活血通络颗粒对缺血性视神经病变的临床研究

Clinical studies of Huoxuetongluo granula on the treatment of ischemic optic neuropathy

摘要:

目的：探讨活血通络颗粒对气虚血瘀型非动脉炎性前部缺血性视神经病变的临床疗效。

方法：采用随机对照试验，将100例非动脉炎性前部缺血性视神经病变患者随机分为对照组和治疗组，治疗组51例72眼，对照组49例70眼。对照组给予复方樟柳碱注射液颞浅动脉旁注射，2mL/次，1次/d。在上述治疗的基础上，治疗组患者加用活血通络颗粒(10g/次，口服，2次/d)进行干预。3mo后，观察并分析两组患者视神经病变的总体疗效、视力、视野平均光敏感度、血脂水平及血液流变学指标的改善情况。

结果：治疗后，治疗组患者视神经病变的总有效率为88.2%，显著高于对照组71.4%(Z=2.890，P=0.004)； 治疗组患者的视力和视野平均敏感度均显著性提高，差异有统计学意义(t=-4.65，P<0.01； t=-3.69，P=0.0004)； 治疗组患者的血清总胆固醇、甘油三脂、低密度脂蛋白胆固醇水平较治疗前均下降，高密度脂蛋白胆固醇较治疗前升高，差异有统计学意义(t=6.25，P<0.01； t=4.14，P<0.01； t=4.48，P<0.01； t=3.76，P=0.0003； t=-4.31，P<0.01)； 治疗组患者的全血高切黏度、低切黏度、血浆黏度和血浆纤维蛋白原均显著降低(t=3.40，P=0.0011； t=5.75，P<0.01； t=3.61，P=0.0005； t=6.78，P<0.01； t=3.13，P=0.0025)。

结论：复方樟柳碱注射液联合活血通络颗粒可显著改善NAION患者的视力、视野、血脂水平和血液流变学指标。

Abstract:

AIM: To evaluate the clinical efficacy of Huoxuetongluo granula on the treatment of qi deficiency and blood stasis type of non-arteritic anterior ischemic optic neuropathy(NAION).

METHODS: A total of 100 patients with NAION were enrolled in the randomized controlled trial. They were divided into control group(49 cases with 70 eyes)and treatment group(51 cases with 72 eyes). The patients in control group were treated with only injections of compound anisodine(CA)beside superficial temporal artery,2ml each time, once per day. The patients in treatment group received huoxuetongluo granula, 10g each time, twice per days, besides CA. Patients were followed up for 3mo, and the overall cure effect, visual acuity, mean sensitivity(MS), serum lipid levels and hemorheology indicators were measured and analyzed.

RESULTS: After treatments, the total effective rate of treatment group were 88.2%, which was significantly higher than that of the control group(71.4%)(Z=2.890,P=0.004). Compared with the control group, the visual acuity and MS of treatment group were significantly higher and the differences were statistical(t=-4.65,P<0.0001; t=-3.69,P=0.0004). The TC, TG and low-density lipoprotein cholesterol(LDL-C)levels were significantly lower, the high-density lipoprotein cholesterol(HDL-C)significantly increased than those before treatments(t=6.25, P<0.01; t=4.14,P<0.01; t=4.48, P<0.01; t=3.76, P=0.0003; t=-4.31, P<0.01). After treatments, the whole blood high shear viscosity, low shear viscosity, plasma viscosity and fibrinogen of the treatment group were significantly lower than those of control group(t=3.40, P=0.0011; t=5.75; P<0.01; t=3.61, P=0.0005; t=6.78, P<0.01; t=3.13, P=0.0025).

CONCLUSION: The combination of CA and huoxuetongluo granula can improve the visual acuity, MS, serum lipid levels and hemorheology indicators significantly.