JIANG Pengfei1， PENG Jun2， HUANG Xuesi3， ZENG Zhicheng4， ZHOU Yasha1， YAO Xiaolei2， PENG Qinghua1

Pengfei JIANG; Jun PENG; Xuesi HUANG; Zhicheng ZENG; Yasha ZHOU; Xiaolei YAO; Qinghua PENG

doi:10.13288/j.11-2166/r.2022.05.009

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JIANG Pengfei¹， PENG Jun²， HUANG Xuesi³， ZENG Zhicheng⁴， ZHOU Yasha¹， YAO Xiaolei²， PENG Qinghua¹

更新时间：2022-02-28

- JIANG Pengfei¹， PENG Jun²， HUANG Xuesi³， ZENG Zhicheng⁴， ZHOU Yasha¹， YAO Xiaolei²， PENG Qinghua¹
- Journal of Traditional Chinese Medicine Vol. 63, Issue 5, Pages: 443-449(2022)
- 作者机构：
  
  1.湖南中医药大学，湖南省长沙市岳麓区学士路300号，410208
  2.湖南中医药大学第一附属医院
  3.湖南中医药高等专科学校第一附属医院
  4.湖南省桂阳县第一人民医院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2022.05.009
  CLC：
- Received：14 August 2021，
  
  Revised：2021-12-16，
  
  Published：02 March 2022
- 稿件说明：
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蒋鹏飞,彭俊,黄学思等.青光安Ⅱ号方治疗眼压已控制的青光眼气阴两虚血瘀证患者60例临床观察[J].中医杂志,2022,63(05):443-449.

JIANG Pengfei,PENG Jun,HUANG Xuesi,et al.JIANG Pengfei¹， PENG Jun²， HUANG Xuesi³， ZENG Zhicheng⁴， ZHOU Yasha¹， YAO Xiaolei²， PENG Qinghua¹[J].Journal of Traditional Chinese Medicine,2022,63(05):443-449. DOI: 10.13288/j.11-2166/r.2022.05.009.
蒋鹏飞,彭俊,黄学思等.青光安Ⅱ号方治疗眼压已控制的青光眼气阴两虚血瘀证患者60例临床观察[J].中医杂志,2022,63(05):443-449. DOI： 10.13288/j.11-2166/r.2022.05.009.

JIANG Pengfei,PENG Jun,HUANG Xuesi,et al.JIANG Pengfei¹， PENG Jun²， HUANG Xuesi³， ZENG Zhicheng⁴， ZHOU Yasha¹， YAO Xiaolei²， PENG Qinghua¹[J].Journal of Traditional Chinese Medicine,2022,63(05):443-449. DOI: 10.13288/j.11-2166/r.2022.05.009. DOI：

摘要

目的

观察青光安Ⅱ号方对眼压已控制的青光眼气阴两虚血瘀证患者的疗效。

方法

120例眼压已控制的青光眼气阴两虚血瘀证患者随机分为对照组和治疗组各60例，治疗组中原发性开角型青光眼（POAG）患者32例，原发性闭角型青光眼（PACG）患者28例；对照组中POAG患者25例，PACG患者35例。对照组予以降眼压及对症治疗，治疗组在对照组的基础上加用青光安Ⅱ号方治疗，每日1剂，分2次口服。分别于治疗前1天及治疗1、3、6个月，比较两组患者最佳矫正视力、视野［包括静态视野的平均敏感度（MS）、平均缺损（MD）、丢失方差平方根（sLV）］、眼压、视觉诱发电位［诱发电位潜伏时（LP100）和诱发电位振幅（AP100）］、中医证候积分（包括视盘色淡、腰膝酸软、身体疲乏、舌质暗或有瘀点、脉细涩积分）、视网膜神经纤维层厚度及视盘形态；分别于治疗前1天及治疗6个月时进行进展期青光眼干预研究（AGIS）评分，比较不同类型（POAG与PACG）、不同年龄段（≤40岁、41~50岁、51~60岁、≥61岁）、不同程度视野缺损（轻度、中度、严重）患者AGIS评分。治疗6个月后继续随访6个月，观察患者视野疗效巩固率。

结果

两组患者治疗前1天及治疗1、3、6个月时最佳矫正视力、眼压、视盘和周边不同方位视网膜神经纤维层厚度、杯盘比值和盘沿面积、LP100、AP100水平组间及组内比较，差异均无统计学意义（

