目的:观察中西医结合综合疗法治疗发病时间较长的视网膜动脉阻塞的临床疗效,并探讨视网膜动脉阻塞治疗的时间窗。方法:采用常规疗法、联合中药、神经修复的综合方法治疗14例15眼连续就诊于中国中医科学院眼科医院一病区的患者,并对其进行回顾性研究,比较并分析治疗后7,14,30d视力结果及治疗前后视野结果。结果:患者13例14眼完成14d治疗,11例12眼完成30d治疗。治疗7d后15眼中有11眼(73.33%)视力改善,14d后14眼中11眼(78.57%)视力改善,治疗30d后12眼中有11眼(91.67%)视力改善。治疗7d与治疗前比较(P<0.01)、治疗14d与7d比较(P<0.05)、治疗30d与14d比较(P<0.05)视力均有显著的提高。14例中12例完成视野检查,治疗后视野平均敏感度较治疗前显著意义的改善(P<0.05)。结论:常规疗法、联合中药、神经修复的综合方法治疗视网膜动脉阻塞有较好疗效,尤其对发病后视网膜水肿未消失之前治疗价值更高,同时治疗时机也不应拘泥在传统概念的发病3d内,或许更长,比如60d。

AIM: To observe the clinical effects of traditional Chinese medicine combined with Western medicine for acute retinal artery occlusion(RAO) after a long time onset and to evaluate the treatment time window. METHODS: This retrospective study included 14 cases (15 eyes) with acute RAO, who received a combined modality therapy for 30 days, including conventional treatment, integrating traditional Chinese medicine and nerve cells restoration. The clinical data of visual acuity after treating 7 days, 14 days, 30 days and visual field pre-therapy and post-treatment were analyzed and evaluated. RESULTS: Thirteen cases(14 eyes)completed 14 days treatment, 11 cases(12 eyes)completed 30 days treatment. 11 eyes of 15 eyes(73.33%)at 7 days, 11 eyes of 14 eyes(78.57%)at 14 days, 11 eyes of 12 eyes(91.67%)at 30 days respectively gained significant vision improvement after treatment. Vision increased significantly after 7 days’ treatment compared with pre-therapy(P<0.01). The vision also increased significantly after 14 days’ treatment compared with 7 days’ and after 30 days’ treatment compared with 14 days’ respectively(P<0.05). 12 of 14 cases completed visual field(VF) examination, VF mean sensitivity after treatment had significant improvement than before treatment (P<0.05). CONCLUSION: Synthetic therapies,including conventional treatment,integrating traditional Chinese medicine and nerve cells restoration are effective and available in RAO, especially when the retinal edema is exisent. So treatment opportunity should not be limited within 3 days of symptom onset instead of a longer time, even 60 days.

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