| ObjectivesWith the progress of ophthalmic instrument and ophthalmologic operation,the efficacy of phacoemulsification combined with viscogoniosynechialysis in cataract and primary angle closure patients has been widely recognized.However,due to the anatomical particularity of the eyes of patients with primary angle closure,postoperative intraocular pressure control and surgical damage to the retina can affect the postoperative visual function parameters of patients.The purpose of this study was to further observe the changes of retina optical coherence tomography and functional parameters after phacoemulsification extraction combined with goniosynechialysis with traditional Chinese medicine.MethodsPatients diagnosed with depression of the liver generates pathogenic fire type and cataract complicated with primary angle closure with normal intraocular pressure were selected from dongzhimen hospital,Beijing university of traditional Chinese medicine from January 2019 to January 2020.The patients were randomly divided into the experimental group and the control group by randomized control method.The experimental group was given Chinese medicine formulae twice a day on the basis of conventional treatment,while the control group was only given conventional treatment.Chinese medicine formulae 2 weeks for a course of treatment,a total of 2 courses.The TCM syndrome score,vision and intraocular pressure,visual field,optical coherence tomography and anterior segment inflammation score before and after treatment were observed and recorded to observe whether there was statistical significance.ResultsIn this study,there were 57 effective cases(57 eyes),including 28 cases(28 eyes)in the experimental group and 29 cases(29 eyes)in the control group.Statistical analysis by SPSS 26.0 software showed that the baseline conditions of the two groups were stable and comparable.1.After 4 weeks of treatment,there was no peripheral anterior synechia in the experimental group and the control group,and the width of angle of anterior chamber increased compared with that before and after the treatment(P<0.05).There was no statistically significant difference in the width of angle of anterior chamber between the two groups before and after the treatment(P>0.05).Of experimental group and control group before and after treatment and the best corrected visual acuity,intraocular pressure and anterior chamber reaction score for repeated measurements analysis of variance,two groups of best corrected visual acuity with extended time gradually improve,7 days after surgery patients vision is significantly higher than control group(P<0.05),the rest of the time point of vision similar between the two groups had no significant statistical significance(P>0.05);After treatment,IOP in both groups showed a decreasing trend,and there was no statistically significant difference between the two groups at each time point(P>0.05).The anterior chamber reaction score of the two groups decreased before and after treatment,and the anterior chamber reaction score of the experimental group was significantly lower than that of the control group on the 3rd and 7th day after surgery(P<0.05),but there was no significant difference in anterior segment score between the two groups before treatment and the 14th day after surgery(P>0.05).2.There was no significant difference in VFI,MD,and PSD between the experimental group and the control group before treatment(P>0.05),and there was significant difference in VFI and MD between the two groups after treatment(P<0.05),suggesting that the improvement of VFI and MD after treatment was significantly higher than that of the control group.3.In the experimental group,the total thickness of cpRNFL and the thickness of the lower quadrant were improved,and the difference between the groups before and after treatment was statistically significant(P<0.05),while the difference between the groups was not statistically significant(P>0.05),indicating that the improvement of cpRNFL thickness by Chinese medicine formulae treatment was very small.The RNFL thickness of macular fovea increased in both groups before and after treatment,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference between the two groups before and after treatment(P>0.05).4.After 4 weeks of treatment,the total effective rate of the experimental group was 86.21%.The total effective rate of the control group was 10.71%,and the overall Chinese symptom improvement of the experimental group was significantly better than that of the control group(P<0.05)).In terms of symptom improvement in traditional Chinese medicine,the symptoms of eye distension,dizziness or headache,irritability and depression,sighing,dry and blurred eyes,dry and bitter mouth,red eyes,abnormal bowel movements,and sleep were significantly improved in the test group after treatment(P<0.05).After treatment,the improvement of symptoms of irritability and depression,sighing,dry and blurred eyes and abnormal defecation in the test group was significantly better than that in the control group(P<0.05).No adverse events occurred during the treatment,suggesting that the safety of oral therapy with mingmu juannyi prescription is better.ConclusionsIt has been preliminarily verified that mingmu juhanyi prescription of traditional Chinese medicine has certain improvement effect on functional parameters and RNFL thickness of patients with depression of the liver generates pathogenic fire type PAC combined with ARCs after phaco combined viscogoniosynechialysis. |
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