目的 探究葛根素葡萄糖注射液聯(lián)合長春胺緩釋膠囊治療前部缺血性視神經(jīng)病變的臨床效果。方法 選取2017年2月—2019年12月在保定市第四中心醫(yī)院接受治療的前部缺血性視神經(jīng)病變患者96例（130眼）作為研究對象。按照隨機數(shù)字表法分為對照組48例（65眼）和觀察組48例（65眼）。對照組患者口服長春胺緩釋膠囊，1粒/次，2次/d。觀察組在對照組治療的基礎上靜脈滴注葛根素葡萄糖注射液250 mL，1次/d。兩組均連續(xù)治療4周。觀察兩組患者的臨床療效，同時比較兩組治療前后的視野水平、視力、光敏感度水平、視網(wǎng)膜神經(jīng)節(jié)細胞復合體厚度及視盤周圍神經(jīng)厚度、視覺誘發(fā)電位振幅水平及眼底熒光血管造影數(shù)據(jù)。結(jié)果 治療后，兩組患者的治療有效率分別為95.00%和82.00%，觀察組患者顯著高于對照組（P<0.05）。治療后，兩組患者的視野水平均有顯著改善（P<0.05），且觀察組患者的視野水平明顯優(yōu)于對照組患者（P<0.05）。治療后，兩組患者的視力以及光敏感度水平均有顯著提高（P<0.05），且觀察組患者的視力以及光敏感度水平明顯高于對照組患者（P<0.05）。兩組患者的視網(wǎng)膜神經(jīng)節(jié)細胞復合體厚度及視盤周圍神經(jīng)厚度均有顯著減輕（P<0.05），且觀察組患者的視網(wǎng)膜神經(jīng)節(jié)細胞復合體厚度及視盤周圍神經(jīng)厚度明顯低于對照組患者（P<0.05）。治療后，兩組患者的視覺誘發(fā)電位振幅均有顯著升高，從注射熒光素鈉針至視盤開始出現(xiàn)熒光時間均有顯著下降（P<0.05），且觀察組患者的視覺誘發(fā)電位振幅明顯高于對照組患者，從注射熒光素鈉針至視盤開始出現(xiàn)熒光時間顯著低于對照組患者（P<0.05）。結(jié)論 葛根素葡萄糖注射液聯(lián)合長春胺緩釋膠囊治療前部缺血性視神經(jīng)病變療效顯著，可有效改善患者的視力及光敏感程度，緩解視網(wǎng)膜神經(jīng)節(jié)細胞復合體及視盤周圍神經(jīng)萎縮，恢復視覺誘發(fā)電位改善眼部微循環(huán)，值得臨床推廣使用。

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

河北省衛(wèi)生廳科研基金項目（20194002）