＞0.05）。与本组治疗前1天及治疗1个月时比较，治疗组治疗6个月时MS升高，MD、sLV降低（

＜0.05）；与对照组同时间比较，治疗组治疗6个月时MS升高，MD、sLV降低（

＜0.05）。治疗组POAG与PACG患者治疗6个月时较本组治疗前1天AGIS评分明显降低，且均低于对照组治疗6个月时（

＜0.05）。治疗组治疗6个月时41~60岁患者AGIS评分较治疗前1天明显降低，且均低于同时间对照组（

＜0.05）；治疗组中度视野缺损与严重视野缺损患者治疗6个月时AGIS评分较治疗前1天明显降低，也低于同时间对照组（

＜0.05）。治疗组治疗3、6个月时，视盘色淡、腰膝酸软、身体疲乏、舌质暗或有瘀点、脉细涩积分均低于本组治疗前和同时间对照组（

＜0.05）。随访6个月，治疗组视野巩固率为75.93%，对照组为36.54%，治疗组视野巩固率高于对照组（

＜0.01）。

结论

青光安Ⅱ号方可改善眼压已控制的青光眼气阴两虚血瘀证患者视野和中医证候，并能提高视野巩固率。

Abstract

Objective

To explore the effect of

Qingguang'an Ⅱ

（青光安

Ⅱ

号方） on intraocular pressure-controlled glaucoma with

yin

deficiency and blood stasis pattern.

Methods

Totally 120 intraocular pressure-controlled glaucoma patients with

yin

deficiency and blood stasis pattern were randomly divided into two groups， with 32 primary open angle glaucoma （POAG） cases and 28 primary angle closure glaucoma （PACG） cases in the intervention group， and 25 POAG cases and 35 PACG cases in the control group. The control group received intraocular pressure lowering and symptomatic treatment， while the intervention group was treated with

Qingguang'an Ⅱ

， one dose daily， based on the control treatment. The best corrected visual acuity （BCVA）， visual field indicators including mean sensitivity （MS）， mean defect （MD）， missing square root of variance （sLV） for static visual field， intraocular pressure， visual evoked potential indicators including evoked potential latency （LP100） and evoked potential amplitude （AP100）， traditional Chinese medicine （TCM） syndrome scores including pale optic disc， sore waist and knees， physical fatigue， dusky tongue or tongue with stasis spots， thready and choppy pulse， retinal nerve fiber layer （RNFL） thickness， and optic disc morphology of the patients in both groups were measured and compared one day before the treatment， and at the end of 1-， 3- and 6-month treatment. The advanced glaucoma intervention study (AGIS) score was assessed one day before treatment and at 6-month after treatment

and was compared between different types (POAG versus PACG)

different ages (≤40 years old

41-50 years old

51-60 years old

≥61 years old) and different degrees of visual field defect (mild

moderate

severe). After 6-month treatment

the patients were followed up for 6 months to explore the visual field consolidation rate.

Results

There were no significant differences in BCVA， intraocular pressure， optic disc， RNFL thickness of the optic disc and surrounding parts， cup-to-disk ratio and disc area， LP100 and AP100 levels measured one day before the treatment and at the end of 1-， 3- and 6-month treatment when compared between groups and when compared between before and after treatment （

＞0.05）. MS measured at the end of 6-month treatment in the intervention group significantly increased， while MD and sLV significantly decreased when compared to those measured one day before treatment and at the end of 1-month treatment （

＜0.05）， and when compared to those in the control group measured at the end of 6-month treatment （

＜0.05）. The AGIS scores of POAG and PACG patients at the end of 6-month treatment in the intervention group were significantly lower than those measured one day before treatment， and than those measured at 6-month treatment in the control group （

＜0.05）. The AGIS results were similar for the subgroup of patients aged 41-60 years old （

＜0.05）， and for moderate visual field defect and severe visual field defect patients （

＜0.05）. TCM syndrome scores （pale optic disc， sore waist and knees， physical fatigue， dusky tongue or tongue with stasis spots， thready and choppy pulse） of the intervention group at the end of 3-month and 6-month treatment were significantly lower than those before treatment and those of the control group measured at the same time point （

＜0.05）. After 6 months， the visual field consolidation rate in the intervention group was 75.93%， significantly higher than 36.54% in the control group （

＜0.01）.

Conclusion

Qingguang'an Ⅱ

can improve the visual field and TCM syndromes of intraocular pressure-controlled glaucoma with

yin

deficiency and blood stasis pattern， and can improve visual field consolidation rate.

关键词

Keywords

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