益气养阴活血化瘀法对青光眼术后视神经的保护作用研究

摘要

目的 观察益气养阴活血化瘀法对青光眼术后患者视神经的保护作用.方法 将113例青光眼术后3个月、眼压控制≤18 mmHg(1 mmHg=0.133 kPa)且诊断有青光眼性视神经病变的患者随机分为2组,对照组(56例86眼)给予甲钴胺胶囊服用2个月,观察组(57例88眼)在对照组基础上给予自拟益气养阴活血化瘀方水煎服2个月,观察2组治疗前后矫正视力、眼压、视野(光敏度、缺损情况)、图像视觉诱发电位以及血液流变学指标(全血黏度高切、全血黏度低切、血浆黏度、血沉、纤维蛋白原、红细胞聚集指数)变化情况.结果 2组治疗后矫正视力、眼压、视野、图像视觉诱发电位均较治疗前显著改善(P均<0.05),且观察组矫正视力、光敏度、缺损情况、图像视觉诱发电位改善情况明显优于对照组(P均<0.05);治疗后,观察组全血黏度高切、全血黏度低切、血浆黏度、红细胞聚集指数均明显低于对照组(P均<0.05).结论 益气养阴活血化瘀法可有效提高青光眼术后患者视力,改善眼压和视野,其中改善部分血液流变学指标可能是中医益气养阴活血化瘀法发挥作用的重要机制.%Objective It is to observe the protective effect of supplementing Qi, nourishing Yin, and activating blood circulation to dissipate blood stasis method on optic nerve in patients after anti glaucoma surgery. Methods One hundred and thirteen patients who were diagnosed with glaucomatous optic neuropathy after 3 months of anti glaucoma surgery, in-traocular pressure control less than 18 mmHg (1 mmHg= 0. 133 kPa), were randomly divided into 2 groups. The control group (56 cases, 86 eyes) was given Mecobalamin Capsules for 2 months;the observation group (57 cases, 88 eyes) was given decoction of supplementing Qi, nourishing Yin, and activating blood circulation to dissipate blood stasis for 2 months on the basis of the control group. The changes of corrected visual acuity, intraocular pressure, visual field ( photosensitivi-ty, defect) , visual evoked potential and hemorheological indexes ( high shear whole blood viscosity, low shear whole blood viscosity, plasma viscosity, erythrocyte sedimentation rate, fibrinogen and erythrocyte aggregation index) were observed be-fore and after treatment in the 2 groups. Results After treatment, the corrected visual acuity, intraocular pressure, visual field and image visual evoked potentials in the 2 groups were significantly improved compared with those before treatment (all P<0. 05), and the corrected visual acuity, photosensitivity, defect and image visual evoked potential in the observa-tion group were significantly better than those in the control group (all P<0. 05). After treatment, the high shear whole blood viscosity, low shear whole blood viscosity, plasma viscosity and erythrocyte aggregation index in the observation group were significantly lower than before treatment and those in the control group (all P<0. 05). Conclusion Supplementing Qi, nourishing Yin, and activating blood circulation to dissipate blood stasis method can effectively improve eyesight of pa-tients after anti glaucoma surgery, ameliorate intraocular pressure and visual field, the improvement of some hemorheologi-cal indexes may be an important mechanism for TCM to supplementing Qi, nourishing Yin, and activating blood circulation to dissipate blood stasis.