平肝活血汤治疗非动脉炎性前部缺血性视神经病变的临床研究

Clinical research on Pinggan Huoxue Decoction in the treatment of non-arteritic anterior ischemic optic neuropathy

目的观察平肝活血汤治疗非动脉炎性前部缺血性视神经病变的临床疗效。方法将2018年1月—2019年9月来天津市眼科医院就诊的早期非动脉炎性前部缺血性视神经病变患者62例(72眼)随机分为对照组和治疗组。对照组给予静滴小牛血清去蛋白提取物注射液、肌肉注射甲钴胺注射液、颞浅动脉旁皮下注射复方樟柳碱等治疗;治疗组在对照组治疗基础上给予平肝活血汤口服。2组均以14 d为1个疗程,共治疗2个疗程。观察比较2组患眼治疗前后最佳矫正视力(BCVA)、视野平均敏感度(MS)、视野平均缺损(MD)及视盘平均视网膜神经纤维层厚度(RNFL)。结果2组治疗后BCVA、MS、MD、RNFL均较治疗前明显改善(P均<0.05),但2组治疗后BCVA、MS、MD、RNFL比较差异均无统计学意义(P均>0.05),2组治疗前后MS、MD、RNFL的差值比较差异均有统计学意义(P均<0.05)。结论平肝活血汤可改善视神经缺血状态,减轻视神经水肿及视神经损伤,有效保护视功能。

Objective It is to observe the clinical efficacy of Pinggan Huoxue Decoction in the treatment of non-arteritic anterior ischemic optic neuropathy(NA-AION).Methods Sixty-two patients(72 eyes)with early-onset NA-AION treated in Tianjin Eye Hospital from January 2018 to September 2019 were randomly divided into two groups:treatment group and control group.The control group was given intravenous infusion of calf serum deproteinized extract injection,intramuscular injection of mecobalamin injection,subcutaneous injection of compound anisodine next to superficial temporal artery,etc.The treatment group was treated with Pinggan Huoxue Decoction orally on the basis of the control group.14 days as one course of treatment,and both groups were treated for 2 courses in total.The best corrected visual acuity(BCVA),mean sensitivity(MS),mean defect(MD)and mean retinal nerve fiber layer thickness(RNFL)of optic disc before and after treatment were observed and compared between the two groups.Results After treatment,BCVA,MS,MD,and RNFL in the two groups were significantly improved compared to before treatment(all P<0.05),but there was no statistically significant difference in BCVA,MS,MD,and RNFL between the two groups after treatment(all P>0.05).The differences in the differences of MS,MD,RNFL before and after treatment were statistically significant between the two group(all P>0.05).Conclusion Pinggan Huoxue Decoction can improve optic nerve ischemia,relieve optic nerve edema and optic nerve damage and effectively protect visual function.