[1]杨霞霞,闫 瑾,张自峰,等.牵正散联合肉毒素及复方樟柳碱治疗目偏视临床研究[J].陕西中医,2024,(10):1377-1381.[doi:DOI:10.3969/j.issn.1000-7369.2024.10.018]
　YANG Xiaxia,YAN Jin,ZHANG Zifeng,et al.Qianzheng powder combined with botulinum toxin A extraocular injection and compound anisodine subcutaneous injection in treatment of eye deviation[J].,2024,(10):1377-1381.[doi:DOI:10.3969/j.issn.1000-7369.2024.10.018]
点击复制

牵正散联合肉毒素及复方樟柳碱治疗目偏视临床研究
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年10期
页码:
1377-1381
栏目:
临床研究
出版日期:
2024-10-05

文章信息/Info

Title:
Qianzheng powder combined with botulinum toxin A extraocular injection and compound anisodine subcutaneous injection in treatment of eye deviation
作者:
杨霞霞1; 闫 瑾2; 张自峰1; 张桂鸥1
(1.空军军医大学西京医院眼科,陕西 西安 710032; 2.西安医学院医学技术学院眼视光教研室,陕西 西安 710021)
Author(s):
YANG Xiaxia; YAN Jin; ZHANG Zifeng; ZHANG Guiou
(Department of Ophthalmology,Xijing Hospital,Air Force Medical University,Xi'an 710032,China)
关键词:
目偏视;  麻痹性内斜视;  牵正散;  A型肉毒素;  复方樟柳碱
Keywords:
Eye deviation;  Paralytic esotropia;  Qianzheng powder;  Botulinum toxin A;  Compound anisodine
分类号:
R 276.7
DOI:
DOI:10.3969/j.issn.1000-7369.2024.10.018
文献标志码:
A
摘要:
目的:评价牵正散加减联合A型肉毒素(BTA)眼外肌注射及复方樟柳碱颞浅皮下注射治疗目偏视的临床疗效。方法:收集诊断为目偏视(麻痹性内斜视)的患者79例(93眼),根据治疗方案分组:营养神经等基础治疗者27例(31眼)纳入对照组; 基础治疗加用BTA眼外肌注射及复方樟柳碱颞浅皮下注射者28例(33眼)纳入注射组; 注射组基础上加用牵正散加减者24例(29眼)纳入联合组。观察比较三组患者治疗前后三棱镜斜视度、患眼外直肌功能、临床症状评分、疗程及疗效。结果:治疗后三组患者斜视度、患眼外展功能、临床症状总评分均较治疗前好转,差异有统计学意义(均P<0.01); 三组间患者斜视度、患眼外展功能、临床症状总评分改善差异有统计学意义(P<0.05),其中联合组较对照组和注射组改善更佳,差异有统计学意义(均P<0.05)。联合组治愈率(70.8%)高于对照组(44.4%)及注射组(35.7%),差异有统计学意义(P<0.05)。治愈者中联合组患者疗程更短,较其余两组差异有统计学意义(P<0.05)。结论:牵正散加减联合A型肉毒素眼外肌注射及复方樟柳碱颞浅皮下注射是治疗目偏视(麻痹性内斜视)的有效方法,可降低斜视度数、改善外直肌功能及临床症状评分、缩短疗程、提高治愈率。
Abstract:
Objective:To evaluate the clinical efficacy of Qianzheng powder combined with botulinum toxin A(BTA)extraocular injection and compound anisodine subcutaneous injection in the treatment of eye deviation.Methods:A retrospective analysis was performed.A total of 79 patients(93 eyes)diagnosed with eye deviation(paralytic esotropia)were collected.They were grouped according to the treatment plan:27 patients(31 eyes)who received basic treatment such as nutritional support for nerves were included in the control group; 28 patients(33 eyes)who were treated with botulinum toxin A extraocular injection and compound anisodine subcutaneous injection were included in the injection group; the combination group,in addition to the treatment provided to the injection group,received additional Qianzheng powder,consisting of 24 cases(29 eyes).The degree of tricprism strabismus,the function of the affected external rectus muscle,the score of clinical symptoms,the course of treatment and the curative effect of the three groups were observed and compared.Results:After treatment,the degree of strabismus,the abduction function of the affected eye and the total score of clinical symptoms of the three groups were improved compared with that before treatment,and the differences were statistically significant(P<0.01).There were statistical differences in the improvement of strabismus,abductive function of affected eye and total score of clinical symptoms among the three groups(P<0.05).The combination group improved more than the control group and the injection group,and the difference was statistically significant(P<0.05).The cure rate of combination group(70.8%)was higher than that of control group(44.4%)and injection group(35.7%),and the difference was statistically significant(P<0.05).Moreover,the treatment course was shorter in the combination group than that of the other two groups,and the difference was also statistically significant(P<0.05).Conclusion:Qianzheng powder combined with botulinum toxin A extraocular injection and compound anisodine subcutaneous injection is an effective method to treat eye deviation(paralytic esotropia).It can reduce the degree of strabismus,improve the function of external rectus muscle and clinical symptom score,shorten the course of treatment and increase the cure rate.

