研究疾病:
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非动脉炎性缺血性视神经病变
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研究疾病代码:
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Target disease:
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non-Arterial Ischemic Optic Neuropathy
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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其它
Others
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研究目的:
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1.研究益气活血通窍明目方对非动脉炎性缺血性视神经病变(non-arteritic ischemic optic neuropathy, NAION)的临床疗效;2.探究血浆内皮素-1(endothelin-1,ET-1)水平高低与NAION病情的关系,为NAION的诊断、疗效提供新指标;3.探索益气活血通窍明目方对ET-1水平的影响,为将该方制成院内制剂奠定理论基础;4.为形成NAION的新的治疗指南及专家共识提供临床依据
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Objectives of Study:
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1. To study the clinical efficacy of Yiqihuoxuetongqiaomingmu recipe in the treatment of non-arterial inflammatory ischemic optic neuropathy (non-arteritic ischemic optic neuropathy, NAION)); 2. To explore the relationship between the level of plasma endothelin-1 (endothelin-1,ET-1) and the condition of NAION, so as to provide a new index for the diagnosis and curative effect of NAION; 3. To explore the effect of Yiqihuoxuetongqiaomingmu recipe on the level of ET-1 in order to lay a theoretical foundation for making this prescription into hospital preparation; 4. To provide clinical basis for the formation of new treatment guidelines and expert consensus for NAION.
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药物成份或治疗方案详述:
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观察组:
注射用甲泼尼龙琥珀酸钠80mg,加入0.9%NS 250mL中静脉滴注治疗,每日1次,连用7天,后减量至40mg,加入0.9%NS 250mL中静脉滴注治疗,每日1次,连用7天,后改为口服甲泼尼龙片,逐渐减量至20mg、12mg、8mg、4mg,分别持续7天,每日一次。足三里穴位注射甲钴胺注射液0.5mg,每日一次,一周三次,连用2周;太阳穴位注射复方樟柳碱注射液2mL,每日一次,连用2周;控制全身疾病及其他危险因素;口服益气活血通窍明目方治疗(桃仁10g 红花10g 生地黄15g 赤芍10g 川芎10g 当归10g 柴胡10g 黄芪45g 党参45g 丹参15g 三七15g 路路通30g 石菖蒲15g 郁金10g),溶于150mL温开水中,每日早上8:00一次口服,从首次服药开始连续服用15d。
对照组:
注射用甲泼尼龙琥珀酸钠80mg,加入0.9%NS 250mL中静脉滴注治疗,每日1次,连用7天,后减量至40mg,加入0.9%NS 250mL中静脉滴注治疗,每日1次,连用7天,后改为口服甲泼尼龙片,逐渐减量至20mg、12mg、8mg、4mg,分别持续7天,每日一次;足三里穴位注射甲钴胺注射液0.5mg,每日一次,一周三次,连用2周;太阳穴位注射复方樟柳碱注射液2mL,每日一次,连用2周;控制全身疾病及其他危险因素;
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Description for medicine or protocol of treatment in detail:
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Experimental group:
Methylprednisolone sodium succinate 80 mg for injection was treated with intravenous drip of methylprednisolone succinate sodium in 0.9%NS 250mL once a day for 7 days, then reduced to 40 mg once a day for 7 days. Then it was changed to oral methylprednisolone tablets, and gradually reduced to 20mg, 12mg, 8mg, 4mg for 7 days; Zusanli acupoint injection of mecobalamin 0.5mg, once a day, three times a week, for 2 weeks; Control of systemic diseases and other risk factors; Oral Yiqihuoxuetongqiaomingmu recipe (peach kernel 10g safflower 10g raw Radix Rehmanniae 15g Radix Paeoniae Rubra 10g Chuanxiong 10g Radix angelicae 10g Radix Bupleuri 10g Radix Astragali 45g Radix Salviae Miltiorrhizae 45g Salvia miltiorrhiza 15g Sanqi 15g Putong 30g Acorus calamus 15g Yujin 10g), dissolved in 150mL for 15 days.
Control group:
Methylprednisolone sodium succinate 80 mg for injection was treated with intravenous drip of methylprednisolone succinate sodium in 0.9%NS 250mL once a day for 7 days, then reduced to 40 mg once a day for 7 days. Then it was changed to oral methylprednisolone tablets, and gradually reduced to 20mg, 12mg, 8mg, 4mg for 7 days; Zusanli acupoint injection of mecobalamin 0.5mg, once a day, three times a week, for 2 weeks; Sun acupoint injection of compound anisodine injection 2 mL, once a day for 2 weeks; Control of systemic diseases and other risk factors.
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纳入标准:
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(1)符合《我国非动脉炎性缺血性视神经病变诊断和治疗专家共识(2015年)》诊断标准;
(2)年龄介于18至70岁之间;
(3)经中医辨证符合气虚血瘀证:
主证:①视物昏花②视物遮挡;
兼证1:①面色淡白或暗滞②心悸气短,纳少健忘③神疲乏力,面色萎黄,倦怠懒言④舌质偏淡;
兼证2:①头痛或眼痛,疼痛如刺,痛处固定不移②舌质见瘀斑③脉象细涩或细数无力。
具备主症中至少一个症状,并分别具备次症 1 和次症 2 中至少一个症状。
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Inclusion criteria
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1. In accordance with the diagnostic criteria of "expert consensus on diagnosis and treatment of non-arteritis Ischemic Optic Neuropathy in China (2015)";
2. Aged 18 to 70 years old;
3. the syndrome differentiation of traditional Chinese medicine accords with the syndrome of qi deficiency and blood stasis:
The main syndrome:
(1) the visual object is faint;
(2) the visual object is occluded;
Concurrently syndrome 1:
(1) the complexion was pale or dark;
(2) Palpitations, shortness of breath and forgetfulness;
(3) Tired, yellowed, tired and lazy;
(4) The quality of the tongue is light
Concurrently syndrome 2:
(1) headache or eye pain, pain such as a thorn, pain fixed;
(2) Ecchymosis of tongue;
(3) the pulse is thin or weak
Has at least one of the main symptoms, and has at least one of the concurrently syndrome 1 and 2 respectively.
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排除标准:
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(1)并发影响视功能的其他眼病及颞动脉炎性病变;
(2)无光感超过7°者;病程超过3个月者;
(3)排除其他可引起视盘水肿和视力下降的视神经疾病,如青光眼、视神经炎、视神经萎缩等;
(4)对药物过敏者(包括甲泼尼龙琥珀酸钠、甲泼尼龙片、维生素B1、甲钴胺片、中药颗粒);
(5)孕妇及哺乳期妇女。
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Exclusion criteria:
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(1) complicated with other ophthalmopathy and temporal artery inflammatory lesions affecting visual function;
(2) absence of light sensation more than 7 degree, course of disease more than 3 months;
(3) excluding other optic nerve diseases that can cause optic disc edema and visual impairment, such as glaucoma, optic neuritis, optic nerve atrophy and so on;
(4) allergic to drugs (including methylprednisolone sodium succinate, methylprednisolone tablets, vitamin B1, mecobalamin tablets, traditional Chinese medicine granules);
(5) pregnant and lactating women.
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研究实施时间:
Study execute time:
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从From
2019-11-20
至To
2019-12-31
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征募观察对象时间:
Recruiting time:
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从From
2019-11-20
至To
2019-12-31
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