| Ischemic optic neuropathy(ION) is one of the acute and severe ocular diseases since it is urgent of occurrence, with bad visual sight and slowly recovery. One of the important pathogeny of ION is diabetes. Diabetes is a kind of systemic metabolic diseases, the morbidity of which is growing up in our country, and which could lead to many kinds of ocular diseases. In the past, many studies is focused on the diabetic retinopathy, few studies is about diabetes induced ischemic optic neuropathy. Based on the systemic and local treatment according to syndrome differentiation, Chinese medical sciences has good curative effect with multiple methods. As one of the micro-needle therapy system, eye acupuncture therapy is good at to treat with acute.stagnate and pain diseases, so there is a pressing need to evaluate whether eye acupuncture therapy could be effective with ischemic optic neuropathy in diabetes.Objective:1. To sum up and analyze the therapeutic effect of Chinese medical comprehensive therapy on ischemic optic neuropathy in diabetes by checking up the in-patients of recent 5 years.2. To study the effect of eye acupuncture therapy combined with Yiqitongluo method on ischemic optic neuropathy in diabetes through prospective randomized controlled clinical trail, analyze the availability and safety, explore a new method to treat with this kind of diseases.Methods:1. Methods of retrospective study was used to choose the subjects by following criteria. Vision sight, ocular fundus and visual fields were observed, standard of curative effect were chosen to analyze the effectiveness of Chinese medical comprehensive therapy on ischemic optic neuropathy in diabetes. P value less than 0.05 is regarded to significant different or correlative in statistical process.2.Prospective randomized controlled clinical trail was studied, diagnostic criteria,syndrome differentiation standard, inclusion criteria and exclusion criteria were setting up. All the enrolled patients were randomly divided into two groups, one was treated with yiqitongluo method as control group, one was treated with yiqitongluo method combined with eye acupuncture therapy as treated group. Vision sight, visual fields, TCM syndrome score, blood count, urine test and blood biochemistry test before and after treatment were observed, standard of curative effect were analyzed. P value less than 0.05 is regarded to significant different or correlative in statistical process.Results:1. The retrospective study was enrolled 98 patients with 134 eyes, the average course of disease was 6.1 months. Both the uncorrected visual acuity(UCVA)and the best corrected visual acuity (BCVA) were improved significantly, p<0.05. After the treatment, mean sensitivity of the visual field (MS) was enhanced significantly, p=0.000<0.05;mean defect of visual field(MD) was descended obviously, p=0.007<0.05.Based on the standard of curative effect, the treatment cured 15 eyes (11.19%), had significant effect on 43 eyes (32.09%), had good effect on 38 eyes(28.36%),had no effect on 38 eyes(28.36%), the total effective percentage was 71.64%.2. The prospective randomized controlled clinical trail was enrolled 30 patients with 41 eyes in treated group and 30 patients with 42 eyes in control group. Before the treatment, each baseline index of the two groups had no significant difference. After the treatment, both UCVA and BCVA were improved obviously in each group, but even the vision in treated group was seemed improving more rapidly, the comparison with control group had no significant difference.After the treatment, MS was improved significantly in both groups, while there was no different between groups.About MD, there was significant reduction in treated group,P<0.05;while there had no statistical change in control group; obvious differensiation was observed between those two groups, P<0.05. Based on the standard of curative effect, the effective percentage was 73.81% in control group and 80.49% in treated group,no difference was observed between two groups. TCM syndrome score were all fallowing down in two groups, P<0.05, while more changes was found in treated group when comparing with D-value, P<0.05. No changes were found in both of the two groups of blood count, urine test and blood biochemistry test, no adverse reaction was found in all treatments, no adverse event was appeared when using eye acupuncture therapy.Conclusion:1. Chinese medical comprehensive therapy could improve UCVA and BCVA, improve the visual field, decrease the visual defect and improve the quality of life in ischemic optic neuropathy of diabetes patients.2. Eye acupuncture therapy combined with Yiqitongluo method could improve the vision sight, visual fields and TCM syndrome score in ischemic optic neuropathy of diabetes patients, which is safe and easy to learn.3. Eye acupuncture therapy could significant decrease MD value in visual field, which has much more value on visual field improvement.4. Eye acupuncture therapy could significant reduce TCM syndrome score by which could improve the quality of patients’life. |
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