| Clinical research, Part I, epidemiology and hemodynamic characteristics of non-arteritic anterior ischemic optic neuropathy(AION)patientsObjective Get clinical epidemiological data of AION patients through the previous medical materials s were reviewed.Methods108cases of AION patients from our hospital within January2010and December2010were collected in this research, all the medical records about epidemiology and hemodynamic characteristics were be used to fill the preliminary designed casesheet and then statistical analysis done.Results Of the108AION patients in this study, there were57(52.8%) male patients and51(47.2%) female patients, the average age was57.23+/-11.95years old, there were50Unilateral cases (46.3%) and58bilateral cases (53.7%)with an average interval time of15.3+/-25.1m,72patients (66.7%) can describe the exact onset time, among them61cases (56.5%) aware it sudenly,78cases (72.2%) denied the existence of the inducing factors,66cases (61.1%) patients with history of cerebral infarction, hypertension, hyperlipidemia, diabetes, heart disease or cervical spondylosis.62cases (57.4%) patients were initially diagnosed AION,45cases (41.7%) of them accepted glucocorticoid therapy. Patients came to our hosptial21.2+/-51.1m after onset, with an average vision acuity0.35+/-0.36and intraocular pressure15.0+/-2.8mmHg.138eyes were accepted examination of visual field, the most common type of visual field loss were below half defect (18.8%), the central tube or nearly tubular vision (14.5%), wedge-Shaped defect(10.9%).55(65.5%) patients accepted imaging examination, amon them36cases were labeled "abnormal" with ischemia, infarction, or demyelinating lesions.62patients were examined ophthalmic artery(OA), central retinal artery (CRA), or short posterior ciliary artery(sPCA) with color doppler flow imaging(CDFI),27cases found arteriosclerosis or flow reduction.47cases examined carotid artery with CDFI,29cases (61.7%) detected carotid atherosclerosis, stenosis or plaque. The average heart rate was74.7+/-6.8prm, systolic blood pressure was124.8+/-15.1mmHg, diastolic blood pressure was77.9+/-8.7mmHg,29cases (26.9%) were higher than normal blood pressure. The proportion of patients with abnormal venous blood glucose, total cholesterol, triglyceride, and low density lipoprotein cholesterol were23.5%,26.3%,40.4%and31.6%, respectively. Patients with the most commonly complaint about poor sleep (22%). The typical tongue obeserved were pink or dim red tongue, thin white moss, typical pulse detected were string or fine pulse. The most common traditional Chinese medicine (TCM) syndrome were qi deficiency and blood stasis, Qi-stagnancy and blood stasis, qi-blood deficiency, liver Qi stagnation. Qinkgo biloba extract, breviscapines, and ligustrazine were the most frequently used TCM injection.Conclusion AION has a typical epidemiological characteristics, these characteristics can be used to promot the understanding of AION pathological mechanism, prevention of the disease and finding treatment strategies.Clinical research, Part II, The effect of activating blood circulation by TCM medicine for hemodynamics of AION patientsObjective to study the influence of activating blood circulation by TCM medicine for hemodynamics of AION patients.Methods A retrospective analysis of33defected eyes of22AION cases given the treatment of TCM medicine for activating blood circulation more than14days. Patients were examined with CDFI before and after treatment, peak systolic velocit(PSV) and resistance index(RI) of OA, CRA, sPCA and diameter of OA were measured, as well as the visual acuity(Va), mean sensitivity(MS) of visual field.Results Patients were treated for23.7+/-8.2days, Va were3.67+/-1.32and3.91+/-1.18before and after treatment respectively, with significant differences (t=2.328, P=0.039) by comparison. MS were12.93+/-6.27dB and13.37+/-5.49dB respectively, no significant difference by comparison (t=1.361, P=0.198). PSV and RI of OA, CRA, sPCA and diameter of OA had no significant difference (P>0.05) before and after treatment.Conclusion33eyes of22AION cases treated with TCM medicine for activating blood circulation in this study showed an significant impiovement of acuity (Va) and a possible improvement of mean sensitivity (MS) of visual field, but there were no evidence supported that AION patients get benefit from treatment of TCM medicine for activating blood circulation.Clinical research, Part Ⅲ, The curative effect of TCM injection treatment on AION by activating blood circulationObjective To evaluate the The curative effect of ginkgo biloba extract injection and breviscapines indection on AION.Methods50cases of AION patients were randomly grouped into three groups, Group A treated with ginkgo biloba extract injection,87.5mg Qd, Group B treated with breviscapines injection,50ml Qd, and Group C with no TCM injection treatment, each of the patients from3groups were treated with acupuncture, compound anisodine and ohter supporting treatment. Best corrected Va and MS of visual field were detected before and after2weeks continuous treatment to evaluation the efficacy.Results General data of each group had no statistical difterence before treatment. Va of all the three groups were higher than before treatment, the difference were significant (P<0.05) in Group A and Group B but no significant (P>0.05) in Group C. But the vision improvement were no significant (P>0.05) difference between the three Groups. MS ofGroup A and Group C were higher after treatment than before, the difference in Group B was significant (P>0.05). While the MS of control group(Group C) after treatment has decreased, although there was no significant difference (P>0.05).The total effective rate based on the patients number of the three groups were65%,65%,40%respectively, while the effective rate based on the eyes number of the three groups were46.7%,45.2%,26.7%respectively. The effective rate had no any statistical difference between the three groups (P>0.05).Conclusion breviscapines injection, and ginkgo biloba extract injection had an similer curative effect on AION treatment, both were slightly higher than the control group with no TCM injection, which suggests that TCM injection by activating blood circulation of AION patients may have a good application prospect in the future, but there are still no enough evidence to confirm it. |
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