The Clinical Research For Ischemic Optic Neuropathy Treated With The Methods Of Promoting Qi Flow And Soothing Liver

Background:Ischemic optic neuropathy(ION)is a common disease of ophthalmology,and it is a syndrome characterized by visual extinction suddenly,papilledema and quadrant defect combined with physiologic blind spot. ION has sudden onset,and if the patients should not be treated timely and effectively,it may lead to visual functional damage very severe.It does not exist the name of "ischemic optic neuropathy" in Traditional Chinese Medicine(TCM).But it belongs to the categories of "Shizhanhunmiao" (blurring of vision)or "Baomang"(sudden blindness)in TCM.The TCM says that "Qi is the commander of blood",the normal flowing of blood is depending on the normal flowing of qi;liver governing conveyance and dispersion;eyes as the windows of liver,so eyes have the closest relationship with liver in "Wuzang"(five solid organs).The Miraculous Pivot points out that "Liver-qi being connected with eyes,so eyes can distinguish Wuse(five colours)if liver-qi is harmon".The Wonder Book of Ophthalmology puts forward "Cataracta is qi","To cure cataracta with the TCM of dissipating stagnant qi,such as bitter orange,areca catechu,Curcuma aromatica,nutgrass galingale rhizome,and so on".However there has not been systematic research that the TCM with promoting Qi flow and smoothing liver whether it can improve visual funcition of patients with ION.My advisor guide me to finish the systematic clinical reasearch for ION treated with the methods of promoting Qi flow and smoothing liver in the stage of my postgraduate.And it gain satisfactory curative effect.Objective:Observe whether the methods of promoting qi flow and soothing liver can improve visual funcition of patients with ION,or not.Methods:All cases in the investigation cover ophthalmology outpatients in Guangdong Provincial Hospital of TCM from November 2006 to March 2008.This study followed the simple-random contrast rule.They were allocated randomly into two groups:the treatment group and the control group.The treatment group(37 cases,51 eyes):adopting to take orally herbal decoction with compound formula of Chinese herbal promoting Qi flow and smoothing liver,three times per day,one agent per day;the control group(39 cases,51 eyes):adopting to take orally Fufang Xueshuantong capsule(mainly consisted of Sanchi, dan-shen root and membranous milkvetch root),3 granulations once,three times per day,and lasted for two weeks as a course,total four courses.The observation indexes were vision,mean sensitivity of visual field(MS),mean damage of visual field(MD)and loss variation of visual field(LV).At last we filled in observation scale for achievement evaluation.Result:The 76 cases(102 eyes)were followed up.Vision,MS,MD and LV of two groups after treatment had remarkable significance respectively(P＜0.05); After treatment comparing to the control group,acuity of vision,MS,MD and LV in treatment group had remarkable significance(P＜0.05);In the treatment group,the healing well,the excellence,utility and useless were 5,7,33,6, and 2,5,30,14 in the control group.Comparing to the control group,effective power had remarkable significance(P＜0.05).Conclusions:The methods of promoting Qi flow and soothing liver can improve vision,MS,at the same time decrease MD and LV,showing to be an effective therapy for ischemic optic neuropathy.