【摘要】 目的 观察韦氏活血通络方对气虚血瘀型萎缩期非动脉炎性前部缺血性视神经病变（NAION）的疗效及可能的机制。方法 82例气虚血瘀型萎缩期NAION患者随机分为治疗组、对照组各41例。治疗组给予韦氏活血通络方颗粒口服（每日2次）及患侧颞浅动脉旁注射灭菌注射用水（每次2 ml、每日1次）；对照组给予患侧颞浅动脉旁注射复方樟柳碱注射液（每次2 ml、每日1次）及韦氏活血通络方颗粒模拟剂口服（每日2次），两组均治疗14天。比较两组治疗前及治疗第7、14天最佳矫正视力（BCVA），视盘血管灌流密度（PD）、通量指数（FI），黄斑浅层PD、血管密度（VD）及中医证候评分；比较两组治疗前后视野平均缺损（MD）、平均敏感度（MS），并进行安全性评价。结果 与本组治疗前比较，两组治疗后BCVA、视野MD及MS、中医证候评分均改善（P<0.05或P<0.01）。治疗组治疗第14天中医证候评分低于对照组（P<0.05）。与本组治疗前比较，两组治疗后视盘PD和FI、黄斑浅层PD及VD无明显改善（P>0.05），仅治疗第7天对照组黄斑浅层中心凹PD高于治疗组（P<0.05）。两组治疗期间未出现严重不良事件。结论 韦氏活血通络方能改善气虚血瘀型萎缩期NAION患者视力、视野等视功能指标和中医证候评分，具有临床安全性，但对视盘及黄斑血流未见明显影响。更多还原

【Abstract】 Objective To evaluate the efficacy and possible mechanism of Wei’s Huoxue Tongluo Formula （韦氏 活 血 通 络 方,WHTF） in treating atrophic-stage non-arteritic anterior ischemic optic neuropathy(NAION) with qi deficiency and blood stasis. Methods A total of 82 atrophic-stage NAION patients with qi deficiency and blood stasis were randomly divided into a treatment group and a control group, with 41 cases in each group. The treatment group was given oral administration of WHTF twice a day plus acupoint injection of distilled water 2 ml at Taiyang(EX-HN5) once daily, while the control group received injection of compound anisodine injection 2 ml at Taiyang(EX-HN5) once daily and oral administration of WHTF placebo twice a day. Both groups received treatment for a course of 14 days. The best-corrected visual acuity(BCVA), optic disc perfusion density(PD), flux index(FI), macular superficial PD, vascular density(VD), and traditional Chinese medicine(TCM) syndrome scores were compared between groups before treatment and on day 7 and day 14 of treatment. Additionally, mean defect(MD) and mean sensitivity(MS) of visual fields were measured before treatment and on day 14, along with safety evaluation. Results After treatment, both groups showed significant improvement in BCVA, visual field MD and MS, and TCM syndrome scores(P<0. 05 or P<0. 01). On day 14 of treatment, the TCM syndrome score in the treatment group was significantly lower than that in the control group(P<0. 05). There was no significant improvement in optic disc PD and FI, and macular superficial PD and VD after treatment in either group(P>0. 05) except that on day 7 the macular superficial foveal PD in the control group was significantly better than that in the treatment group(P<0. 05). During the treatment period, no serious adverse events occurred in either group. Conclusion WHTF can improve the visual function indicators including visual acuity and visual field, as well as TCM syndrome scores in atrophic-stage NAION patients with qi deficiency and blood stasis. It shows clinical safety, although it does not appear to have a significant effect on optic disc or macular blood flow.更多还原