活血化瘀方对青光眼视盘血流的作用观察  

An Observation on the Effect of Huoxue Huayu Formula on Optic Disc Blood Flow in Glaucoma

作　　者：于敬妮[1] 吕泽仪 何军强[3] 龚珂[1] 王双梅[1] 邵娟[1] Yu Jingni;Lü Zeyi;He Junqiang;Gong Ke;Wang Shuangmei;Shao Juan(Xi'an Fourth Hospital,Xian Shaanxi,710004;The First Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou Guangdong,250001;Nanyang Medical College,Nanyang Henan,473061)

机构地区：[1]西安市第四医院,陕西西安710004 [2]广州中医药大学第一临床医学院,广东广州250001 [3]南阳医学高等专科学校,河南南阳473061

出　　处：《现代中医药》2020年第6期66-69,76,共5页Modern Chinese Medicine

基　　金：国家自然科学基金面上项目(81273902);西安市卫生局项目(J201601013)。

摘　　要：目的通过血流OCT(OCTA)观察活血化瘀方对晚期青光眼(青风内障、青盲)视盘血流的影响。方法把晚期青光眼患者,进行辨证分型,临床辩证为血瘀兼肝肾不足的晚期青光眼患者79例,随机分为治疗组和对照组,治疗组48例84只眼,对照组31例54只眼,对照组采用降眼压治疗,治疗组降眼压治疗并给予活血化瘀方治疗,于治疗前、治疗后3月,分别检测最佳矫正视力(BCVA)、视盘各层血流OCT,观察BCVA及视盘血流情况。结果治疗组BCVA提高66只眼,总有效率84.4%,对照组视力提高18只眼,总有效率33.3%,两组疗效差异有显著性(P<0.05);治疗组视盘血流4层血管均有显著改变,总有效率均大于84.5%,对照组视盘血流4层血管仅有部分改变,总有效率为24.1%~31.5%,两组疗效差异有显著性(P<0.05)。结论活血化瘀方通过扶正祛瘀,能明显增加视盘血流微循环,改善视网膜神经节细胞微环境,最终拯救受损的视功能,将成为传统青光眼降眼压治疗的一种重要的治疗措施。Objective To observe the effect of Huoxue Huayu(activating blood and dispersing stasis)Formula on optic disc blood flow in advanced glaucoma(glaucoma, glaucoma blindness) through blood flow OCT(OCTA). Methods 79 advanced glaucoma patients who were clinically diagnosed as blood stasis and liver associated with kidney deficiency were randomly divided into treatment group and control group among which 48 cases in former with 84 eyes and 31 cases in the latter with 54 eyes. The control group was treated by lowering intraocular pressure while the treatment group was treated by lowering intraocular pressure plus Huoxue Huayu Decoction. 3 months before and after treatment, the best corrected visual acuity(BCVA) and OCT of each layer of optic disc were tested and observe BCVA as well as optic disc blood flow. Results The BCVA in the treatment group increased in 66 eyes with a total effective rate of 84.4%, and the visual acuity of the control group increased in 18 eyes with a total effective rate of 33.3%. There was a significant difference in efficacy between the two groups(P<0.05);All have significant changes, the total effective rate was greater than 84.5% while the optic disc blood flow in the control group had only partial changes in the 4 layers of blood vessels, the total effective rate was 24.1%-31.5%, so the difference between the two groups was significant(P<0.05). Conclusion Huoxue Huayu Decoction can significantly increase the blood flow microcirculation of the optic disc, improve the microenvironment of retinal ganglion cells, and ultimately save the impaired visual function by strengthening the body and removing blood stasis, which will become an important treatment to lower intraocular pressure for traditional glaucoma.

关 键 词：活血化瘀方 血流OCT 青光眼 视盘 

分 类 号：R773[医药卫生—眼科]