摘要
目的探讨中西医结合药物联合星状神经节阻滞治疗视网膜中央动脉阻塞患者视功能恢复的临床疗效。方法回顾性分析2013—2017年治疗视网膜中央动脉阻塞,分为对照组,给予中西医结合药物治疗(75例75只眼);观察组,中西医结合联合星状神经节阻滞治疗(64例65只眼)。2组均采取以下治疗:急诊患者在初诊或急诊时立即舌下含服硝酸甘油片;球后注射硫酸阿托品注射液;按摩眼球;吸氧;降眼压;静脉滴注溶栓剂、扩张血管药物、根据辨证分型予中药注射液;针刺;神经营养剂;患侧颞浅动脉旁皮下注射复方樟柳碱注射液。中医辨证分为气血瘀阻、气虚血瘀、肝阳上亢、风痰阻络4型。观察组在此常规治疗的基础上行星状神经节阻滞(SGB)治疗。结果观察组视力改善显著、视网膜动脉扩张显著、视网膜水肿消失时间缩短。观察组,治愈1只眼,显效24只眼,有效22只眼,无效18只眼,总有效率为72%;对照组,治愈4只眼,显效16只眼,有效22只眼,无效33只眼,总有效率为56%。观察组总有效率高于对照组,2组比较具有统计学意义(P<0.05)。结论视网膜中央动脉阻塞经中西医结合药物治疗能够取得一定的疗效,但联合SGB治疗可迅速改善缺血缺氧区视网膜的血液供应,恢复视神经纤维的活性,减少视力的不可逆的丧失,提高临床疗效。
OBJECTIVE To evaluate the clinical efficacy of integrated traditional Chinese and western medicine combined with stellate ganglion block(SGB)in promoting visual function recovery in patients with central retinal artery occlusion(CRAO).METHODS A retrospective analysis(from2013to2017)was conducted in patients with CRAO who were treated with integrated traditional Chinese and western medicine alone(control group,75eyes of75cases)or in combination with SGB(observation group,65eyes of64cases).The following treatments were taken in both groups:at the time of initial diagnosis or emergency room visit,patients were immediately given nitroglycerin tablets sublingually,followed by injection of atropine sulfate in the posterior segment of eyeballs,massage of eyeballs,oxygen inhalation,intraocular pressure reduction,and intravenous infusion with thrombolytic agents and vasodilators.According to traditional Chinese medicine(TCM)syndrome differentiation,patients were given the following treatments which include TCM injection,acupuncture,neurotrophic agent,and subcutaneous injec tion of compound anisodine hydrobromide solution in the lateral superficial temporal artery.TCM syndrome differentiation yielded four types:qi and blood stasis,qi deficiency and blood stasis,hyperactivity of the liver yang,and wind phlegm blocking collaterals.In addition to the above-mentioned conventional treatments,patients in the observation group were also given SGB.RESULTS Significant improvement in visual acuity,significant retinal artery dilatation,and shortened disappearance of retinal edema were demonstrated in the observation group.In the observation group,out of the65eyes,1eye was cured,24eyes were significantly improved,22eyes showed effectiveness,and18eyes were ineffective.In the control group which consists of75eyes,4eyes were cured,16eyes were markedly improved,22eyes showed some effectiveness,and33eyes were ineffective.The overall efficacy was72%in the observation group and56%in the control group,respectively.The difference between the two groups was statistically significant(P<0.05).CONCLUSIONS Treatment of CRAO with traditional Chinese and western medicine was of moderate efficacy.However,when added with SGB therapy,this integrated approach rapidly improved the blood supply to the retina in the ischemic and hypoxic zone,restored the activity of optic nerve fibers,reduced the irreversible loss of vision,and improved clinical efficacy.
作者
石慧君
赵晓丽
张铭连
常永业
解世朋
庞朝善
杨洁
荣素然
王聪颖
SHI Huijun;ZHAO Xiaoli;ZHANG Minglian(Hebei Eye Hospital,Hebei Provincial Key Laboratory of Ophthalmology,Hebei Provincial Institute of Ophthalmology,Xingtai054001,China)
出处
《中国中医眼科杂志》
2018年第6期389-393,共5页
China Journal of Chinese Ophthalmology
基金
邢台市科技计划项目(2015ZZ027-7)
关键词
中西医结合药物
星状神经节阻滞治疗
视网膜中央动脉阻塞
traditional Chinese and western medicine
stellate ganglion block
central retinal artery occlusion
