摘要
目的探讨非动脉炎性前部缺血性视神经病变(NA-AION)患者的相关危险因素,以期积极治疗或控制原发病,阻止眼部病变进展及预防该病发生,同时分析中医辨证分型,指导中医辨证施治。并对患者经综合治疗后的临床疗效进行总结分析。方法回顾分析2016年1月—2018年6月236例NA-AION住院患者相关危险因素、中医证型及治疗效果。结果非动脉炎性前部缺血性视神经病患者236例(283只眼),患高血压病83例(35.1%),糖尿病43例(18.2%),脑梗塞18例(7.0%),冠状动脉粥样硬化性心脏病7例(2.9%),颈动脉斑块14例(5.9%),高脂血症39例(16.5%),高同型半胱氨酸血症31例(13.1%),血粘度高24例(10.1%),患高血压病合并糖尿病20例(8.4%),高血压病合并糖尿病及高脂血症12例(5.0%),高血压病合并糖尿病及高同型半胱氨酸血症5例(2.1%),高同型半胱氨酸血症合并高脂血症17例(7.2%),阻塞性睡眠呼吸暂停综合征14例(5.9%),心动过缓23例(9.7%),贫血6例(2.5%),高海拔因素发病6例(2.5%),低血压病史7例(2.9%),服用胺碘酮后发病2例(0.8%),合并小视盘29例(12.2%),视盘埋藏疣3例(1.3%),伴视网膜动脉硬化21例(8.8%)。辨证分型:气滞血瘀证114例(48.3%);气虚血瘀证89例(37.7%);肝阳上亢证12例(5.0%);痰热上壅证8例(3.4%);肝郁气滞证10例(4.3%);阴虚火旺证3例(1.3%)。治疗效果:显效54.1%,有效40.6%,无效5.3%,总有效率94.7%。结论 NA-AION的发病机制复杂,其相关危险因素既可有眼局部因素,也可有系统性全身因素,因此综合分析其致病机制才能做到未病先防、既病防变。中西医结合治疗能够一定程度的改善视功能。
OBJECTIVE Non-arteritis anterior ischemic optic neuropathy(NA-AION) is a kind of common acute blind eye disease which mainly occurs in the elderly. To discuss the relative risk factors of the NA-AION, further to treat or to manage the primary diseases actively, eventually to prevent the occurrence of this disease, or to stop its progression. To analyze the Traditional Chinese Medicine(TCM) classification and syndrome differentiation and further to guide the TCM syndrome differentiation and treatment. In addition, to summarize the effects of intervention.METHODS The relatively local and systematic risk factors and syndrome of Chinese Medicine and therapeutic effects of the 236 pa tients who were diagnosed as the NA-AION and were admitted in our hospital between2016 and 2018 were analyzed retrospectively. RESULTS Among the 236 NA-AION patients(283 eyes), 83 patients were ill with hypertension(35.1%), 43 patients had diabetes mellitus(18.2%), 18 patients got cerebral infarction(7.0%), 7 patients were sick with coronary atherosclerotic cardiopathy( 2. 0%), 14 patients took carotid plaques(5.9%), 39 patients caught hyperlipemia(16.5%), 31 patients suffered from hyperhomocysteinemia(13.1%), 24 patients with high blood viscosity(10.1%), 20 patients fall ill with hypertension and diabetes mellitus(8.4%), 12 patients were seized with hypertension, diabetes mellitus and hyperlipemia(5.0%), 5 patients were troubled with hypertension, diabetes mellitus and hyperhomocysteinemia(2.1%), 17 patients were attacked with hyperhomocysteinemia and hyperlipemia(7.2%), 14 patients were afflicted with obstructive sleep apnoea syndrome(5.9%), 23 patients were affected by bradycardia(9.7%), 6 patients had anemia(2.5%), 6 patients had a history of the high altitude localities(2.5%), 7 patients got the history of hypotension(2.9%), 2 patients fall ill after taking amiodarone(0.8%), 29 patients were complicated with small optic disk(12.2%), 3 patients were with optic disc burial wart(1.2%),21 patients were of arteriosclerosis of retina(8.8%). Analysis of TCM syndrome showed that 114 patients were in blood stasis due to qi stagnation syndrome(48.3%), 89 patients were in qi deficiency with blood stasis syndrome(37.7%), 12 patients were in ascendant of liver yang syndrome(5.0%), 8 patients were in upward congesting of phlegm-heat syndrome(3.4%), 10 patients were in liver depression and qi stagnation syndrome(4.3%), 3 patients were in yin deficiency with effulgent f ire syndrome(1.3%). The treatment effect: remarked effective rate was 54.1%, effective rate was40.6%, invalid rate was 5.3%, total effective rate was 94.7%. CONCLUSIONS The pathogenesis of the NA-AION was complex, whose relative risk factors contained the local ophthalmic factors and systematic factors, and the comprehensive analyses were necessary to prevent the illness and avoid the existing illness from becoming more serious. Integrated Chinese and western medicine treatment improved the visual function to a certain extent.
作者
石慧君
赵晓丽
杨洁
常永业
解世朋
荣素然
王聪颖
李亚
张铭连
SHI Huijun;ZHAO Xiaoli;YANG Jie(Hebei Eye Hospital,Hebei Provincial Key Laboratory of Ophthalmology,Hebei Provincial Institute of Ophthalmology,Xingtai 054001,China)
出处
《中国中医眼科杂志》
2020年第1期20-25,共6页
China Journal of Chinese Ophthalmology
基金
邢台市科技计划项目(2015ZZ027-7)
河北省重点研发计划项目(19277710D)
河北省科技计划项目(13277754D).
关键词
非动脉炎性前部缺血性视神经病变
危险因素
中医辨证分型
干预效果
non-arteritis anterior ischemic optic neuropathy
risk factors
classification and syndrome differentiation by Traditional Chinese Medicine
effect of intervention
作者简介
通讯作者:张铭连,E-mail:zhmlyk@sohu.com