参考文献/References:

[1] 邢静,李慧丽,张腾,等.目偏牵正汤联合针刺治疗目偏视的临床研究[J].中国中医眼科杂志,2024,34(1):40-45.
[2] 梁甜,李俊红.外展神经麻痹的定位诊断及治疗进展[J].中华眼科医学杂志(电子版),2018,8(4):187-192.
[3] 艾立坤,郭芮琳,吴海亮,等.三种不同术式治疗外展神经麻痹内斜视的疗效观察[J].中国斜视与小儿眼科杂志,2019,27(1):10-14,25.
[4] 邢凯,张晓旭,张娇,等.针刺联合复方樟柳碱注射液治疗糖尿病麻痹性斜视68例[J].中医眼耳鼻喉杂志,2023,13(2):77-78,88.
[5] 邢凯,郑霜,张晓旭,等.三棱镜试戴法与针刺联合复方樟柳碱注射液治疗麻痹性斜视的临床观察[J].中华养生保健,2023,41(21):20-23.
[6] 吴晓.A型肉毒毒素在麻痹性内斜视治疗中的应用[J].中华眼科杂志,2002,12(8):12-16.
[7] 张晓,徐菲.定风明视胶囊治疗后天性麻痹性斜视风痰阻络证的临床研究[J].中国中医眼科杂志,2019,29(6):447-450.
[8] 王予伟,孔德兰,霍勤,等.针灸及曲安奈德治疗麻痹性斜视的研究进展[J].河南医学研究,2020,29(2):381-382.
[9] 银子涵,李燕婷,曾鹏飞,等.针灸及其相关疗法治疗麻痹性斜视的临床进展[J].中国中医眼科杂志,2019,29(4):332-334.
[10] ISSAHO D C,CARVALHO F,TABUSE M,et al.The use of botulinum toxin to treat infantile esotropia:A systematic review with Meta-analysis[J].Invest Ophthalmol Vis Sci,2017,58(12):5468-5476.
[11] 刘睿,张晓慧,邹蕾蕾,等.部分直肌转位术治疗外直肌完全麻痹的疗效观察[J].中华眼科杂志,2013,49(7):599-603.
[12] 谢立科,黄少兰,张明亮,等.正斜丸治疗麻痹性斜视临床研究[J].中国中医眼科杂志,1999,9(4):208-211.
[13] 巢元方.诸病源候论[M].沈阳:辽宁科学技术出版社,1997:133.
[14] 张晓利,樊淑红,刘丹.后天性麻痹性斜视的诊断治疗研究[J].中华眼外伤职业眼病杂志,2020,42(4):302-305.
[15] 汤垟,孙子雯,王燨烔,等.后天麻痹性斜视的临床治疗进展[J].昆明医科大学学报,2019,40(12):1-6.
[16] ROWE F.Prevalence of ocular motor cranial nerve palsy and associations following stroke[J].Eye,2011,25(7):881-887.
[17] 周欢粉,魏世辉.外展神经麻痹住院患者47例的相关因素分析[J].国际眼科杂志,2008,13(9):1940-1942.
[18] KIM M,LEW H.Binocular visual rehabilitation in paralytic strabismus by botulinum a toxin chemodenervation[J].Korean J Ophthalmol,2022,36(1):60-65.
[19] 刘振豹,郑丽平,孙翠苹.复方樟柳碱穴位注射在脑梗死引起眼外肌麻痹患者中的疗效观察及对眼外肌功能的影响研究[J].国际医药卫生导报,2020,26(10):1420-1422.
[20] 杨阳,周引群.复方樟柳碱治疗麻痹性斜视的疗效及对丙二醛和超氧化物歧化酶的影响[J].国际眼科杂志,2016,16(10):1902-1904.
[21] 王志强,张智军.正珠笑容汤化裁治疗后天性麻痹性斜视临床观察[J].现代中医药,2016,36(5):40-41.
[22] WONG E S,LAM C P,LAU F H,et al.Botulinum toxin as an initial therapy for management of sixth nerve palsies caused by nasopharyngeal carcinomas[J].Eye(Lond),2018,32(4):768-774.
[23] 汪晓瑜,王小莉,喻磊,等.非肌电图引导Tenon氏囊下注射不同剂量A型肉毒毒素治疗先天性内斜视临床疗效观察[J].陕西医学杂志,2022,51(2):219-221,244.
[24] 刘小春,张卫华,赵娴.国医大师郭诚杰治疗周围性面瘫急性期经验[J].陕西中医,2022,43(12):1781-1783.
[25] 王岚萱,吴若辉,贺小卉,等.牵正散合桂枝加葛根汤加减、温针灸联合康复训练治疗顽固性周围性面瘫临床研究[J].陕西中医,2020,41(9):1262-1265.

备注/Memo

备注/Memo:
基金项目:陕西省自然科学基础研究计划项目(2023-JC-YB-772); 陕西省重点研发计划项目(2024SF-YBXM-320)
更新日期/Last Update: 2024-10-08