摘要
目的观察明目逍遥颗粒保护眼压控制稳定的原发性青光眼患者(肝郁血虚证)视神经的临床疗效。方法纳入2016年11月—2019年1月中国中医科学院广安门医院眼科诊治的肝郁血虚型原发性青光眼患者72例(144只眼),以随机数字表法分为试验组和对照组,每组各36例(72只眼)。试验组予明目逍遥颗粒口服,对照组予安慰剂口服。2组均治疗6个月。分别于治疗前、治疗后3个月和6个月检测受试者的视野平均缺损(MD)、晚期青光眼干预研究(AGIS)计分、P点个数、杯盘比(C/D)、最佳矫正视力(BCVA)、眼压和中医症候评分,并做统计分析。结果2组治疗前,以下各指标均无统计学意义(P>0.05)。(1)BCVA和眼压:治疗前后比较及治疗后组间比较,2组在BCVA和眼压方面均无统计学意义(P>0.05)。(2)视野指标:对照组治疗后MD较治疗前增加,差异有统计学意义(t=2.768,P=0.008)。治疗后2组间比较,试验组MD较对照组减少,差异有统计学意义(t=2.012,P=0.047)。试验组治疗后AGIS总分较治疗前减少,差异有统计学意义(t=2.114,P=0.039)。治疗后2组间比较,试验组AGIS总分较对照组减少,差异有统计学意义(t=2.010,P=0.047)。试验组治疗后P点总数较治疗前减少,差异有统计学意义(t=2.070,P=0.043);对照组治疗后P点总数较治疗前增加,差异有统计学意义(t=3.110,P=0.000)。治疗后2组间比较,试验组P点总数较对照组减少,差异有统计学意义(t=2.587,P=0.011)。(3)C/D:治疗前后比较及治疗后组间比较,2组在C/D方面均无统计学意义(P>0.05)。(4)中医症状积分:2组治疗后中医症状积分均较治疗前减少,差异均有统计学意义(t_(试验组)=6.169,P=0.000;t对照组=3.101,P=0.004)。治疗后2组间比较,试验组中医症状积分较对照组减少,差异有统计学意义(t=4.302,P=0.000)。结论明目逍遥颗粒可改善眼压控制稳定的原发性青光眼患者(肝郁血虚证)的视野敏感度,减少视野局部损害,有较好的视神经保护作用,同时能够调整机体情志状态。
OBJECTIVE To observe the clinical effect of Mingmu Xiaoyao Granule on protecting the optic nerve of patients with primary glaucoma(liver depression and blood deficiency syndrome)with stable intraocular pressure(IOP)control.METHODS A total of 72 patients(144 eyes)with primary glaucoma of liver depression and blood deficiency syndrome who were diagnosed in the Department of Ophthalmology of Guang´anmen Hospital,China Academy of Chinese Medical Sciences from November 2016 to January 2019 were included in the study.They were divided into the experimental group(EG)and the control group(CG)by random number table method,with 36 patients(72 eyes)in each group.The experimental group was given Mingmu Xiaoyao Granules orally,and the control group was given placebo orally.Both groups were treated for six months.The mean visual field defect(MD),the scores of the Advanced Glaucoma Intervention Study(AGIS),the number of significant decline points in visual field sensitivity(P),the ratio of cup/disc(C/D),the best corrected visual acuity(BCVA),the IOP,and the scores of Traditional Chinese Medicine(TCM)symptoms were measured before the treatment,three and six months after the treatment.RESULTS Before the treatment,there was no significant difference in the following indexes between the two groups(P>0.05).(1)BCVA and IOP:There was no significant difference in BCVA and IOP between the two groups before and after the treatment(P>0.05).(2)Visual field indexes:The MD of the control group increased significantly after the treatment compared with that before the treatment(t=2.768,P=0.008).After the treatment,the MD of the experimental group decreased significantly when compared with that of the control group(t=2.012,P=0.047).The total scores of AGIS in the experimental group after the treatment was significantly lower than that before the treatment(t=2.114,P=0.039).The total number of P points in the experimental group after the treatment was significantly lower than that before the treatment(t=2.010,P=0.047).The total number of P points in the control group increased after the treatment compared with that before the treatment,with a statistically significant difference(t=3.110,P=0.000).After the treatment,the total number of P points in the experimental group was significantly lower than that in the control group(t=2.587,P=0.011).(3)C/D ratio:There was no significant difference in C/D ratio between the two groups before and after the treatment(P>0.05).(4)TCM symptom scores:After the treatment,the TCM symptom scores of the two groups decreased compared with that before the treatment,and the differences were statistically significant(t_(EG)=6.169,P=0.000;tCG=3.101,P=0.004).After the treatment,the TCM symptom scores of the experimental group decreased significantly when compared with that of the control group(t=4.302,P=0.000).CONCLUSION Mingmu Xiaoyao Granule can improve the visual field sensitivity of primary glaucoma patients(liver depression and blood deficiency syndrome)with stable intraocular pressure control,reduce the local damage to the visual field,protect the optic nerve,and adjust the emotional state of the whole body at the same time.
作者
张亿
桑子瑾
胡佩
何宇鹏
武丹蕾
张国亮
张婷婷
吴烈
ZHANG Yi;SANG Zijin;HU Pei;HE Yupeng;WU Danlei;ZHANG Guoliang;ZHANG Tingting;WU Lie(Guang´anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)
出处
《中国中医眼科杂志》
2023年第4期317-321,353,共6页
China Journal of Chinese Ophthalmology
基金
国家自然科学基金面上项目(81574030)。
关键词
疏肝养血
升阳通窍
明目逍遥颗粒
原发性青光眼
视神经损害
dispersing the stagnation of liver Qi and nourishing blood
promoting the spleen-yang and unblocking stuffy orifices
Mingmu Xiaoyao Granule
primary glaucoma
gaucomatous optic neuropathy
