牵正散联合肉毒素及复方樟柳碱治疗目偏视临床研究  

Qianzheng powder combined with botulinum toxin A extraocular injection and compound anisodine subcutaneous injection in treatment of eye deviation

作　　者：杨霞霞 闫瑾 张自峰 张桂鸥 YANG Xiaxia;YAN Jin;ZHANG Zifeng;ZHANG Guiou(Department of Ophthalmology,Xijing Hospital,Air Force Medical University,Xi’an 710032,China)

机构地区：[1]空军军医大学西京医院眼科,陕西西安710032 [2]西安医学院医学技术学院眼视光教研室,陕西西安710021

出　　处：《陕西中医》2024年第10期1377-1381,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：陕西省自然科学基础研究计划项目(2023-JC-YB-772);陕西省重点研发计划项目(2024SF-YBXM-320)。

摘　　要：目的:评价牵正散加减联合A型肉毒素(BTA)眼外肌注射及复方樟柳碱颞浅皮下注射治疗目偏视的临床疗效。方法:收集诊断为目偏视(麻痹性内斜视)的患者79例(93眼),根据治疗方案分组:营养神经等基础治疗者27例(31眼)纳入对照组;基础治疗加用BTA眼外肌注射及复方樟柳碱颞浅皮下注射者28例(33眼)纳入注射组;注射组基础上加用牵正散加减者24例(29眼)纳入联合组。观察比较三组患者治疗前后三棱镜斜视度、患眼外直肌功能、临床症状评分、疗程及疗效。结果:治疗后三组患者斜视度、患眼外展功能、临床症状总评分均较治疗前好转,差异有统计学意义(均P<0.01);三组间患者斜视度、患眼外展功能、临床症状总评分改善差异有统计学意义(P<0.05),其中联合组较对照组和注射组改善更佳,差异有统计学意义(均P<0.05)。联合组治愈率(70.8%)高于对照组(44.4%)及注射组(35.7%),差异有统计学意义(P<0.05)。治愈者中联合组患者疗程更短,较其余两组差异有统计学意义(P<0.05)。结论:牵正散加减联合A型肉毒素眼外肌注射及复方樟柳碱颞浅皮下注射是治疗目偏视(麻痹性内斜视)的有效方法,可降低斜视度数、改善外直肌功能及临床症状评分、缩短疗程、提高治愈率。Objective:To evaluate the clinical efficacy of Qianzheng powder combined with botulinum toxin A(BTA)extraocular injection and compound anisodine subcutaneous injection in the treatment of eye deviation.Methods:A retrospective analysis was performed.A total of 79 patients(93 eyes)diagnosed with eye deviation(paralytic esotropia)were collected.They were grouped according to the treatment plan:27 patients(31 eyes)who received basic treatment such as nutritional support for nerves were included in the control group;28 patients(33 eyes)who were treated with botulinum toxin A extraocular injection and compound anisodine subcutaneous injection were included in the injection group;the combination group,in addition to the treatment provided to the injection group,received additional Qianzheng powder,consisting of 24 cases(29 eyes).The degree of tricprism strabismus,the function of the affected external rectus muscle,the score of clinical symptoms,the course of treatment and the curative effect of the three groups were observed and compared.Results:After treatment,the degree of strabismus,the abduction function of the affected eye and the total score of clinical symptoms of the three groups were improved compared with that before treatment,and the differences were statistically significant(P<0.01).There were statistical differences in the improvement of strabismus,abductive function of affected eye and total score of clinical symptoms among the three groups(P<0.05).The combination group improved more than the control group and the injection group,and the difference was statistically significant(P<0.05).The cure rate of combination group(70.8%)was higher than that of control group(44.4%)and injection group(35.7%),and the difference was statistically significant(P<0.05).Moreover,the treatment course was shorter in the combination group than that of the other two groups,and the difference was also statistically significant(P<0.05).Conclusion:Qianzheng powder combined with botulinum toxin A extraocular injection and compound a

关 键 词：目偏视 麻痹性内斜视 牵正散 A型肉毒素 复方樟柳碱 

分 类 号：R276.7[医药卫生—中医五官科学]