青盲复明方联合针刺治疗视神经萎缩的临床观察  

Clinical Observation on the Treatment of Optic Atrophy with Qingmang Fuming Pre⁃scription Combined with Acupuncture

作　　者：冀佳豪 张洁 陈小华[2] 戎曙欣[2] 王晓玲[2] 曹钰晴 JI Jiahao;ZHANG Jie;CHEN Xiaohua;RONG Shuxin;WANG Xiaoling;CAO Yuqing(Hebei University of Chinese Medicine,Shijiazhuang 050091,China;Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 065900,China)

机构地区：[1]河北中医药大学,石家庄050091 [2]河北省中医院,石家庄065900

出　　处：《中国中医眼科杂志》2025年第2期121-126,共6页China Journal of Chinese Ophthalmology

基　　金：河北省中医药管理局科研项目计划(2019019)。

摘　　要：目的观察自拟方青盲复明方联合针刺治疗视神经萎缩(OA)患者的临床疗效。方法纳入2022年10月—2023年10月河北省中医院确诊为肝郁脾虚证OA患者65例(65只眼)。双眼发病者,则纳入右眼。采用随机数字表法分为对照组和治疗组,最终每组纳入30例(30只眼)。对照组予胞磷胆碱钠胶囊及甲钴胺片口服,治疗组在对照组的基础上联合青盲复明方及针刺治疗,2组均观察28 d。分别于治疗前和治疗后检测受试者的最佳矫正视力(BCVA)、视野相关指标和中医症候积分。结果(1)BCVA:治疗前后比较,2组治疗后BCVA均较治疗前改善,差异均有统计学意义(t治疗组=8.915、t对照组=4.086,均P=0.000)。治疗后2组间比较,治疗组BCVA优于对照组,差异有统计学意义(t=2.211,P=0.031)。(2)视野相关指标:治疗前后比较,2组治疗后MD均较治疗前降低(t治疗组=13.509、t对照组=7.562,均P=0.000),MS均较治疗前升高(t治疗组=7.579、t对照组=4.289,均P=0.000),差异均有统计学意义。治疗后2组间比较,治疗组MD低于对照组,MS高于对照组,差异均有统计学意义(tMD=9.785,P=0.000;tMS=2.977,P=0.004)。(3)中医症候积分:治疗前后比较,2组治疗后中医症候积分均较治疗前降低,差异均有统计学意义(t治疗组=19.240、t对照组=5.503,均P=0.000)。治疗后2组间比较,治疗组中医症候积分低于对照组,差异有统计学意义(t=9.489,P=0.000)。(4)临床疗效:治疗组的总有效率为86.67%,高于对照组的36.67%,差异有统计学意义(χ2=15.864,P=0.000)。结论自拟青盲复明方联合针刺治疗肝郁脾虚证OA患者具有良好疗效,能够有效地提高视力,改善视野缺损状态,明显改善临床症状。OBJECTIVE To observe the clinical efficacy of Qingmang Fuming Prescription combined with acupuncture in the treatment of patients with optic atrophy(OA).METHODS A total of 65 patients(65 eyes)with OA diagnosed with liver depression and spleen deficiency syndrome in Hebei Provincial Hospital of Traditional Chinese Medicine from October 2022 to October 2023 were enrolled.For patients with bilateral onset,the right eye was included.Patients were randomly divided into a control group(CG)and a treatment group(TG)using a random number table,with 30 patients(30 eyes)in each group ultimately.The control group received oral citicoline sodium capsules and mecobalamin tablets,while the treatment group received Qingmang Fuming Prescription and acupuncture in addition to the treatment given to the control group.Both groups were observed for 28 days.Best corrected visual acuity(BCVA),visual field-related indicators,and Traditional Chinese Medicine(TCM)syndrome scores were measured before and after treatment.RESULTS(1)BCVA:After treatment,both groups showed improved BCVA compared with before treatment,with statistically significant differences(tTG=8.915,tCG=4.086,both P=0.000).Comparison between the two groups after treatment showed that the BCVA of the treatment group was better than that of the control group,with a statistically significant difference(t=2.211,P=0.031).(2)Visual field-related indicators:After treatment,both groups showed decreased mean deviation(MD)compared with before treatment(tTG=13.509,tCG=7.562,both P=0.000)and increased mean sensitivity(MS)compared with before treatment(tTG=7.579,tCG=4.289,both P=0.000),with statistically significant differences.Comparison between the two groups after treatment showed that the MD of the treatment group was lower than that of the control group,and the MS of the treatment group was higher than that of the control group,with statistically significant differences(tMD=9.785,P=0.000;tMS=2.977,P=0.004).(3)TCM syndrome scores:After treatment,both groups showed decreased TCM synd

关 键 词：气机升降理论 青盲复明方 针刺 肝郁脾虚证 视神经萎缩 

分 类 号：R774.6[医药卫生—眼科] R246.82[医药卫生—临床医学]