血府逐瘀汤加减联合复方樟柳碱注射液治疗早期缺血性视神经病变气滞络阻证35例临床观察

Clinical observation on 35 cases of early ischemic optic neuropathy with collateral obstruction due to qi stagnation syndrome treated by modified Xuefu Zhuyu Tang(血府逐瘀汤)combinded with compound anisodine hydrobromide injection

目的 观察血府逐瘀汤加减联合复方樟柳碱注射液治疗早期缺血性视神经病变气滞络阻证的临床疗效。方法 采用随机数字表法将70例早期缺血性视神经病变气滞络阻证患者分为对照组和治疗组,各35例。对照组给予复方樟柳碱注射液颞浅动脉旁皮下注射治疗,治疗组在对照组治疗方法的基础上联合血府逐瘀汤加减口服。连续治疗8周后比较2组治疗前后的视功能相关指标(包括最佳矫正视力、视野平均光敏感度、视野平均缺损)及眼部血流动力学指标[检测睫状后短动脉的舒张末期血流速度(EDV)、收缩期峰值血流速度(PSV)、阻力指数(RI)]。结果 治疗后2组最佳矫正视力、视野平均光敏感度明显升高,视野平均缺损明显降低,与同组治疗前比较差异均有统计学意义(P<0.05或P<0.01),且治疗组改善更明显,与对照组治疗后比较差异均有统计学意义(P<0.05或P<0.01);治疗后2组睫状后短动脉的PSV、EDV明显升高,RI明显降低,与同组治疗前比较差异均有统计学意义(P<0.05或P<0.01),且治疗组改善更明显,与对照组治疗后比较差异均有统计学意义(P<0.01)。结论 血府逐瘀汤加减联合复方樟柳碱注射液治疗早期缺血性视神经病变气滞络阻证疗效显著,可明显改善患者的视功能和眼部血流动力学,值得临床推广。

Objective To observe the clinical efficacy of modified Xuefu Zhuyu Tang(血府逐瘀汤,XFZYT)combined with compound anisodine hydrobromide injection in the treatment of early ischemic optic neuropathy(ION)with collateral obstruction due to qi stagnation syndrome.Methods Seventy cases of early ION with collateral obstruction due to qi stagnation syndrome were divided into control group and treatment group according to random number table method,with 35 cases in each group.The control group was given subcutaneous injections with compound anisodine hydrobromide injection near the superficial temporal artery,on this basis,the treatment group was combined with oral administration of modified XFZYT.After 8 weeks of continuous treatment,the visual function related indexes[including best corrected visual acuity(BCVA),the mean light sensitivity of visual fields,the mean visual field defect)]and the ocular hemodynamic indexes[the end diastolic blood flow velocity(EDV),the peak systolic blood flow velocity(PSV),and the resistance index(RI)of the short posterior ciliary arteries]were compared between the 2 groups before and after treatment.Results After treatment,BCVA,the mean light sensitivity of visual fields significantly improved,whereas the mean visual field defect significantly decreased in the 2groups,and the difference was statistically significant as compared with the same group before treatment(P<0.05 or P<0.01),moreover,the treatment group improved more significantly,and the difference was statistically significant as compared with the control group after treatment(P<0.05 or P<0.01).After treatment,PSV and EDV of the short posterior ciliary arteries in the 2 group increased significantly,whereas RI significantly decreased,and the difference was statistically significant as compared with the same group before treatment(P<0.05 or P<0.01),moreover,the treatment group improved more significantly,and the difference was statistically significant as compared with the control group after treatment(P<0.01).Conclusion It has marked efficacy,can markedly alleviate the visual function and ocular hemodynamics of the patients to use modified XFZYT combined with compound anisodine hydrobromide injection in the treatment of early ION with collateral obstruction due to qi stagnation syndrome,which deserves clinical promotion and application.