Clinical Study Of Acupuncture Combined With Traditional Chinese Medicine In The Treatment Of Non-arteritis Anterior Ischemic Optic Neuropathy

RESEARCH BACKGROUND:Ischemic optic neuropathy(ION)is an eye disease characterized by sudden decrease of visual acuity,caused by blockage of the blood vessels supplyins the optic nerve leading to insufficiency blood supply of the optic nerve before and after the sieve plate.Non-arteritis anterior ischemic optic neuropathy(NA-AION),which is the most common type of ION.is one of the significant reasons that endanger the visual function of quinquagenarian.In TCM.the disease is called shi zhan hun miao(视瞻昏渺 blurred vision)or bao mang(暴盲.sudden blindness).It believes that NA-AION is caused by the obstruction of the mu xi(目系)."Qi is the commander of blood".thus,Qi deficiency can’t promote blood circulation and lead to blood stasis,Qi and blood can’t nourish the eyes and cause disease.At present,there is no definite method to treat NA-AION clinically.My tutor has been engaged in the clinical treatment of NA-AION for decades.She has observed that acupuncture combined with Yiqi Huoxue Tongluo Formula plays an important effect on Qi deficiency and blood stasis type of NA-AION.OBJECTIVE:To explore the clinical effect of acupuncture combined with Yiqi Huoxue Tongluo Formula in the treatment of Non-arteritis anterior ischemic optic neuropathy.METHOD:From January 2017 to December 2018,84 patients with Non-arteritis anterior ischemic optic neuropathy diagnosed in Ophthalmology Department of Xiyuan Hospital or in Ophthalmology Hospital both of China Academy of Chinese Medical Sciences or in Ophthalmology Department of Dongfang Hospital were randomly divided into treatment group and control group according to random numbers.The treatment group was treated with acupuncture combined with Yiqi Huoxue Tongluo Formula.During eight weeks of treatment,acupuncture was daily given five days a week and took two days off,meanwhile,Yiqi Huoxue Tongluo Formula was given one dose daily.The control group was given hormone orally and intramuscular injection of cobalamin adenosine.The hormone was taken at 0.5-1 mg/kg,of which the dose was reduced by 10 mg per week until drug withdrawal.Intramuscular injection was daily given two weeks and took one week off for three courses.It was the best corrected visual acuity(5 points recording),average visual field sensitivity and average visual field defect that were observed and recorded before and after treatment in both groups.RESULT:The total effective rate was 90.48%in the treatment group and 78.57%in the control group.There was no significant difference between two groups in improving NA-AION vision(P=0.529>0.05).The treatment group was superior to the control group in improving the average sensitivity of visual field and reducing the average defect of visual field.It was significantly different after 8 weeks of treatment(P=0.034,0.044<0.05).CONCLUSION:Acupuncture combined with Yiqi Huoxue Tongluo Formula can improve the average visual field sensitivity and reduce the average visual field defect,which is better than hormone combined with cobalamin adenosine injection group in 8 weeks after treatment.There was no difference between two groups in improving visual acuity.The total effective rate of the treatment group was better than that of the control group.