银杏叶提取物联合灯盏细辛防治青光眼术后神经损伤的临床研究

摘要

Objective To investigate the effect of ginkgo biloba extract combined fleabane on nerve damage prevention and treatment after glaucoma surgery.Methods Total of 95 cases (145 eyes) admitted to Mianyang City Third People′s Hospital from Jan.2012 to Nov.2014 were included in the study and divi-ded into ginkgo biloba extract group(group A,32 cases,46 eyes),fleabane group(group B,32 cases,51 eyes) and ginkgo biloba extract combined fleabane group( group C,31 cases,48 eyes) according to random number table method.Group A was given oral ginkgo biloba capsules,1 capsule per time,1 time per day;group B was treated with fleabane( Yimaikang tablets) orally,2 tablets per time,1 time per day;group C was treated with ginkgo biloba extract and fleabane.Each group received treatment for three months continuously. Then the visual acuity,intraocular pressure( IOP) and visual field of the three groups before and after treat-ment were measured.Results The efficacy of group C was significantly higher than group A and group B [14.6(7/48)vs 6.5%(3/46),7.8%(4/51)](P<0.05).The value of IOP in the order of group A,B,C after treatment was (13.8 ±1.2) mmHg,(13.6 ±1.5) mmHg,(13.1 ±1.3) mmHg respectively,the IOP of group was significantly lower than group A(P <0.05).After treatment,the average light sensitivity of group C was significantly higher than that in group A and group B[(22 ±9) dB vs (18 ±7) dB,(19 ± 7) dB](P<0.05).The average defect of group C was significantly lower than group A and group B[(12 ± 3) dB vs (14 ±4) dB,(13 ±4) dB](P<0.05).Conclusion Ginkgo biloba extract combined fleabane has better effect than single application of ginkgo biloba extract or fleabane on reducing IOP ,improving vision and visual acuity,thus is worthy of clinical application.%目的：探讨银杏叶提取物联合灯盏细辛防治青光眼术后神经损伤的作用。方法选取2012年1月至2014年11月在绵阳市第三人民医院接受青光眼小梁切除术的患者95例（145眼），依据随机数字表法分为银杏叶提取物组（A 组）、灯盏细辛组（B组）和银杏叶提取物联合灯盏细辛组（C组），其中A组32例（46眼），B组32例（51眼），C 组31例（48眼）。 A 组患者给予银杏叶胶囊口服，每次1片，每日1次；B组患者给予灯盏细辛（益脉康片）口服，每次2片，每日1次；C组患者给予银杏叶提取物和细辛灯盏，剂量与用法同A、B组。各组连续服用3个月。分别在治疗前后对三组患者视力、眼压和视野进行测定。结果 C 组患者有效率明显高于 A 组和 B 组[14．6（7／48）比6．5％（3／46）、7．8％（4／51）]，差异有统计学意义（P＜0．05）。治疗后A、B、C组眼压依次为（13．8±1．2） mmHg（1 mmHg＝0．133 kPa）、（13．6±1．5） mmHg、（13．1±1．3） mmHg，C组眼压低于A组，差异有统计学意义（P＜0．05）。治疗后 C 组患者平均光敏度显著高于 A 组和 B 组[（22±9） dB 比（18±7） dB、（19±7） dB]，差异有统计学意义（ P ＜0．05）；C 组患者平均缺损度显著低于 A 组和B组[（12±3） dB比（14±4） dB、（13±4） dB]，差异有统计学意义（ P＜0．05）。结论与单纯应用银杏叶提取物或灯盏细辛相比，银杏叶提取物联合灯盏细辛能更有效地降低青光眼患者术后眼内压，改善视野，提高患者视力，值得临床推广使用。