| Background:Optic neuritis generally refers to any inflammatory affection which betide optic nerve. The major manifestation of the disease is acute or subacute diminution of vision accompanied with central visual field defect. It is one of the most common optic nerve diseases in neuro-ophthalmology. Glucocorticoids have been accepted as the preferred treatment in the industry. While in the field of Traditional Chinese Medicine, glucocorticoids are considered as manly drugs which can cause a good deal of side effect and influence patients’types of syndrome with long term use of large dose. Therefore the evolvement rule of types of syndrome of optic neuritis patients who received large dose hormonotherapy need to be researched. In addition, on this basis, integrated traditional Chinese and western medicine therapy of optic neuritis needs further evaluation to improve visual function, increase curative effect. reduce side effect of glucocorticoids, mitigate symptom and also enhance patients’ living quality.Purpose:The research summarizes the domestic and overseas optic neuritis treatment progress and the knowing of traditional Chinese medicine in optic neuritis honnonotherapy. It mainly discusses the anteroposterior TCM syndrome characteristic of optic neuritis which received hormonotherapy and the curative effect analysis of integrated traditional Chinese and western medicine therapy in optic neuritis of hyperactivity of fire caused by deficiency of YIN.Method:1. Syndrome research:70cases of optic neuritis patients were brought into research in Beijing University of Chinese Medicine Dongfang Hospital and Peking Union Medical College Hospital. According to the clinical observation questionnaires, Syndrome informations prior to hormone therapy in patients with optic neuritis and after treatment of28±3days are registered. The optic neuritis syndrome characteristics and the evolution law before and after hormone treatment are explored by using descriptive analysis and clustering analysis.2. Research of curative effect of traditional Chinese medicine:60cases of optic neuritis patients were brought into research in Beijing University of Chinese Medicine Dongfang Hospital and Peking Union Medical College Hospital. The experimental group contains45cases and the control group15cases. The experimental group is treated by using zengyedihuang tang and hormone therapy. The control group uses hormone therapy. Then the two groups’visual acuity, visual field (MS, MD) and TCM symptoms total credits are analyzed statistically by respective observation before and after treatment.Result:1. Syndrome research:In this research, the syndromes of optic neuritis patients before hormone therapy are Qi-blood deficiency (28cases,41.2%), Heat of liverchannel&predominant heat impairing Yin (14cases,20.6%), Yang deficiency of spleen and kidney (13cases,19.1%),Yin deficiency of liver and kidney (7cases,10.1%), Stagnation of liver qi&insufficiency of kidney essence(6cases,8.8%). The syndromes of optic neuritis patients after hormone therapy are Hyperactivity of fire caused by deficiency of YIN(46cases,67.7%), Qi-blood deficiency&deficiency of Yin (13cases,19.1%), Stagnation of liver qi&insufficiency of kidney essence (9cases,13.2%).2.Research of curative effect of traditional Chinese medicine:In the aspect of vision acuity:vision acuity of patients after treatment in both experimental group and control group is increased, but there is no statistical differences between two groups (p=0.86). In terms of MS value of visual field:The MS value of patients befcre and after treatment shows statistic difference in both experimental group and control group (P=0.000, P=0.001). In addition, there is statistic difference between the two groups (p=0.045). The curative effect of the experimental group is better than that of the control group. In the aspect of MD value of view field:Before and after the treatment, the MD value of experimental group and control group shows statistic difference (P=0.000, P=0.001). Meanwhile there is statistic difference between the two groups (p=0.032). The curative effect of the experimental group is better than the control group. the improvement range of MS value and MD value negatively correlate to the days of onset in experimental group. The longer the onset, the less visual field is improved. In the aspect of TCM symptom total credits: The TCM symptom total credits before and after the treatment exist statistic difference (p=0.001). The TCM symptom total credits dropped significantly after the treatment.While TCM symptom total credits of control group have no statistic differences before and after treatment (P=0.367). And significant difference is found in two groups in improving the TCM symptom total credits aspect.Conclusion:The studies have shown that hormones have significant impact in TCM syndrome types of patients with optic neuritis. Especially, hyperactivity of fire caused by deficiency of YIN is one of the important syndrome type of optic neuritis patients after hormone therapy, so great attention should be paid on this in clinical practice.Zengyedihung tang functioning in nourishing yin forlowering fire can enhance the curative effect of hormonotherapy, improve patients’visual function, relieve side effect of glucocorticoids and mitigate patients’symptom. |
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