活血明目方对已控制的原发性开角型青光眼视神经保护治疗的临床疗效观察

【作者】 张菁；

【导师】 李杜军；

【作者基本信息】 湖北中医学院 ， 中西医结合眼科学， 2008， 硕士

【摘要】 目的:探究活血明目方对已控制的原发性开角型青光眼的视神经保护治疗的疗效。方法:56例（95眼）患者随机分为两组,治疗组28例（48眼）用活血明目方配合能量合剂和神经营养剂治疗,对照组28例（47眼）单纯用能量合剂和神经营养剂治疗,同时观察两组治疗前后的疗效、视野、PVEP、彩色多普勒超声及血液流变学等各指标的改变。结果:治疗组显效19眼,好转13眼,稳定14眼,无效2眼,总有效率66.7%,对照组显效2眼,好转8眼,稳定33眼,无效4眼,总有效率21.3%,治疗组疗效显著优于对照组（p＜0.05）;治疗组治疗后平均光敏度、OA、CRA及S PCA的PSV和EDV与治疗前比较有显著性提高（p＜0.05）,与治疗后对照组比较亦有显著性提高（p＜0.05）;治疗组治疗后平均缺损、OA、cRA及SPCA的RI、全血粘度、血浆粘度、红细胞压积、纤维蛋白原与治疗前比较有显著性降低（p＜0.05）,与治疗后对照组比较亦有显著性降低（p＜0.05）;治疗组治疗后LP₁₀₀和AP₁₀₀与治疗前比较无显著性差异（p＞0.05）,与治疗后对照组比较亦无显著性差异（p＞0.05）。结论:推测由于活血明日方降低血液粘滞度、改善全身血液流变学状态,从而加快眼局部血流速度、降低血管阻力,增加局部血流灌注和供氧量,促进半凋亡RGCs恢复,加速未凋亡RGCs代偿功能,改善黄斑部轴浆流转运,扩大视野,提高视力,最终起到视神经保护的作用。更多还原

【Abstract】 Objective:To investigate the therapeutic effects of Huoxuemingmu Prescription（HXMMP）in the protective treatment of optic nerve,for the patients with primary open angle glaucoma controlled.Method:56patients were randomly divided into two groups, with 48 eyes of 28 patients in treating group treated by HXMMP, nutrient nerve drug and mixed preparation of energy,and 47 eyes of 28 patients in controlling group treated only by nutrient nerve drug and mixed preparation of energy.Meanwhile the indexes were detected included curative effect,visual field, pattern-VEP,CDFI and hemorheology before and after treating course.Results:The total effective rate was 66.7%in treating group,with 19 eyes significantly effective,13 eyes improved, 14 eyes stable and 2 eye ineffective.In contrast,it was only 21.3%in controlling group,with 2 eye significantly effective, 8 eyes improved,33 eyes stable and 4 eyes ineffective,and treating group being superior to controlling group（p＜0.05）. When compared with that before treating course,average photosensitivity,PSV and EDV of OA,CRA and SPCA were all significantly higher in treating group after treating course （p＜0.05）.Furthermore,there were alse significant differences in the same indexes between treating group and controlling group after treating course,with obviously higher in treating group（p＜0.05）.When compared with that before treating course, average defect,RI of OA,CRA and SPCA,blood viscosity,plasma viscosity,HCT and fibrinogen were all significantly lower in treating group after treating course.Moreover,there were also significant differences in the same indexes between treating group and controlling group after treating course,with obviously lower in treating group（p＜0.05）.There were no significant differences in LP₁₀₀and AP₁₀₀of treating group between before and after treating course,and the same result were observed between treating group and controlling group after treating course.Conclusion:HXMMP can enlarge visual field,elevate visual acuity and protect optic nerve owing to accelerating blood flow velocity,lowering vessel resistance,enhancing blood and oxygen quantity within eye bails,improving damaged, not dead,RGCs’ recovery,speeding up normal RGCs’ compensation and ameliorating axial flow transportation in the district of yellow spot.更多还原