益精补阳还五汤辅治开角型青光眼对其眼压及预后的影响
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摘要
目的:研究益精补阳还五汤辅治开角型青光眼患者对其眼压控制及预后影响效果。方法:选取我院2015-07/2017-07收治的开角型青光眼患者93例186眼。按照随机数字表法将所有患者分为两组。观察组47例94眼,给予马来酸噻吗洛尔滴眼液结合益精补阳还五汤辅助治疗;对照组46例92眼,仅使用马来酸噻吗洛尔滴眼液治疗。观察比较两组患者治疗后临床疗效,治疗前后视力、眼压、视网膜中央动脉血流测定值、平均缺损范围、视野平均光敏度以及图像诱发视觉电位情况。结果:观察组治疗后总有效率明显高于对照组(85. 1%vs63. 0%)(P<0. 01)。治疗后,观察组眼压明显低于对照组(P<0. 01)。观察组治疗后视网膜中央动脉血流RI测定值明显低于对照组(P<0. 01),PSA、EDV测定值明显高于对照组(P=0. 011、<0. 01)。观察组治疗后视野平均光敏度明显高于对照组(P=0. 001),平均缺损范围明显少于对照组(P=0. 011)。结论:使用益精补阳还五汤辅治开角型青光眼临床疗效显著,可有效控制患者眼压水平,扩大视野范围,促进血流循环,改善预后。
AIM: To study the effect of Yijing Buyang Huanwu Decoction on intraocular pressure control and prognosis in patients with open angle glaucoma.METHODS: Totally 93 patients( 186 eyes) with open angle glaucoma admitted to our hospital from July 2015 to July 2017 were selected. All patients were divided into two groups according to the random number table method. In the observation group,47 cases( 94 eyes) were treated with timolol eye drop combined with Yijing Buyang Huanwu Decoction,and in the control group,46 cases( 92 eyes) were treated with timolol eye drop only. The clinical effect,visual acuity,intraocular pressure,central retinal artery blood flow,mean defect area,visual field average photosensitivity and image evoked visual potential were observed and compared before and after treatment.RESULTS: The total effective rate of the observation group after treatment was significantly higher than that of the control group( 85.1% vs 63.0%,P<0.01). After treatment,the intraocular pressure in the observation group was significantly lower than that in the control group( P<0.01). After treatment,RI values of central retinal artery blood flow in observation group were significantly lower than those in control group( P < 0. 01). PSA and EDV values were significantly higher than those in control group( P = 0. 011,< 0. 01). After treatment,the average photosensitivity of the observation group was significantly higher than that of the control group( P = 0. 001),and the average defect area was significantly less than that of the controlgroup( P = 0.011).CONCLUSION: Yijing Buyang Huanwu Decoction is effective in the treatment of open angle glaucoma. It can effectively control the level of intraocular pressure,enlarge the visual field,promote blood circulation and improve the prognosis.
AIM: To study the effect of Yijing Buyang Huanwu Decoction on intraocular pressure control and prognosis in patients with open angle glaucoma.METHODS: Totally 93 patients( 186 eyes) with open angle glaucoma admitted to our hospital from July 2015 to July 2017 were selected. All patients were divided into two groups according to the random number table method. In the observation group,47 cases( 94 eyes) were treated with timolol eye drop combined with Yijing Buyang Huanwu Decoction,and in the control group,46 cases( 92 eyes) were treated with timolol eye drop only. The clinical effect,visual acuity,intraocular pressure,central retinal artery blood flow,mean defect area,visual field average photosensitivity and image evoked visual potential were observed and compared before and after treatment.RESULTS: The total effective rate of the observation group after treatment was significantly higher than that of the control group( 85.1% vs 63.0%,P<0.01). After treatment,the intraocular pressure in the observation group was significantly lower than that in the control group( P<0.01). After treatment,RI values of central retinal artery blood flow in observation group were significantly lower than those in control group( P < 0. 01). PSA and EDV values were significantly higher than those in control group( P = 0. 011,< 0. 01). After treatment,the average photosensitivity of the observation group was significantly higher than that of the control group( P = 0. 001),and the average defect area was significantly less than that of the controlgroup( P = 0.011).CONCLUSION: Yijing Buyang Huanwu Decoction is effective in the treatment of open angle glaucoma. It can effectively control the level of intraocular pressure,enlarge the visual field,promote blood circulation and improve the prognosis.
