中国中医眼科杂志2025，Vol.35Issue(7)：607-613,653,8.DOI:10.13444/j.cnki.zgzyykzz.2025.07.002
基于OCTA定量分析补阳还五汤合水蛭对小视盘合并NAION患者视盘血流的影响
Effect of Buyang Huanwu Decoction and Hirudo on Optic Disc Blood Flow in Patients with Small Optic Disc and NAION Based on OCTA Quantitative Analysis
摘要
Abstract
OBJECTIVE To observe the blood flow characteristics of patients with small optic disc using optical coherence tomography angiography(OCTA)quantitative analysis technology and to investigate the effect of Yiqi Tongluo therapy(a method for invigorating Qi and unblocking collaterals)on optic disc blood flow in patients with small optic disc combined with nonarteritic anterior ischemic optic neuropathy(NAION).METHODS A total of 86 patients(86 eyes)with small optic disc diagnosed and treated at Beijing Hospital of Traditional Chinese Medicine affiliated with Capital Medical University from February 2024 to March 2025 were enrolled,all of whom exhibited Qi stagnation and blood stasis syndrome.They were divided into two groups based on the presence of NAION:Small optic disc group(Group A,44 cases,44 eyes)and small optic disc combined with NAION group(Group B,42 cases,42 eyes).Group B was further randomized into ischemic small optic disc Chinese medicines group(Group C,22 cases,22 eyes),and ischemic small optic disc control group(Group D,20 cases,20 eyes).Additionally,45 healthy individuals(45 eyes)with normal optic discs(Group E)were included.Group A received routine lifestyle guidance.Group C received oral Chinese medicines(Buyang Huanwu Decoction+Hirudo)in addition to Group A's regimen.Group D received oral Ginkgo biloba tablets in addition to Group A's regimen.Group E received no intervention.Groups C and D were observed for one month.Optic disc perfusion density(PD),flow index(FI),retinal nerve fiber layer(RNFL)thickness,and cup-to-disc ratio were measured in Groups A,B,and E at baseline.PD and FI were re-measured in Groups C and D after treatment,and data were recorded for statistical analysis.RESULTS(1)PD:① PD in Groups A,B and E:Significant differences were observed in overall PD and regional PD among the three groups(P<0.05).Pairwise comparisons showed that Group B had lower overall and regional PD than Group A,Group E had higher overall and superior PD than Group A,and Group E had higher overall and regional PD than Group B(all P<0.05).② PD in Groups C and D:Group C showed increased overall PD after treatment(P<0.05),but no significant differences were observed in other regional PD in Group C or in overall and regional PD in Group D before and after treatment(P>0.05).No significant differences were found between the two groups before or after treatment(P>0.05).(2)FI:① FI in Groups A,B and E:Significant differences were observed in overall,inferior,and nasal FI among the three groups(P<0.05),but no differences were found in superior and temporal FI(P>0.05).Pairwise comparisons revealed that Group B had lower overall,inferior,superior,and nasal FI than Group A,and Group E had higher overall,inferior,nasal,and temporal FI than Group B(all P<0.05).Other comparisons showed no significant differences(P>0.05).② FI in Groups C and D:No significant differences were observed in overall or regional FI within or between the two groups before and after treatment(P>0.05).(3)RNFL thickness in Groups A,B and E:Significant differences were observed in nasal and temporal RNFL thickness among the three groups(P<0.05),but no differences were found in average,inferior,or superior RNFL thickness(P>0.05).Pairwise comparisons showed that Group B had lower average,nasal,and temporal RNFL thickness than Group A,and Group E had higher average RNFL thickness than Group B(all P<0.05).Other comparisons showed no significant differences(P>0.05).(4)Cup-to-disc ratio in Groups A,B and E:Significant differences were observed among the three groups(P<0.05).Pairwise comparisons showed that Group E had a higher cup-to-disc ratio than Groups A and B(both P<0.05),while no difference was found between Groups A and B(P>0.05).(5)Correlation analysis of average RNFL thickness with overall PD,overall FI,and cup-to-disc ratio:Average RNFL thickness was positively correlated with overall PD and overall FI(both P<0.05)but not with cup-to-disc ratio(P>0.05).CONCLUSIONS The patients with small optic disc exhibit lower optic disc blood flow than those with normal optic discs,providing a quantitative reference for monitoring optic disc blood flow.Yiqi Tongluo therapy(Buyang Huanwu Decoction combined with Hirudo)shows a trend toward improving optic disc blood flow in the patients with small optic disc and NAION,offering new insights and efficacy monitoring techniques for treating NAION with Chinese medicines.关键词
小视盘/视盘血流/光学相干断层扫描血管成像/补阳还五汤/水蛭Key words
small optic disc/optic disc blood flow/optical coherence tomography angiogra-phy/Buyang Huanwu Decoction/Hirudo分类
医药卫生引用本文复制引用
武燕,闫仁杰,吴小艳,李钠,杨自逸,杨潮,杨迎新..基于OCTA定量分析补阳还五汤合水蛭对小视盘合并NAION患者视盘血流的影响[J].中国中医眼科杂志,2025,35(7):607-613,653,8.基金项目
国家自然科学基金项目(81873344) （81873344）
