【摘要】 目的：观察耳穴压豆联合疏肝中药疗法对肝郁型原发性开角型青光眼(POAG)患者眼压、视野缺损及眼部血流的影响。方法：选取2020年2月～2023年5月本院收治的110例肝郁型POAG患者，简单随机法分为两组。基础组55例(110眼)给予西医基础治疗，中医疗法组55例(110眼)在基础组基础上给予耳穴压豆联合疏肝中药疗法治疗。比较两组昼夜眼压、视野平均缺损、跨筛板压力差(TCLPD)、视野指数(VFI)、视盘光学相干断层扫描(OCT)指标[盘沿面积、垂直C/D比率、视杯体积、视网膜纤维层厚度(RNFLT)]、眼部血流、中医证候评分差异。结果：比较昼夜眼压、视野平均缺损、视盘OCT指标、TCLPD、VFI治疗前水平，无差异(P>0.05);两组治疗后视野平均缺损、TCLPD及7点、14点、21点的眼压均较治疗前降低，中医疗法组昼夜眼压、视野平均缺损、TCLPD更低(P<0.05)。两组治疗后VFI、RNFLT升高，中医疗法组治疗后VFI、RNFLT更高(P<0.05);两组盘沿面积、垂直C/D比率、视杯体积治疗前后比较及两组治疗后比较，均无差异(P>0.05)。比较眼部血流治疗前水平，无差异(P>0.05);两组治疗后视网膜中央动脉和睫状后动脉的舒张末期血流速度(EDV)、收缩期峰值血流速度(PSA)较治疗前升高，中医疗法组更高(P<0.05)。两组治疗后视网膜中央动脉和睫状后动脉的阻力指数(RI)降低，中医疗法组治疗后更低(P<0.05)。比较中医证候评分治疗前水平，无差异(P>0.05);两组治疗后视物昏朦、目珠微张、瞳神稍大、情志不舒、胸胁胀痛、口干口苦、耳鸣、便秘评分降低，中医疗法组治疗后更低(P<0.05)。结论：耳穴压豆联合疏肝中药疗法治疗肝郁型POAG可减轻症状，降低昼夜眼压，改善眼部血流循环，提高视野。更多还原

【Abstract】 Objective To observe the effects of auricular acupoint pressure on intraocular pressure, visual field defect and ocular blood flow in patients with primary open Angle glaucoma(POAG) with liver depression.Methods A total of 110 patients with hepatic depression type POAG admitted to our hospital from February 2020 to May 2023 were divided into two groups by simple random method. In the basic group, 55 cases(110 eyes) were given basic Western medicine treatment, and in the traditional Chinese medicine treatment group, 55 cases(110 eyes) were given auricular point compression bean combined with liver soothing Chinese medicine treatment on the basis of basic group. The diurnal intraocular pressure, mean visual field defect, trans-mesh plate pressure difference(TCLPD), visual field index(VFI), optic disc optical coherence tomography(OCT) indexes [disk area, vertical C/D ratio, optic cup volume, retinal fiber layer thickness(RNFLT)], ocular blood flow and TCM syndrome score were compared between the two groups.Results There were no significant differences between day and night iOP, average visual field defect, optic disc OCT, TCLPD and VFI before treatment(P>0.05). After treatment, the mean visual field defect, TCLPD and IOP at 7, 14 and 21 points were lower in both groups than before treatment, and the mean visual field defect and TCLPD were lower in the TCM treatment group(P< 0.05). After treatment, VFI and RNFLT were increased in the two groups, and higher in the Chinese medicine treatment group(P<0.05). There were no differences in the disk rim area, vertical C/D ratio and visual cup volume between the two groups before and after treatment(P>0.05). There was no difference in eye blood flow before treatment(P>0.05). After treatment, the end-diastolic blood flow velocity(EDV) and peak systolic blood flow velocity(PSA) of the central retinal artery and posterior ciliary artery were higher than those before treatment in the two groups, and those in the traditional Chinese medicine treatment group were higher(P< 0.05). The resistance index(RI) of central retinal artery and posterior ciliary artery was lower in two groups after treatment, and lower in TCM group(P<0.05). There was no difference in TCM syndrome score before treatment(P>0.05). After treatment, the scores of dim vision, slightly dilated eyes, larger pupils, emotional discomfort, chest pain, dry mouth, bitter mouth, tinnitus and constipation were lower in the two groups, and lower in the Chinese medicine treatment group(P<0.05).Conclusion The treatment of POAG of liver depression can relieve symptoms, reduce day and night intraocular pressure, improve eye blood circulation and enhance visual field.更多还原