引文
1杨华,尹连荣,高健生,等.益精补阳还五汤对中晚期青光眼患者视神经保护作用的临床研究.中国中医眼科杂志2015;25(6):405-408
2 Wang F,Yang LI,Lan L,et al.Ser341Pro MYOC gene mutation in a family with primary open-angle glaucoma.Int J Mol Med 2015;35(5):1230-1236
3韩光杰,周和政,张文强,等.有无前列腺素类药物对眼压控制的原发性开角型青光眼患者24h眼压的影响.临床眼科杂志2015;23(1):59-61
4王佳.曲伏前列素滴眼液对开角型青光眼眼压、血流动力学的影响及其相关性分析.临床眼科杂志2017;25(4):296-298
5蔡萧君,赵晓龙.疏肝明目汤联合甲钴胺对肝郁气滞型原发性开角型青光眼患者眼压视敏度及CRP的影响分析.河北医学2017;23(4):675-679
6李建超,彭俊,曾志成,等.原发性开角型青光眼患者眼血流动力学的改变及与中医证型关系的研究.湖南中医药大学学报2016;36(12):27-30
7李璇,刘茁,何志,等.马来酸噻吗洛尔联合拉坦前列腺素治疗高眼压型开角型青光眼的效果.现代生物医学进展2015;15(25):4967-4970
8 Gong B,Qu C,Li X,et al.Mutation spectrum of CYP1B1 in Chinese patients with primary open-angle glaucoma.Br J Ophthalmol 2015;99(3):425-430
9 Yao YH,Wang YQ,Fang WF,et al.A recurrent G367R mutation in MYOC associated with juvenile open angle glaucoma in a large Chinese family.Int J Ophthalmol 2018;11(3):369-374
10白建民.加味益精补阳还五汤对青光眼术后患者视神经的保护作用.辽宁中医杂志2017;44(11):2351-2353
11 Lee JA,Han K,Min JA,et al.Associations of sleep duration with open angle glaucoma in the Korea national health and nutrition examination survey.Medicine 2016;95(52):4258-4267
12尹连荣,高健生.益精补阳还五汤不同组分对高眼压大鼠视网膜神经节细胞保护差异研究.辽宁中医杂志2015;42(10):2008-2011
13 Restrepo NA,Bailey JNC.Primary Open-Angle Glaucoma Genetics in African Americans.Curr Genet Med Rep 2017;5(4):167-174
14 Wen W,Zhang P,Liu T,et al.A Novel Motion-on-Color Paradigm for Isolating Magnocellular Pathway Function in Preperimetric Glaucoma.Invest Ophthalmol Vis Sci 2015;56(8):4439-4446
15 Wang L,Sha F,Guo DD,et al.Efficacy and economic analysis of ExPRESS implantation versus trabeculectomy in uncontrolled glaucoma:a systematic review and Meta-analysis.Int J Ophthalmol 2016;9(1):124-131
16 Pappas T,Founti P,Yin XJ,et al.Structure-Function Correlation Using Confocal Laser Ophthalmoscope in Primary Open-Angle Glaucoma and Pseudoexfoliative Glaucoma.J Glaucoma 2016;25(4):377-382
17 Bailey JN,Loomis SJ,Kang JH,et al.Genome-wide association analysis identifies TXNRD2,ATXN2 and FOXC1 as susceptibility loci for primary open-angle glaucoma.Nat Genet 2016;48(2):189-194
18 Chao L,Na L,Bin L,et al.A meta-analysis of neuroprotective effect for traditional Chinese medicine(TCM)in the treatment of glaucoma.Open Med(Wars)2016;11(1):25-30
19 Li B,Wang FY,Lv TL,et al.Effects of phacoemulsification and intraocular lens implantation combined with ciliarotomy in the treatment of angle-closure glaucoma with cataract.Exp Ther Med 2016;12(4):2501-2504
