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目的观察补肾活血中药对原发性青光眼术后眼压已控制患者视神经的保护作用。方法采用前瞻性研究方法收集已行抗青光眼手术且眼压已控制的原发性青光眼患者36例,随机分为对照组与治疗组,对照组仅予卡替洛尔滴眼液控制眼压,治疗组在对照组基础上给予口服补肾活血中药3个疗程,每个疗程2个月,共6个月。观察用药前后视力、眼压、视野、视神经视网膜扫描、视觉电生理(VEP)等指标的变化。结果治疗组和对照组用药前后视力、眼压无明显变化。与用药前比较,治疗组用药后视野平均光敏感度(MS)、平均缺损(MD)、丢失方差(LV)、平均视网膜神经纤维(RNFL)厚度、图形视觉诱发电位(LP100,AP100)差异均有统计学意义(P<0.05);杯盘比(C/D)、盘沿面积(RA)与用药前比较差异无统计学意义(P>0.05)。对照组用药前后各指标无显著性差异。与对照组用药后比较,治疗组用药后MS、MD、LV、平均RNFL厚度、LP100、AP100有显著性差异(P<0.05),MS无显著性差异(P>0.05)。结论补肾活血中药可改善原发性青光眼术后眼压已控制患者的视野、图形视觉诱发电位及视网膜神经纤维层厚度等指标,从而保护青光眼患者视神经和视功能。
Objective To observe the protective effect of Bushen Huoxue Chinese medicine on the optic nerve which has been controlled by intraocular pressure in patients with primary glaucoma. Methods A prospective study was conducted to collect 36 patients with primary glaucoma undergoing glaucoma surgery and controlled intraocular pressure. The patients were randomly divided into control group and treatment group. The control group received intraocular pressure (IOP) only by carteolol eye drops, On the basis of the control group, the treatment group was given 3 courses of Chinese medicine for invigorating the kidney and promoting blood circulation, each for 2 months for a total of 6 months. Visual acuity, intraocular pressure, visual field, optic nerve retinal scan and visual electrophysiology (VEP) were observed before and after treatment. Results There was no significant change in visual acuity and intraocular pressure before and after treatment in the treatment group and the control group. Compared with those before treatment, the mean field of view light sensitivity (MS), average defect (MD), loss of variance (LV), average thickness of retinal nerve fiber (RNFL), and visual evoked potentials (LP100, AP100) Statistical significance (P <0.05); There was no significant difference between the C / D ratio and RA area before administration (P> 0.05). There was no significant difference in each index before and after treatment in the control group. Compared with the control group, MS, MD, LV, average RNFL thickness, LP100 and AP100 after treatment were significantly different (P <0.05). There was no significant difference between the two groups (P> 0.05). Conclusion Bushen Huoxue Chinese medicine can improve the visual field and visual evoked potentials of retinal nerve fiber layer in patients with primary glaucoma after IOP control and thus protect optic nerve and visual function in patients with glaucoma.