原发性青光眼抗青光眼术后中医证候特征研究

目的通过证候调查及专家问卷咨询探讨原发性青光眼抗青光眼术后中医证候特点,以建立青光眼术后证候诊断标准。方法将青光眼术后证候调查结果汇总为调查问卷进行专家咨询,根据回馈建议修正证候分型并通过术后1个月、6个月及1年对比分析总结其证候特点,确定证候诊断。结果 （1）根据专家咨询建议将证候类型修正为气郁证、气虚证、气血两虚证、肝肾阴虚证4种,且绝大多数患者可纳入此4种证候分型。（2）原发性青光眼患者在术后1个月气郁证46例,气虚证18例,气血两虚证19例,肝肾阴虚证23例;术后6个月上述4种证型分别为37、15、33、29例;术后1年分别为32、9、36、31例。（3）青光眼患者在术后6个月时证候转化率为28.9%,1年时证候转化率为10.2%。（4）血瘀证兼证在青光眼术后1个月、6个月、1年的比例分别是73.6%、64.1%、75.9%。结论 （1）原发性青光眼患者术后均可分为气郁证、气虚证、气血两虚证、肝肾阴虚证4种证型。（2）原发性青光眼患者在术后早期均以气郁证多见;证型稳定后以气郁证、气血两虚证、肝肾阴虚证多见;随着病程延长,存在着证候由气郁证向气血两虚证、肝肾阴虚证转化,即由实转虚的趋势。（3）原发性青光眼在术后6个月以后证型相对稳定,说明术后青光眼具有相同或类似的病例基础。（4）血瘀证是青光眼术后重要的病理特点之一。

Study of TCM Syndromes on postoperative patients with primary glaucoma

OBJECTIVE To investigate the characteristics of TCM syndromes and evolution in postoperative patients with primary glaucoma through expert consultation and ＂The TCM Syndromes Questionnaire＂. METHODS Revised the syndrome types of postoperative glaucoma based on expert suggestion of ＂The TCM Syndromes Ques- tionnaire＂. And then the distribution and evolution of TCM syndromes were analyzed comparatively in postoperative patients at one month, six month and lyear. RESULTS （ 1 ） the TCM syndromes were qi stagnation due to depression of the liver qi deficiency, deficiency of both qi and blood, yin deficiency of liver and kidney; and most of patients could be included among these 4 kinds. （2） The patients of primary glaucoma with qi stagnation syndrome, qi defi- ciency, deficiency of both qi and blood, yin deficiency of liver and kidney were respectively 46, 18, 19 and 23 cases one month of postoperative; 37, 15, 33 and 29 cases six months, and 32, 9, 36 and 31 cases one year postoperative. （3） The change of TCM syndrome was 28.9% six month postoperative; but 10.2% 1 year postoperative. （4） The rate of blood stasis syndrome in one month, six months and 1 year postoperative was 73.6%, 64.1% and 75.9%. CON- CLUSlONS （ 1 ）The syndromes of postoperative glaucoma could be divided into 4 types of qi stagnation due to de- pression of the liver, qi deficiency, deficiency of both qi and blood, yin deficiency of liver and kidney. （2） Four types of glaucoma had the same types of syndrome in the early postoperative they were more common qi stagnation. With the extension of the course, there was the trend of transformation from excess into deficiency syndrome. （3） Af- ter 6 months, the TCM syndrome was relatively more stable. （4） Blood stasis syndrome was an important pathology with postoperative glaucoma.