阿胶鸡子黄汤加减联合典必舒对青光眼患者术后视力及视神经功能的影响

Effects of Modified Ejiao Jizihuang Decoction(阿胶鸡子黄汤加减)Combined with TD Eye Drops on Postoperative Visual Acuity and Optic Nerve Function of Glaucoma Patients

目的分析阿胶鸡子黄汤加减联合典必舒对青光眼患者术后视力及视神经功能的影响。方法选取2020年10月—2021年10月中国人民解放军联勤保障部队第901医院收治的96例青光眼患者为研究对象,依据入院先后顺序将患者分为对照组(48例)和研究组(48例)。两组患者均行青光眼小梁切除术,术后对照组予以典必舒治疗,研究组在对照组基础上运用阿胶鸡子黄汤加减治疗,两组均治疗1个疗程后观察效果。比较两组治疗前后的视力、眼压情况,比较两组治疗前后的视神经功能[平均光敏度(MS)、视野平均缺损(MD)值、视野模式标准差(PSD)]变化、视网膜中央动脉血流参数[收缩期峰值血流速度(PSV)、血流的舒张末期血流速度(EDV)、血管阻力指数(R1)]变化,并对比两组的临床疗效和不良反应情况。结果治疗后两组的视力、眼压较治疗前均有所改善,且研究组视力显著优于对照组,眼压显著低于对照组(P<0.05);治疗后两组MS均升高,MD、PSD均降低,且研究组MS高于对照组,MD、PSD低于对照组(P<0.05);治疗后两组PSV、EDV有所升高,R1有所下降,且研究组各指标显著优于对照组(P<0.05)。研究组的治疗总有效率显著高于对照组(P<0.05);两组不良反应比较差异无统计学意义(P>0.05)。结论阿胶鸡子黄汤加减联合典必舒治疗对青光眼术后患者疗效显著,安全性高,能促进患者术后视力和眼压恢复,改善患者的视网膜中央动脉血流参数,促进视神经功能恢复,值得临床考究。

Objective To analyze the effects of Modified Ejiao Jizihuang Decoction(阿胶鸡子黄汤加减)combined with TD eye drops on postoperative visual acuity and optic nerve function of glaucoma patients.Methods A total of 96 glaucoma patients admitted to the hospital from October 2020 to October 2021 were selected as the study subjects,and they were divided into control group(48 cases)and study group(48 cases)according to the order of admission.Both groups were treated with trabeculectomy for glaucoma,and the control group was treated with dianbiculus after surgery.The research group was treated with Modified Ejiao Jizihuang Decoction on the basis of the control group,and the effect was observed after 1 course of treatment in both groups.The visual acuity and intraocular pressure of the two groups were compared before and after treatment.Before and after the treatment,the optic nerve function[average light sensitivity(MS),mean defect(MD)value view,view pattern standard deviation(PSD)],central retinal artery blood flow parameters[systolic peak flow velocity(PSV),end-diastolic velocity(EDV)of blood flow,vascular resistance index(R1)],the clinical efficacy and adverse reactions of the two groups were compared.Results After treatment,the visual acuity and intraocular pressure(IOP)of the two groups were improved,and the visual acuity of the study group was significantly better than that of the control group,while IOP was significantly lower than that of the control group(P<0.05).After treatment,MS values in both groups were increased,the values of MD and PSD were decreased,and the MS value in the study group was higher than that in the control group,while the values of MD and PSD were lower than those in the control group(P<0.05).After treatment,the values of PSV and EDV in the two groups increased,while R1 decreased,and the indexes in the study group were significantly better than those in the control group(P<0.05).The total effective rate in the study group was significantly higher than that in the control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P<0.05).Conclusion Modified Ejiao Jizihuang Decoction combined with TD eye drops has significant curative effect and high safety on postoperative glaucoma patients,which can promote postoperative vision and intraocular pressure recovery,improve the blood flow parameters of central retinal artery and promote the recovery of optic nerve function,worthy of clinical investigation.