摘要
目的探究球后视神经炎患者采用龙胆泻肝汤联合甲强龙冲击治疗的效果及安全性。方法选取成武县人民医院2020年10月—2022年9月收治的108例球后视神经炎患者为研究对象,按随机数字表法将其分为对照组(n=54)及观察组(n=54)。对照组采用甲强龙冲击治疗,观察组在此基础上采用龙胆泻肝汤治疗。对比两组患者的视功能恢复优良率、中医证候评分、视野、视力、血清学指标及不良反应发生情况。结果观察组的视功能恢复优良率为94.44%,高于对照组的74.07%,差异有统计学意义(P<0.05)。治疗后,观察组的目赤肿痛、头晕眼花、视物不清、畏光流泪等中医证候评分分别为(0.54±0.03)分、(0.66±0.28)分、(0.57±0.16)分、(0.68±0.14)分,均低于对照组的(1.01±0.24)分、(1.05±0.33)分、(1.12±0.13)分、(1.11±0.15)分,组间差异有统计学意义(P<0.05);观察组的视盘水肿高度、视野缺损分别为(263.75±51.56)μm、(0.49±0.13)dB,均低于对照组的(328.94±50.95)μm、(1.02±0.46)dB,最佳矫正视力为(0.72±0.15),高于对照组的(0.55±0.16),视神经纤维层厚度为(109.47±18.6)μm,厚于对照组的(86.73±15.24)μm,组间差异有统计学意义(P<0.05);观察组的干扰素γ、肿瘤坏死因子-α水平分别为(60.13±6.58)pg/mL、(1.08±0.23)ng/mL,均低于对照组的(67.98±6.43)pg/mL、(2.22±0.25)ng/mL,血清补体C_(3)、血清补体C_(4)水平分别为(111.45±16.38)mg/dL、(28.57±2.25)mg/dL,均高于对照组的(95.44±15.67)mg/dL、(24.32±2.21)mg/dL,组间差异有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论采用龙胆泻肝汤联合甲强龙冲击治疗球后视神经炎的效果确切,能改善患者视野、视力,缓解其临床症状,减轻炎性损伤,增强免疫功能,且安全性良好,值得临床推广使用。
Objective To explore the efficacy and safety of Longdan Xiegan Decoction combined with methylprednone pulse therapy in patients with retrobulbus optic neuritis.Methods 108 patients with retrobulbar optic neuritis admitted to the Chengwu County People's Hospital from October 2020 to September 2022 were selected as the study objects,and were divided into a control group(n=54)and an observation group(n=54)according to random number table method.The control group was treated with methylprednisolone pulse therapy,and the observation group was treated with Longdan Xiegan Decoction on this basis.The excellent and good rate of visual function recovery,TCM syndrome scores,visual field,visual acuity,serological indexes and occurrence of adverse reactions were compared between the two groups.Results The rate of visual function recovery in the observation group was 94.44%,which was higher than 74.07%in the control group,and the difference was statistically significant(P<0.05).After treatment,the TCM syndrome scores of eye swelling and pain,dizziness,blurred vision and photophobic tears in the observation group were(0.54±0.03)points,(0.66±0.28)points,(0.57±0.16)points and(0.68±0.14)points,respectively,which were lower than(1.01±0.24)points,(1.05±0.33)points,(1.12±0.13)points,(1.11±0.15)points in the control group,and the differences between the groups were statistically significant(P<0.05);the height of optic disc edema and visual field defect of the observation group were(263.75±51.56)μm and(0.49±0.13)dB,respectively,which were lower than(328.94±50.95)μm and(1.02±0.46)dB of the control group,while the optimal corrected visual acuity was(0.72±0.15),which was higher than(0.55±0.16)of the control group,the thickness of optic nerve fiber layer was(109.47±18.6)μm,which was thicker than(86.73±15.24)μm of the control group,and the differences between the groups were statistically significant(P<0.05);the levels of interferon γ and tumor necrosis factor α in the observation group were(60.13±6.58)pg/mL and(1.08±0.23)ng/mL,respectively,which were lower than(67.98±6.43)pg/mL and(2.22±0.25)ng/mL in the control group,while the levels of serum complement C_(3) and C_(4) were(111.45±16.38)mg/dL and(28.57±2.25)mg/dL,respectively,which were higher than(95.44±15.67)mg/dL and(24.32±2.21)mg/dL of the control group,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The effect of Longdan Xiegan Decoction combined with methylprednone pulse therapy in the treatment of retrobulbar optic neuritis is accurate,which can improve patients'visual field,visual acuity,relieve clinical symptoms,reduce inflammatory damage,enhance immune function,and is safe,worthy of clinical promotion.
作者
朱建军
艾衍良
贺俊
ZHU Jianjun;AI Yanliang;HE Jun(Department of Ophthalmology,Chengwu County People's Hospital,Heze Shandong,274200,China)
出处
《反射疗法与康复医学》
2023年第14期50-54,共5页
Reflexology And Rehabilitation Medicine
关键词
球后视神经炎
龙胆泻肝汤
甲强龙
中医证候评分
视野
视力
不良反应
Retrobulbar optic neuritis
Longdan Xiegan Decoction
Methylprednisolone
Traditional Chinese medicine syndrome score
Field of vision
Vision
Adverse reactions
