中西医结合先通后补法治疗顽固性视神经萎缩的临床研究

目的评价中西医结合、通补结合法治疗视神经萎缩的确切疗效,以及经其他方法治疗无效后的"顽固性视神经萎缩"患者的治疗意义,提高对视神经萎缩的临床治疗水平,并探讨疗效机理.方法对观察组132例、对照组50例顽固性视神经萎缩患者采用中西医结合,先通后补法进行治疗,并对两组治疗前后的视力、视野、色觉、FFA、L-VEP进行比较.结果观察组视力提高率为74.07%,对照组为41.38%,两组差异显著(P＜0.01).两组治疗前后视野及色觉均无显著意义改善.FFA及L-VEP指标观察组具有明显改善,而对照组虽有改善,但不具有显著性差异,两组比较差异显著(P＜0.05,P＜0.01).结论对视神经萎缩患者,不论其病因为何,均不能轻易放弃治疗.中西医结合,先通后补法疗效明显优于一般常规的中医辨证和西药治疗,具有临床优势.

Clinical Research of Integrated TCM-WM Method (Smoothing Followed by Tonifying ) on Refractory Atrophy of Optic Nerve

Objective: To assess the definite effect of the integrated traditional Chinese and western medicine and the integrated tonifying and smoothing method on refractory optic never atrophy, and their treatment effect in patients unresponsive to other therapy in order to enhance the clinical curative effect and to explore its mechanism. Method: 132 cases from treatment group and 50 cases from control with refractory optic never atrophy were treated with smoothing followed by tonifying method in integrated TCM and western medicine.Vision acuity, visual field, color sense, fluorescence fundus angiography (FFA) and visual evoked potential (L-VEP) were compared before and after treatment in both groups. Result: The improving rate of vision acuity was 74.07% and 41.38% in treatment and control groups respectively with significant difference between them (P<0.01). No marked improving of visual field and color sense in either groups. Obvious improving was observed in FFA and L-VEP in treatment group. Although improved,however,significant difference could not be obtained in controt group There was significant difference between these two groups (P<0.05, P<0.01). Conclusion: For the patients from refractory optic nerve atrophy, no matter what the etiologic factor is, the treatment can never been abandoned. The therapeutic method of smoothing followed by tonifying is superior to any routine symptom differentiation in TCM and western medicine only.