和血明目片联合弥可保对青光眼患者术后视神经功能保护作用的研究

The Research of Hexuemingmu Tablet Joint Mecobalamin Tablets on the Protective Effect of Optic Nerve Function for the Patients with Glaucoma after Surgery

目的探讨和血明目片联合弥可保对青光眼患者术后视神经功能的保护作用。方法选择2013年7月-2015年4月收治的96例(96只眼)青光眼患者,所有患者均行小梁切除术降眼压。按照随机数字表法将患者分为对照组与观察组,每组48例(48只眼)。对照组患者参照青光眼临床路径用药进行常规治疗,观察组患者采用和血明目片联合弥可保口服治疗,7 d为1个疗程,连续治疗4个疗程。观察两组手术患者药物治疗前、治疗后28 d血压、脉搏、视力、眼压、视野、视神经纤维层厚度的变化。结果 1药物对两组患者血压、脉搏治疗前、治疗后无明显影响,比较无统计学意义(P>0.05);2观察组与对照组治疗前、治疗后视力比较差异无统计学意义(P>0.05);3治疗后两组眼压与本组治疗前比较均明显下降;4治疗后观察组视野平均缺损(MD)、模式标准差(PSD)、视野平均敏感度(MS)与对照组比较明显降低(P<0.05);5治疗后观察组患者颞侧、上方、下方视网膜神经纤维层(RNFL)厚度减厚趋势慢于对照组(P<0.05)。结论和血明目片联合弥可保可以改善青光眼患者术后的视野平均敏感度,视野平均缺损,延缓视野损害,减轻了患者术后发作后视神经纤维层水肿,延长了RNFL变薄的时间,对青光眼患者术后视神经功能具有一定的保护作用。

Objective To study the protective effect for optic nerve function of Hexuemingmu tablet joint Mecobalamin tablets on the patients with glaucoma after surgery. Methods 96 cases of patients( 96eyes) with glaucoma in our hospital from July 2013 to April 2015 were chosen. Trabeculectomy were performed on all patients to lower intraocular pressure. According to the random number table,they were divided into the control group and the observation group,and 48 cases( 48 eyes) in each group. The control group was taken with glaucoma medication pathway for routine clinical treatment,and the observation group was treated with Hexuemingmu tablet joint Mecobalamin tablets oral treatment,7 days were as a course of treatment,and continuous treatment for four courses. The changes of blood pressure,pulse,visual acuity,intraocular pressure,visual field,optic nerve fiber layer thickness for the two groups before treatment and 28 days after treatment were observed. Results 1Drug had no significant effect on blood pressure,pulse before treatment and after treatment,and there was no significant differences( P > 0. 05). 2The visual acuity in the observation group and the control group before treatment and after treatment were without significant differences,and there were no statistical significance( P > 0. 05). 3 The intraocular pressure after treatment in the observation group and the control group compared with it before treatment was decreased significantly. 4The visual field mean defect( MD),pattern standard deviation( PSD),vision mean sensitivity( MS) in the observation group after treatment compared with the control group were reduced( P < 0. 05). 5The reduction trend of the thicknessof temporal side,above,below retinal nerve fiber layer( RNFL) in the observation group after treatment were slower than the control group( P < 0. 05). Conclusion Hexuemingmu tablet joint Mecobalamin tablets can improve vision mean sensitivity and visual field mean defect for patients with glaucoma after surgery,delay visual field damage,reduce postoperative edema of nerve fiber layer,extend the thinning time of RNFL,and it has protective effect on optic nerve function after surgery for glaucoma patients.