通脉明视汤治疗气血两虚型非动脉炎性前部缺血性视神经病变的疗效观察

Observation on curative effect of Tongmai Mingshi decoction on non-arteritic ischemic optic neuropathy with qi and blood deficiency syndrome

目的观察自拟方通脉明视汤治疗气血两虚型非动脉炎性前部缺血性视神经病变(NAION)的临床效果。方法选择符合纳入标准的NAION患者85例(106只眼),随机分为2组。对照组42例(53只眼),采用改善微循环、减轻视乳头水肿、营养神经等常规治疗。研究组43例(53只眼),在对照组基础上给予自拟方通脉明视汤治疗。观察2组患者治疗前后的最佳矫正视力(BCVA)、视野缺损变化情况,并统计2组的临床疗效。结果(1)BCVA:治疗前后比较,t_(研究组)=16.410,P=0.000,t_(对照组)=11.728,P=0.000,差异均有统计学意义。治疗后2组比较,差异有统计学意义(t=4.238,P=0.000)。(2)平均视野缺损:治疗前后比较,t_(研究组)=5.629,P=0.000,t_(对照组)=2.835,P=0.007,差异均有统计学意义。治疗后2组比较,差异有统计学意义(t=6.209,P=0.000)。(3)临床疗效:研究组总有效率为86.79%,对照组为69.23%,2组比较有统计学意义(Х^(2)=4.363,P=0.037)。结论通脉明视汤联合常规治疗对NAION的效果优于单纯常规治疗,对于改善患者视力、提高生活质量方面具有重要意义,值得广泛应用。

OBJECTIVE To observe the clinical effect of self-made prescription Tongmai Mingshi decoction in the treatment of non-arteritic ischemic optic neuropathy(NAION)with qi and blood deficiency syndrome.METHODS A total of eighty-five cases(106 eyes)with NAION who meeting the inclusion criteria were randomly divided into two groups.The control group with forty-two cases(fifty-three eyes)was treated with routine modalities such as microcirculation improving,papillary edema reducing,nerve nurturing therapy and so on.Forty-three cases(fifty-three eyes)in the study group were treated with self-designed Tongmai Mingshi decoction on the basis of the control group.The changes of best corrected visual acuity(BCVA)and visual field defects before and after treatment in the two groups were observed.The clinical efficacy of the two groups was counted.RESULTS(1)BCVA:After treatment,the study group(t=16.410,P=0.000),the control group(t=11.728,P=0.001)both experienced statistically significant variation.After treatment,the difference between results of both groups was statistically significant(t=4.238,P=0.000).(2)Mean visual field defects:After treatment,the study group(t=5.629,P=0.002),and the control group(t=2.835,P=0.004),both experienced statistically significant variation.The difference between results of two group was statistically significant(t=6.209,P=0.000).(3)Clinical efficacy:the total effective rate was 86.79%in the study group and 69.23%in the control group.The comparison between both groups showed statistically significant difference(Х^(2)=4.363,P=0.037).CONCLUSIONS The effect of Tongmai Mingshi decoction combined with conventional treatment was beter than conventional therapy in the treatment of NAION.It was of great significance in improving patients'vision and quality of life.