本文選題：弱視 + 中藥��； 參考：《南京中醫(yī)藥大學(xué)》2011年碩士論文

【摘要】：目的：導(dǎo)師魏偉教授集多年的臨床經(jīng)驗(yàn)總結(jié)弱視病機(jī)多屬稟賦不足、元精虧虛,治療應(yīng)以補(bǔ)腎、填精、明目、開竅為原則,借鑒已故名老中醫(yī)江育仁教授治療小兒智力低下經(jīng)驗(yàn)方,經(jīng)加減制成“益視合劑”(院內(nèi)制劑)用于兒童弱視治療長(zhǎng)達(dá)20余年。本研究旨在科學(xué)、客觀地評(píng)價(jià)“益視合劑”的療效,以指導(dǎo)兒童弱視的臨床治療。并且通過客觀的檢測(cè)手段初步探討其作用機(jī)理。 方法：根據(jù)病例選擇標(biāo)準(zhǔn)共納入36例61眼進(jìn)行觀察,將其分為兩組,以屈光矯正加精細(xì)目力訓(xùn)練的傳統(tǒng)治療為對(duì)照組,在傳統(tǒng)治療基礎(chǔ)上配合服用“益視合劑”的為治療組,以4周為1個(gè)治療療程,共觀察3個(gè)療程。于治療前及每個(gè)療程結(jié)束后行視力檢查,于治療前和第3個(gè)療程結(jié)束后行圖形視覺誘發(fā)電位(P-VEP)及光學(xué)相干斷層掃描(OCT)檢查。分別觀察兩組視力情況,P100波波峰潛時(shí)及振幅大小,黃斑區(qū)視網(wǎng)膜神經(jīng)上皮層厚度和視乳頭旁視網(wǎng)膜經(jīng)纖維層(RNFL)厚度,以客觀評(píng)價(jià)"益視合劑"的療效,初步探討其作用機(jī)理。 結(jié)果：1.3個(gè)療程結(jié)束后,治療組34眼,基本治愈18眼,進(jìn)步11眼,無效5眼,總有效率為85.3%,基本治愈率為52.9%；對(duì)照組27眼,基本治愈8眼,進(jìn)步8眼,無效11眼,總有效率為59.3%,基本治愈率為29.6%。兩組療效有顯著性差異(P0.05),治療組療效明顯優(yōu)于對(duì)照組,其中屈光不正性弱視及中度弱視療效較好。2.OCT檢查：治療后黃斑區(qū)視網(wǎng)膜神經(jīng)上皮層厚度及視乳頭旁RNFL厚度有不同程度的下降,尤其是黃斑內(nèi)環(huán)區(qū)上方視網(wǎng)膜,外環(huán)區(qū)上方、鼻側(cè)及下方視網(wǎng)膜厚度變化有統(tǒng)計(jì)學(xué)差異。3.P-VEP檢查：經(jīng)治療后在空間頻率1.Ocpd及0.3cpd刺激下測(cè)得的P100波的波峰振幅較治療前有輕度的提高,潛時(shí)較治療前有小幅度的延長(zhǎng),然而,只有在空間頻率為0.3cpd刺激下的P100波波峰潛時(shí)的改變具有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論：中藥益視合劑作為輔助治療方法可以顯著提高兒童弱視的治愈率,縮短治療時(shí)間,在改善視網(wǎng)膜及視中樞的形態(tài)和功能方面起到一定的作用。
[Abstract]:Objective: to sum up the clinical experience of professor Wei Wei for many years and summarize that the pathogenesis of amblyopia is mostly due to the deficiency of endowment and deficiency of essence. The treatment should be based on the principle of tonifying the kidney, filling the essence, opening the eyes and opening the orifices. Referring to the late Professor Jiang Yuren's experience in the treatment of children's mental retardation, "Yi Shi mixture" (hospital preparation) has been used in the treatment of amblyopia for more than 20 years. The purpose of this study was to scientifically and objectively evaluate the curative effect of Yi Shi mixture in order to guide the clinical treatment of amblyopia in children. And through the objective detection means, the mechanism of its action is preliminarily discussed. Methods: according to the criteria of case selection, 36 cases (61 eyes) were observed and divided into two groups: the control group was treated with refractive correction and fine visual training, and the treatment group was treated with "Yi Shi mixture" on the basis of traditional treatment. Four weeks were used as a course of treatment and three courses of treatment were observed. Visual acuity examination was performed before and after each course of treatment, and visual evoked potential (P-VEP) and optical coherence tomography (Oct) were performed before and after the third course of treatment. The time and amplitude of P100 wave peak latency, the thickness of retinal neuroepithelial layer in macular area and the thickness of RNFL in retinal parapapillary retinal layer were observed in order to evaluate the curative effect of "Yishi mixture" objectively and to explore its mechanism. Results: 1.After the end of three courses of treatment, 34 eyes in the treatment group were basically cured, 18 eyes were cured, 11 eyes were improved, 5 eyes were ineffective, the total effective rate was 85.3, and the basic cure rate was 52.9%, while in the control group, 27 eyes were basically cured, 8 eyes were improved, 11 eyes were ineffective. The total effective rate was 59.3 and the basic cure rate was 29.6. There was significant difference between the two groups (P 0.05). The curative effect of the treatment group was better than that of the control group. Among them, ametropia amblyopia and moderate amblyopia were better. 2. Oct: the retinal neuroepithelial layer thickness of macular area and the RNFL thickness of parapapillary region decreased in varying degrees after treatment, especially above the inner macular area and the outer ring area. There were significant differences in retinal thickness between the nasal side and the inferior retinal thickness. 3. P-VEP examination: after treatment, the amplitude of the peak of the P100 wave stimulated by 1. Ocpd and 0.3cpd was slightly higher than that before treatment, and the latent time was slightly longer than that before treatment. However, Only when the spatial frequency is 0.3cpd, the change of peak potential time of P100 wave is statistically significant. Conclusion: Chinese medicine Yishi mixture as an auxiliary treatment method can significantly improve the cure rate of amblyopia in children, shorten the time of treatment, and play a certain role in improving the shape and function of retina and visual center.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R777.44

【引證文獻(xiàn)】

相關(guān)期刊論文 前1條

1 邵淑君;石妮妮;周華祥;;fMRI在弱視方面的研究進(jìn)展[J];湖南中醫(yī)雜志;2013年01期

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本文編號(hào)：2014641