目的 探究葛根素葡萄糖注射液联合长春胺缓释胶囊治疗前部缺血性视神经病变的临床效果。方法 选取2017年2月—2019年12月在保定市第四中心医院接受治疗的前部缺血性视神经病变患者96例（130眼）作为研究对象。按照随机数字表法分为对照组48例（65眼）和观察组48例（65眼）。对照组患者口服长春胺缓释胶囊，1粒/次，2次/d。观察组在对照组治疗的基础上静脉滴注葛根素葡萄糖注射液250 mL，1次/d。两组均连续治疗4周。观察两组患者的临床疗效，同时比较两组治疗前后的视野水平、视力、光敏感度水平、视网膜神经节细胞复合体厚度及视盘周围神经厚度、视觉诱发电位振幅水平及眼底荧光血管造影数据。结果 治疗后，两组患者的治疗有效率分别为95.00%和82.00%，观察组患者显著高于对照组（P<0.05）。治疗后，两组患者的视野水平均有显著改善（P<0.05），且观察组患者的视野水平明显优于对照组患者（P<0.05）。治疗后，两组患者的视力以及光敏感度水平均有显著提高（P<0.05），且观察组患者的视力以及光敏感度水平明显高于对照组患者（P<0.05）。两组患者的视网膜神经节细胞复合体厚度及视盘周围神经厚度均有显著减轻（P<0.05），且观察组患者的视网膜神经节细胞复合体厚度及视盘周围神经厚度明显低于对照组患者（P<0.05）。治疗后，两组患者的视觉诱发电位振幅均有显著升高，从注射荧光素钠针至视盘开始出现荧光时间均有显著下降（P<0.05），且观察组患者的视觉诱发电位振幅明显高于对照组患者，从注射荧光素钠针至视盘开始出现荧光时间显著低于对照组患者（P<0.05）。结论 葛根素葡萄糖注射液联合长春胺缓释胶囊治疗前部缺血性视神经病变疗效显著，可有效改善患者的视力及光敏感程度，缓解视网膜神经节细胞复合体及视盘周围神经萎缩，恢复视觉诱发电位改善眼部微循环，值得临床推广使用。

Objective To explore the clinical effect of Puerarin and Glucose Injection combined with Vincamine Sustained Release Capsules in treatment of anterior ischemic optic neuropathy. Methods A total of 96 patients (130 eyes) with anterior ischemic optic neuropathy who received treatment in Baoding Fourth Central Hospital from February 2017 to December 2019 were selected as the study subjects. According to the random number table method, 48 cases (65 eyes) in the control group and 48 cases (65 eyes) in the observation group were divided. Patients in the control group were po administerd with Vincamine Sustained Release Capsules, 1 grain/time, twice daily. Patients in the observation group were iv administerd with Puerarin and Glucose Injection, 250 mL puerarin glucose injection was injected intravenously on the basis of the control group, once daily. Both groups were treated continuously for 4 weeks. The clinical efficacy of the two groups of patients was observed, and the visual field, vision, light sensitivity, retinal ganglion cell complex thickness, perioptic disc nerve thickness, the amplitude of VEP and fundus fluorescence angiography before and after treatment were compared. Results After treatment, the effective rates of the two groups were 95.00% and 82.00%, respectively, which were significantly higher in the observation group than that in the control group (P<0.05). After treatment, the visual field level in two groups was significantly improved (P<0.05), and the visual field in the observation group was significantly better than that of the control group (P<0.05). After treatment, the visual acuity and light sensitivity levels in two groups were significantly improved (P<0.05), and the visual acuity and light sensitivity levels in the observation group were significantly higher than those of the control group (P<0.05). After treatment, the thickness of retinal ganglion cell complex and peripheral optic disc nerve in two groups were significantly reduced (P<0.05), and the thickness of retinal ganglion cell complex and peripheral optic disc nerve in the observation group was significantly lower than that in the control group (P<0.05). After treatment, amplitude of VEP in two groups were significantly increased, but the time from the injection of sodium fluorescein to the onset of optic disc fluorescence were decreased (P<0.05), and the amplitude of VEP and the time from the injection of sodium fluorescein to the onset of optic disc fluorescence in the observation were significantly better than those in the control group (P<0.05). Conclusion Puerarin and Glucose Injection combined with Vincamine Sustained Release Capsules in treatment of anterior ischemic optic neuropathy has a significant effect, can effectively improve the patient's vision and light sensitivity, alleviate the retinal ganglion cell complex and optic disc peripheral nerve atrophy, restore visual evoked potential and improve the microcirculation of the eye, which is worthy of clinical promotion.

R988.1

河北省卫生厅科研基金项目（20194002）