开郁导滞法治疗早期前部缺血性视神经病变临床研究
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R774.6

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吕海江全国名老中医药专家传承工作室建设项目(国中医药人教涵[2018]134号)


Clinical Study on Method of Removing Constraint and Stagnation for Early Anterior Ischemic Optic Neuropathy
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    摘要:

    目的:观察开郁导滞、通窍明目法对早期前部缺血性视神经病变(AION) 患者视功能的影响。方法:回顾性分析2015 年4 与—2018 年6 月经门诊诊治运用开郁导滞、通窍明目法治疗的早期AION 患者27 例(33 眼),治疗2 周后及治疗2 个月后分别进行最佳矫正视力(BCVA)、视野、视盘周围视网膜神经纤维层厚度(RNFLT) 及视觉诱发电位(VEP) 等方面的检查,并进行临床疗效评估。结果:早期AION 患者治疗2 周后,BCVA、平均视野缺损(MD) 及视野平均敏感度(MS) 较治疗前均有改善,但差异无统计学意义(P>0.05);治疗2 个月后BCVA、MD 及MS 较治疗前均显著改善,差异均有统计学意义(P<0.05)。在改善RNFLT 方面,治疗2 周后视盘盘周上方、颞侧、下方、鼻侧视网膜神经纤维层(RNFL) 及RNFL 平均厚度较治疗前均变薄,但差异无统计学意义(P>0.05),治疗2 个月后除下方外RNFL 上方、颞侧、鼻侧及RNFL 平均厚度较治疗前均显著变薄,差异均有统计学意义(P<0.05),下方RNFL 厚度较治疗前变薄,差异有统计学意义(P<0.05)。在改善VEP 上,治疗2 周后P100 波潜伏期较治疗前缩短,但差异无统计学意义(P>0.05),治疗2 个月后P100 波潜伏期较治疗前显著缩短,差异有统计学意义(P<0.01);治疗2 周后P100 波振幅较治疗前有增加,但差异无统计学意义(P>0.05),治疗2 个月后P100 波振幅较治疗前显著增加,差异有统计学意义(P<0.05)。临床疗效总有效率为81.5%。结论:开郁导滞、通窍明目法能有效改善早期AION 患者的视功能。

    Abstract:

    Abstract: Objective: To observe the effect of the method of removing constraint and stagnation on visual function in patients with early anterior ischemic optic neuropathy(AION). Methods:Retrospective analysis was performed on 27 cases with early AION(33 eyes in total) treated with the method of removing constraint and stagnation and the method of unblocking orifices to improve vision in outpatient department from April 2015 to June 2018. The best corrected visual acuity(BCVA), visual field,retinal nerve fibers layer thickness around optic disc(RNFLT) and visual evoked potential(VEP) were examined two weeks after treatment and two months after treatment,and the clinical effect was evaluated. Results:After two weeks of treatment,the BCVA,mean deviation(MD) and mean sensitivity(MS) of early AION patients were improved,there being no significant difference(P>0.05). After two months of treatment, the BCVA, MD and MS were significantly improved when compared with those before treatment,differences being significant(P<0.05). After two weeks of treatment,in terms of the improvement of the thickness of RNFL, the thickness of above, temporal- side, inferior- side, nasal- side RNFL and average thickness of RNFL was respectively thinner than that before treatment, there being no significant difference(P> 0.05). After two months of treatment,in addition to the thickness of inferior-side RNFL,the thickness of above,temporal-side and nasal-side RNFL as well as average thickness was significantly thinner than that before treatment,differences being significant(P<0.05),and the thickness of inferior- side RNFL was thinner than that before treatment,the difference being significant(P<0.05). After two weeks of treatment, in terms of the improvement of VEP, the P100 wave latency was shortened when compared with that before treatment,there being no significant difference(P>0.05). After two months of treatment,the P100 wave latency was significantly shortened when compared with that before treatment,the difference being significant(P<0.05). After two weeks of treatment, the amplitude of P100 wave was increased, there being no significant difference(P>0.05). After two months of treatment,the amplitude of P100 wave was significantly increased,the difference being significant(P<0.05). The total effective rate was 81.5% (P<0.05). Conclusion: The method of removing constraint and stagnation and the method of unblocking orifices to improve vision can effectively improve the visual function of early AION patients.

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王家良,马宏杰,周尚坤,冯磊,娄艳蕊,指导:吕海江.开郁导滞法治疗早期前部缺血性视神经病变临床研究[J].新中医,2020,52(19):114-117

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  • 在线发布日期: 2020-10-12
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