目的 探讨明目地黄丸联合复方樟柳碱治疗视神经萎缩的临床疗效。方法 选择2014年6月—2015年6月西安市中医医院眼科收治的视神经萎缩患者88例,按照治疗方案不同分为对照组和治疗组,每组各44例。对照组颞浅动脉旁皮下注射复方樟柳碱注射液,2 mL/次,1次/d。治疗组在对照组治疗方法上口服明目地黄丸,1丸/次,2次/d。两周为1个疗程,两组患者均连续治疗3个疗程,每个疗程间隔5 d。观察两组患者的临床疗效,同时比较两组视野缺损、P₁₀₀波潜伏期、视力提高行数的变化。结果 治疗后,对照组和治疗组总有效率分别为75.00%、90.91%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者视野缺损、P₁₀₀波潜伏期均显著降低,同组治疗前后差异具有统计学意义(P<0.05);且治疗组的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗组视力提高行数优于对照组,两组比较差异具有统计学意义(P<0.05)。对照组和治疗组不良反应发生率分别为2.27%、4.55%,两组比较差异无统计学意义。结论 明目地黄丸联合复方樟柳碱治疗视神经萎缩的临床疗效显著,可促进患者视力恢复,减小视野缺损,具有一定的临床推广应用价值。

Objective To observe the clinical effect of Mingmu Dihuang Pills combined with compound anisodine in treatment of optic atrophy. Methods Patients (88 cases) with optic atrophy in Department of Ophthalmology of Xi'an Hospital of Traditional Chinese Medicine from June 2014 to June 2015 were enrolled in this study. According to the different treatment plan, patients were divided into treatment group (44 cases) and control group (44 cases). The patients in the control group were sc administered with Compound Anisodine Hydrobromide Injection, 2 mL/time, once daily. The patients in the treatment group were po administered with Mingmu Dihuang Pills on the basis of control group, 1 pill/time, twice daily. Two weeks was as one course, and the patients in two groups were treated for three courses. Each course had a five-day interval. After treatment, the clinical efficacy were evaluated, and the changes of visual field defect, P₁₀₀ wave incubation period, the lines number of eyesight improve in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.00% and 90.91%, respectively, and there were differences between two groups (P < 0.05). After treatment, visual field defect and P₁₀₀ wave incubation period in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). The line numbers of eyesight improve in treatment group was better than that of control group, with significant difference between two groups (P < 0.05). The incidence of adverse reactions in the control and treatment groups were 2.27% and 4.55%, respectively, and there were no differences between two groups. Conclusion Mingmu Dihuang Pills combined with compound anisodine has distinct clinical effect in treatment of optic atrophy, and can promote the patients' visual acuity, also can reduce visual field defect, which has a certain clinical application value.