摘要
目的:观察具有活血化瘀,通络止痛功效的灯盏花素治疗缺血性视神经病变的临床疗效特点及不良反应。方法:纳入2000-02/2005-03解放军92854部队医院眼科住院及门诊缺血性视神经病变患者46例,数字表法随机分成两组,即灯盏花素组(n=25,30只眼),丹参对照组(n=21,27只眼)。灯盏花素组给予灯盏花素注射液(主要含灯盏乙素(4,5,6-三羟基黄酮-7葡萄糖醛酸苷)、少量灯盏甲素及其他黄酮类成分)50mg,丹参对照组给予复方丹参注射液(主要成分为丹参和降香)10～20mL,均加入250mL生理盐水中静脉点滴,1次/d,10d为1个疗程,共3个疗程。观察治疗30d前后治疗组和对照组的视力、视野、眼底荧光血管照影变化及比较两组间缺血性视神经病变的治疗效果。结果:参与观察的缺血性视神经病变患者46例全部进入结果分析。①两组治疗前后视力比较:应用灯盏花素注射液治疗30d后,视力小于4.0的眼数明显减少,视力大于4.6的眼数明显增加(u=61.00,P<0.01),优于丹参对照组(u=262.00,P<0.05)。②两组治疗前后视野比较:经过30d的治疗,灯盏花素组视野与治疗前比较有明显的改善(t=2.49,P<0.05),比丹参对照组视野改善明显,差异有显著性意义(t=2.10,P<0.05)。③两组治疗前后眼底荧光血管照影平均臂-视网膜循环时间比较:经过30d的治疗,与治疗前相比两组平均臂-视网膜循环时间明显缩短,差异有显著性意义(t=3.18,P<0.01),但灯盏花素组与丹参对照组比较差异无显著性意义(P>0.05)。④两组疗效比较:灯盏花素组总有效率为91%,丹参对照组为63%,两组治疗效果比较差异有显著性(P<0.05)。⑤治疗期间,患者主诉无明显不良反应,也未发现出血、溶血等现象出现。结论:灯盏花素注射液治疗缺血性视神经病变其特点为视力提高明显,视野改善明显,平均臂-视网膜循环时间缩短明显,疗效明显,且无明显不良反应。
To observe the characteristics of clinical effects and side effects of breviscapine, which has the effects of promoting blood flow, dissolving blood stasis, activating meridians and relieving pain on ischemic optic neuropathy.
METHODS： Forty-six inpatients and outpatients with ischemic optic neuropathy between February 2000 and March 2005 were selected from the Department of Ophthalmology, Chinese PLA 92854 Troop, and randomly divided into two groups, breviscapine group （n=25, 30 eyes） and danshen root control group （n=21, 27 eyes）. Subjects in the breviscapine group were treated with 50 mg of breviscapine injection （main components were scutellatin, including 4, 5, 6-trihy.droxymethyl-7 glucuronate, little amount of breviscapine and some other gradients of flavonoids）, and patients in the danshen root control group received venous drop of 250 mL of normal saline, in which 10-20 mL of compound danshen injection dissolved （main gradients were danshen root and dalbergiae odoriferae, lignum）, once a day and 10 days of one course for totally 3 courses. The changes in vision, field of vision and fundus fluorescein angiography were observed in the treatment group and control group at 30 days before and after the administration, and the curative effects on ischemic optic neuropathy between two groups were compared.
RESULTS： A total of 46 enrolled subjects with ischemic optic neuropathy were involved in the analysis of results. ①Comparison in vision between two groups before and after treatment： at 30 days after treatment with breviscapine injection, the number of vision 〈 4.0 was obviously reduced, whereas the number of vision 〉 4.6 was significantly increased （u=61.00 ,P 〈 0.01 ）, which was better than the danshen control group （u=262.00, P 〈 0.05）. ②Comparison in field of vision between two groups before and after treatment： After 30-day treatment, that in the breviscapine group was remarkably ameliorated than the treatment group before treatment （t=2.49, P 〈 0.05）, and the differences in amelioration of field of vision with danshen control group was sifnificant （t=2.10,P 〈 0.05 ）.③Comparison in fundus fluorescein angiography mean cycle time of arm-retina between two groups before and after the treatment： after 30-day treatment, the cycle time was obviously shortened in beth groups than that before treatment, and the differences were remarkable （t=3.18,P 〈 0.01）, whereas there were no significant differences between group （P 〉 0.05）.④Comparison in breviscapine group and danshen control curative effects between two groups： the total effective rate of breviscapine group was 91% and was 63% in the danshen control group, and differences were marked （P 〈 0.05）. ⑤There was no obvious main complaint about side effects during the period of treatment, neither bleeding nor haemocytolysis was found.
CONCLUSION： Treatment of ischemic optic neuropathy by breviscapine injection is characteristic of obvious enhancement of vision, significant amelioration of field of vision, remarkable shortening of the average cycle time of ann-retina , and the curative effects are marked without obvious side effects.
出处
《中国临床康复》
CSCD
北大核心
2006年第23期7-9,共3页
Chinese Journal of Clinical Rehabilitation
