| OBJECTIVE:To explore the therapeutic effect of TCM syndrome differentiation combined with Western medicine on non-arteriotic anterior ischemic optic neuropathy,in order to determine the best intervention time and the best treatment plan of TCM.METHODS:The study was conducted from January 2018 to October 2020,A total of 100 patients diagnosed with Nonarteritic anterior ischemic optic neuropathy(NA-AION)in outpatients and inpatients of Gansu Provincial Hospital of Traditional Chinese Medicine were included in the study.The patients were randomly divided into observation group(50 cases)and control group(50 cases).The control group was treated with glucocorticoid,such as methylprednisolone,etc.The treatment group of integrated Chinese and Western medicine(observation group)was given oral Chinese medicine and acupuncture on the basis of Western medicine treatment.Syndrome differentiation: 1)Yin deficiency and collaterals obstruction syndrome,use Yuyin Qiyang Tongmai decoction;2)The syndrome of Qi deficiency and blood stasis,use Buyang Huanwu decoction;3)For the syndrome of liver-qi stagnation,use Shugan breaking Yu Tongmai Decoction;4)For the syndrome of deficiency of Qi and blood,use ginseng Yangrong Decoction.The best corrected visual acuity,visual field,visual evoked potential,mean light sensitivity(MS),mean visual field defect(MD),and mean nerve fiber layer thickness(ATRNFL)were collected before and after treatment.The curative effect was determined according to the duration of treatment and the evaluation criteria.RESULTS:After multi-drug combination treatment,the curative effect of observation group was significantly better than that of control group,and the difference was statistically significant(P < 0.05).After treatment with integrated Chinese and Western medicine,the MS level in the observation group was significantly increased and significantly higher than that in the control group,while the MD level was significantly decreased and significantly lower than that in the control group,with statistical significance(P < 0.05).There was no significant difference in the ATRNFL level between the two groups compared with the healthy side eye before treatment(P > 0.05).The ATRNFL level improved after treatment,and the ATRNFL level in the observation group was significantly higher than that in the control group after treatment,with statistical significance(P < 0.05).The visual acuity level,peak latency and amplitude of P100 wave time were significantly improved compared with those before treatment(P<0.05),and the improvement was more significant in observation group than control group(P<0.05).The improvement of MS,MD and ATRBNFL in the middle and late stage of the observation group was better than that in the early stage of the observation group(P<0.05).CONCLUSION:1.Compared with the treatment of NA-AION by Western medicine alone,the treatment of NA-AION by integrated Chinese and Western medicine can obtain better curative effect.The treatment of integrated Chinese and western medicine can further improve the visual acuity of patients,reduce visual field defects,increase the thickness of optic nerve fibers,and improve visual evoked potential,which is worthy of clinical recommendation.2.TCM syndrome differentiation combined with Western medicine can reduce toxicity and increase efficacy,and the efficacy is better than that of Western medicine alone.The best intervention time of traditional Chinese medicine for the treatment of this disease is in the acute stage,and the effect is still obvious for the optic nerve atrophy stage.The earlier the time of traditional Chinese medicine intervention,the more obvious the effect of enhancing clinical efficacy.3.Hypertension may be the primary risk factor for NA-AION patients.4.The Chinese medicines frequently used in the treatment of NA-ION syndrome differentiation are: Radix paeoniae,Angelica sinensis,Radix Paeoniae paeoniae and Ligusticum Chuanxiong. |
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