20张国亮,吴烈,杨迎新,等.清肝降压胶囊控制早期原发性开角型青光眼患者眼压的临床观察.中国中医眼科杂志2015;25(2):122-125
2 Wang F,Yang LI,Lan L,et al.Ser341Pro MYOC gene mutation in a family with primary open-angle glaucoma.Int J Mol Med 2015;35(5):1230-1236
3韩光杰,周和政,张文强,等.有无前列腺素类药物对眼压控制的原发性开角型青光眼患者24h眼压的影响.临床眼科杂志2015;23(1):59-61
4王佳.曲伏前列素滴眼液对开角型青光眼眼压、血流动力学的影响及其相关性分析.临床眼科杂志2017;25(4):296-298
5蔡萧君,赵晓龙.疏肝明目汤联合甲钴胺对肝郁气滞型原发性开角型青光眼患者眼压视敏度及CRP的影响分析.河北医学2017;23(4):675-679
6李建超,彭俊,曾志成,等.原发性开角型青光眼患者眼血流动力学的改变及与中医证型关系的研究.湖南中医药大学学报2016;36(12):27-30
7李璇,刘茁,何志,等.马来酸噻吗洛尔联合拉坦前列腺素治疗高眼压型开角型青光眼的效果.现代生物医学进展2015;15(25):4967-4970
8 Gong B,Qu C,Li X,et al.Mutation spectrum of CYP1B1 in Chinese patients with primary open-angle glaucoma.Br J Ophthalmol 2015;99(3):425-430
9 Yao YH,Wang YQ,Fang WF,et al.A recurrent G367R mutation in MYOC associated with juvenile open angle glaucoma in a large Chinese family.Int J Ophthalmol 2018;11(3):369-374
10白建民.加味益精补阳还五汤对青光眼术后患者视神经的保护作用.辽宁中医杂志2017;44(11):2351-2353
11 Lee JA,Han K,Min JA,et al.Associations of sleep duration with open angle glaucoma in the Korea national health and nutrition examination survey.Medicine 2016;95(52):4258-4267
12尹连荣,高健生.益精补阳还五汤不同组分对高眼压大鼠视网膜神经节细胞保护差异研究.辽宁中医杂志2015;42(10):2008-2011
13 Restrepo NA,Bailey JNC.Primary Open-Angle Glaucoma Genetics in African Americans.Curr Genet Med Rep 2017;5(4):167-174
14 Wen W,Zhang P,Liu T,et al.A Novel Motion-on-Color Paradigm for Isolating Magnocellular Pathway Function in Preperimetric Glaucoma.Invest Ophthalmol Vis Sci 2015;56(8):4439-4446
15 Wang L,Sha F,Guo DD,et al.Efficacy and economic analysis of ExPRESS implantation versus trabeculectomy in uncontrolled glaucoma:a systematic review and Meta-analysis.Int J Ophthalmol 2016;9(1):124-131
16 Pappas T,Founti P,Yin XJ,et al.Structure-Function Correlation Using Confocal Laser Ophthalmoscope in Primary Open-Angle Glaucoma and Pseudoexfoliative Glaucoma.J Glaucoma 2016;25(4):377-382
17 Bailey JN,Loomis SJ,Kang JH,et al.Genome-wide association analysis identifies TXNRD2,ATXN2 and FOXC1 as susceptibility loci for primary open-angle glaucoma.Nat Genet 2016;48(2):189-194
18 Chao L,Na L,Bin L,et al.A meta-analysis of neuroprotective effect for traditional Chinese medicine(TCM)in the treatment of glaucoma.Open Med(Wars)2016;11(1):25-30
19 Li B,Wang FY,Lv TL,et al.Effects of phacoemulsification and intraocular lens implantation combined with ciliarotomy in the treatment of angle-closure glaucoma with cataract.Exp Ther Med 2016;12(4):2501-2504
20张国亮,吴烈,杨迎新,等.清肝降压胶囊控制早期原发性开角型青光眼患者眼压的临床观察.中国中医眼科杂志2015;25(2):122-125