Page 151 - วารสารกรมการแพทย์แผนไทยฯ ปีที่ 16 ฉบับที่ 1

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Õ¬Ÿà∑’Ë °‘ËßÕ”‡¿Õ‡¢“§‘™¨°ŸØ ®—ßÀ«—¥®—π∑∫ÿ√’ ¡’ª√–«—μ‘ √“¬∑’Ë 2 ºŸâªÉ«¬À≠‘߉∑¬ Õ“¬ÿ 50 ªï ¿Ÿ¡‘≈”‡π“

√—°…“μâÕÀ‘π‡√◊ÈÕ√—ßμ“¢«“¡“°«à“ 5 ªï μ“´â“¬ Ÿ≠‡ ’¬ Õ¬Ÿà∑’Ë Õ.∫“ߪ–Õ‘π ®.æ√–π§√»√’Õ¬ÿ∏¬“ ¡’ª√–«—μ‘ 4
®“°Õÿ∫—쑇Àμÿμ—Èß·μàÀπÿà¡ √—∫°“√√—°…“∑’Ë√æ.„°≈â∫â“π «—π°àÕπ¡“‚√ß欓∫“≈ ¡’Õ“°“√μ“¡—«≈ß ‡ÀÁπ‰ø ≈—«
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¥â«¬¬“À¬Õ¥ DuoTrav eye drop μ‘¥μ“¡º≈·≈– ≈ß ¡ÕßÀπâ“§π¥”‰ªÀ¡¥ ‰¡à‡ÀÁπ√“¬≈–‡Õ’¬¥¢Õß
§«∫§ÿ¡§«“¡¥—π쓉¥â¥’¡“μ≈Õ¥ 3 «—π°àÕπ¡“ „∫Àπâ“ ‰ªμ√«®√—°…“∑’Ë‚√ß欓∫“≈ 2-3 ·Ààß æ∫«à“
‚√ß欓∫“≈μ“¢«“§àÕ¬ Ê ¡◊¥≈ß®π¥—∫ π‘∑ ®—°…ÿ ‡ªìπμâÕÀ‘𠧫“¡¥—π≈Ÿ°μ“ Ÿß ®“°°“√μ√«®§√—Èß·√°

·æ∑¬å„πæ◊Èπ∑’Ë·®âß«à“ ‡°‘¥®“°ª√– “∑μ“¢“¥‡≈◊Õ¥ ‡¡◊ËÕ«—π∑’Ë 2 ¡‘∂ÿπ“¬π 2557 æ∫«à“ V.A. Fc 2 øÿμ ∑—Èß
®“°°“√μ√«®„π§√—Èß·√°æ∫«à“ V.A. μ“¢«“ no pl, 2 μ“ ocular pressure μ“¢«“ 22.8 mmHg μ“´â“¬

ocular pressure 10.5 mmHg fundus examina- 32.3 mmHg (‰¥â¬“≈¥§«“¡¥—πμ“Õ¬Ÿà·≈â« §◊Õ
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tion æ∫«à“ optic disc ¡’ pale and full cupping Glauco-oph eye drop + Alphagan P eye
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‰¡àæ∫ cherry red spot ‰¥â√—∫°“√«‘π‘®©—¬‡ªìπ blind- drop + Xalatan eye drop + Diamox §√—Èß≈–
ness from advanced POAG ‰¥â√—∫°“√√âÕß¢Õ 1/2 ‡¡Á¥ (√–∫ÿ ¡‘≈≈‘°√—¡) × «—π≈– 4 §√—Èß), fundus
®“°ºŸâªÉ«¬·≈–≠“μ‘ „Àâ™à«¬À“∑“ß√—°…“„Àâ°≈—∫¡“ examination æ∫ optic disc cupping 0.4 ∑—Èß 2
¡Õ߇ÀÁπÕ’°§√—ÈßÀπ÷Ëß ®÷߇√‘Ë¡°“√√—°…“§√—Èß·√°‡¡◊ËÕ«—π μ“ ∫√‘‡«≥ posterior pole æ∫≈—°…≥– ischemic

∑’Ë 17 ¡‘∂ÿπ“¬π 2557 ¥â«¬¬“ steroid + baby as- area ´’¥ ∫«¡ ‡ªìπÀ¬àÕ¡ Ê ∑—Èß 2 μ“ „Àâ°“√
pirin + Palm pressure therapy (PPT) «‘π‘®©—¬‡ªìπ high tension glaucoma with is-
«—π∑’Ë 2 °√°Æ“§¡ 2557 V.A. μ“¢«“ Fc 1 chemic optic neuropathy ·≈–‡√‘Ë¡°“√√—°…“¥â«¬

øÿμ ocular pressure 14.1 mmHg ‡ª≈’Ë¬π¬“ steroid + baby aspirin + PPT + 2%
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À¬Õ¥μ“®“° DuoTrav eye drop ‡ªìπ Timolol Isoptocarpine eye drop «—π≈– 2 §√—Èß∑’Ëμ“∑—Èß 2
eye drop ¢â“ß ‡æ‘Ë¡‡¢â“‰ª®“°¬“‡¥‘¡¢ÕߺŸâªÉ«¬
«—π∑’Ë 9 °√°Æ“§¡ 2557: μ√«® V.A. μ“¢«“ «—π∑’Ë 5 ¡‘∂ÿπ“¬π 2558: æ∫«à“ 3 «—π À≈—ß°“√
Fc 3 øÿμ, ocular pressure 14.1 mmHg √—°…“ V.A. μ“¢«“ 20/70+1 μ“´â“¬ 20/50, ocular

«—π∑’Ë 16 °√°Æ“§¡ 2557: μ√«® V.A. μ“¢«“ pressure μ“¢«“ 7.5 mmHg μ“´â“¬ 9.1 mmHg
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5/200, ocular pressure 16.4 mmHg §«“¡¥—πμ“≈¥≈ߥ’ ∂Õπ Glauco-oph eye drop
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«—π∑’Ë 30 °√°Æ“§¡ 2557: μ√«® V.A. 15/200 ·≈–≈¥¬“ Diamox ®“° §√—Èß≈– 1/2 ‡¡Á¥ (√–∫ÿ
ph 20/200 °“√¡Õ߇ÀÁπ√–¥—∫π’È ™à«¬„À⺟âªÉ«¬ ¡‘≈≈‘°√—¡) × «—π≈– 4 §√—Èß ‡ªìπ §√—Èß≈– 1/2 ‡¡Á¥ ×
“¡“√∂„™â™’«‘쉥â‡À¡◊Õπ‡¥‘¡, ocular pressure 14.1 «—π≈– 2 §√—Èß

mmHg «—π∑’Ë 10 ¡‘∂ÿπ“¬π 2558: μ√«® V.A. μ“¢«“
«—π∑’Ë 18 ¡°√“§¡ 2559: μ√«® Follow up 20/70+1 ph 20/50-1 μ“´â“¬ 20/30-3, ocular pres-
§√—Èß ÿ¥∑⓬ V.A. 17/200 ph 20/200, ocular pres- sure μ“¢«“ 8.8 mmHg μ“´â“¬ 7.6 mmHg
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sure 11.2 mmHg ¬—ß control ¥â«¬ Timolol eye §«“¡¥—πμ“≈¥≈ߥ’ ∂Õπ Alphagan P eye drop
drop + baby aspirin + PPT «—π∑’Ë 17 ¡‘∂ÿπ“¬π 2558: μ√«® V.A. μ“¢«“