针药联合治疗视神经脊髓炎致视神经萎缩的临床疗效观察

Clinical effect of acupuncture combined with Chinese medicine on optic atrophy caused by neuromyelitis optica

目的:探究针药联合治疗视神经脊髓炎(NMO)所致视神经萎缩的临床疗效。方法:收集2016年3月~2019年12月就诊于本院眼科或者神经眼科门诊的以视神经炎(ON)为主要临床表现的NMO所致视神经萎缩患者21例(24眼),以患者自身治疗前后为对比,纳入后接受针刺和中药治疗8周,分别于治疗前和治疗后4周、8周进行最佳矫正视力和动态视野检测,评价针药联合对患者视功能的影响。结果:24眼治疗4周后有8只眼视力提高≥2行,总有效率91.67%,治疗8周后有12眼视力提高≥2行,总有效率100.00%;治疗4周,患者动态视野平均缺损度(MD)及平均敏感度(MS)较前改善,但与治疗前相比,差异无统计学意义(MD:t=1.579,P=0.121;MS:t=−1.500,P=0.140);治疗8周后患者MD显著下降(t=2.65,P<0.05),MS明显提高(t=−2.58,P<0.05),差异均有统计学意义。结论:针药联合可显著提高以ON为主要表现的NMO所致视神经萎缩患者的视功能,明显提高患者最佳矫正视力和动态视野敏感度,降低患者视野缺损。

Objective:To explore the clinical effect of acupuncture combined with traditional Chinese medicine on optic nerve atrophy caused by neuromyelitis optic(NMO).Methods:The patients with optic atrophy caused by NMO with optic neuritis who visited the ophthalmology or neuro-ophthalmology clinic of our hospital from March 2016 to December 2019 were collected.The patients were treated with acupuncture and traditional Chinese medicine for 8 weeks before and after treatment.In order to evaluate the effect of acupuncture combined with traditional Chinese medicine on the visual function of patients,the best corrected visual acuity and dynamic visual field were tested before treatment,4 weeks and 8 weeks after treatment,respectively.Results:After 4 weeks of treatment,the visual acuity of 8 eyes improved more than 2 lines,the total effective rate was 91.67%.After 8 weeks of treatment,the visual acuity of 12 eyes improved more than 2 lines,the total effective rate was 100.00%;after 4 weeks of treatment,the mean defect(MD)and mean sensitivity(MS)of dynamic visual field were improved,but the difference was not statistically significant(MD:t=1.579,P=0.121;MS:t=−1.500,P=0.140);after 8 weeks of treatment,the MD was signifi⁃cantly decreased(t=2.65,P<0.05),and the MS was significantly improved and statistically significant(t=−2.58,P<0.05).Conclusion:The combination of acupuncture and Chinese medicine can significantly improve the visual function of patients with optic atrophy caused by NMO,improve the best corrected visual acuity and dynamic visual field sensitivity,and reduce the visual field defect.