剔络养血明目汤对正常眼压性青光眼患者眼部血流的影响  

Effects of Tiluo Yangxue Mingmu Decoction on Ocular Blood Flow in Patients with Normal-Tension Glaucoma

作　　者：侯文博 冯俊[1] 李欣[1] 王玮[1] HOU Wenbo;FENG Jun;LI Xin;WANG Wei(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing 100040,China)

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《中国中医眼科杂志》2024年第6期525-529,共5页China Journal of Chinese Ophthalmology

基　　金：首都临床特色应用研究项目(Z181100001718045)。

摘　　要：目的观察剔络养血明目汤对正常眼压性青光眼(NTG)患者眼部血流的影响。方法纳入2018年6月—2021年12月中国中医科学院眼科医院诊治的NTG患者32例(63只眼),辨证为瘀血阻络证。随机分为治疗组20例(39只眼)和对照组12例(24只眼)。对照组予银杏叶片和甲钴胺片口服;治疗组在对照组的基础上联合剔络养血明目汤口服。2组均观察28 d。分别于治疗前、后检测受试者的视神经总扫描区域的血流密度(VD1)及视盘周围毛细血管区域的血流密度(VD2),视网膜中央动脉(CRA)和睫状后短动脉(SPCA)的收缩峰值速度(PSV)、舒张末期速度(EDV)和阻力指数(RI)。结果2组治疗前VD1、VD2、EDV、PSV和RI比较,差异均无统计学意义(P>0.05);且对照组治疗后VD1、VD2、CRA和SPCA的PSV、EDV、RI与治疗前比较,差异均无统计学意义(P>0.05)。(1)VD:治疗组治疗后VD1、VD2均较治疗前升高,差异均有统计学意义(tVD1=6.739、tVD2=8.285,均P=0.000)。治疗后2组间VD1、VD2比较,差异无统计学意义(P>0.05)。治疗组治疗前、后的VD1差值与VD2差值均高于对照组,差异均有统计学意义(tVD1=5.599、tVD2=6.210,均P=0.000)。(2)眼部血管血流动力学参数:治疗组治疗后CRA的EDV较治疗前增加、RI较治疗前降低,差异均有统计学意义(tEDV=3.096,P=0.003;tRI=2.446,P=0.017);治疗后2组间CRA的各指标比较,差异均无统计学意义(P>0.05)。治疗组治疗后SPCA的PSV、EDV均较治疗前增加,差异均有统计学意义(tPSV=2.481,P=0.015;tEDV=2.315,P=0.023);治疗后2组间SPCA的各指标比较,差异均无统计学意义(P>0.05)。结论剔络养血明目汤可改善NTG患者的眼部血流,尤其是视神经血流。OBJECTIVE To observe the effects of Tiluo Yangxue Mingmu Decoction on ocular blood flow in patients with normal-tension glaucoma(NTG).METHODS A total of 32 NTG patients(63 eyes),diagnosed with blood stasis obstruction pattern,treated at the Eye Hospital of China Academy of Chinese Medical Sciences from June 2018 to December 2021,were randomly divided into a treatment group(20 cases,39 eyes)and a control group(12 cases,24 eyes).The control group received oral administration of Ginkgo biloba leaf extract and mecobalamin tablets,while the treatment group received Tiluo Yangxue Mingmu Decoction in addition to the control group's treatment.Both groups were observed for 28 days.Ocular blood flow parameters including vessel density(VD1 and VD2)in the total optic nerve head scan area,peak systolic velocity(PSV),end-diastolic velocity(EDV),and resistance index(RI)of the central retinal artery(CRA)and short posterior ciliary artery(SPCA)were measured before and after treatment.RESULTS There were no significant differences in VD1,VD2,EDV,PSV,and RI between the two groups before treatment(P>0.05).Additionally,there were no significant differences in VD1,VD2,CRA,and SPCA PSV,EDV,and RI between before and after treatment in the control group(P>0.05).(1)VD:After treatment,VD1 and VD2 in the treatment group were significantly increased compared to before treatment(tVD1=6.739,tVD2=8.285,both P=0.000).There were no significant differences in VD1 and VD2 between the two groups after treatment(P>0.05).The difference values of VD1 and VD2 before and after treatment in the treatment group were significantly higher than those in the control group(tVD1=5.599,tVD2=6.210,both P=0.000).(2)Regarding ocular vascular hemodynamic parameters:In terms of ocular blood flow parameters,EDV of CRA in the treatment group after treatment was significantly increased,and RI was significantly decreased compared to before treatment(tEDV=3.096,P=0.003;tRI=2.446,P=0.017).There were no significant differences in all indicators of CRA between the two groups a

关 键 词：正常眼压性青光眼 血流密度 剔络养血明目汤 

分 类 号：R276.7[医药卫生—中医五官科学]