nine needling therapy”combined with Qingmang Yihao decoction

目的探讨“韦氏三联九针”联合青盲一号方治疗颅咽管瘤切除术后视神经萎缩的疗效。方法回顾性分析近10年收治的采用“韦氏三联九针”联合青盲一号方治疗的颅咽管瘤术后视神经萎缩患者13例(26只眼)。记录其一般临床特征及治疗前后最佳矫正视力(BCVA)、视野、视网膜神经纤维层(RNFL)厚度的变化,并进行统计学分析。结果(1)BCVA:治疗后,患者平均BCVA(t=4.146,P=0.000)、最佳视力眼的BCVA(t=3.747,P=0.003)较治疗前改善,差异均有统计学意义。(2)视野:治疗后,LVC程序下,患者的平均光敏度(MS)较治疗前提高,差异有统计学意义(t=-2.467,P=0.049);tG2程序下,患者的MS提高、平均缺损(MD)较治疗前减少,差异均有统计学意义(tMS=-2.368,P=0.045;tMD=2.356,P=0.046)。(3)RNFL厚度:治疗前后比较,差异无统计学意义(P>0.05)。结论“韦氏三联九针”联合青盲一号方可有效改善颅咽管瘤术后视神经萎缩患者的BCVA和视野。

OBJECTIVE To explore the clinical efficacy of acupuncture prescription of“Wei’s triple nine needling therapy”combined with Qingmang Yihao decoction on optic atrophy after craniopharyngioma operation.METHODS A retrospective analysis was made of 13 cases(26 eyes)with optic atrophy after craniopharyngioma surgery treated with“Wei’s triple nine needling therapy”combined with Qingmang Yihao decoction in our hospital in recent 10 years.The changes of BCVA,visual field and RNFL thickness before and after treatment were recorded and analyzed statistically.RESULTS(1)BCVA:after treatment,the average BCVA(t=4.146,P=0.000)and BCVA(t=3.747,P=0.003)of the best vision eyes were improved and the differences were statistically significant.(2)Visual field:after treatment,the mean sensitivity(MS)was significantly improved in LVC mode and the differences were statistically significant(t=-2.467,P=0.049).In tG2 mode,the MS was improved and the mean deviation(MD)was decreased after treatment,and the differences were statistically significant(tMS=-2.368,P=0.045;tMD=2.356,P=0.046)(3)Thickness of retinal nerve fiber layer(RNFL):there was no significant difference before and after treatment(P>0.05).CONCLUSIONS“Wei’s triple nine needling therapy”combined with Qingmang Yihao decoction could effectively improve BCVA and visual field in patients with optic atrophy after craniopharyngioma surgery.