自拟化瘀利水方联合雷珠单抗治疗继发性黄斑水肿临床疗效观察  

Clinical Observation ofUsing Huayu Lishui Decoction Combined Lucentis in the Treatment of Secondary Macular Edema

作　　者：朱彦青[1] 丁银银[2] 顾佩霞 ZHU Yanqing;DING Yinyin;GU Peixia(Department of Ophthalmology,Nantong Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Jiangsu Nantong 226000,China;Department of Ophthalmology,Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing Jiangsu 210000,China)

机构地区：[1]南京中医药大学南通附属医院眼科,江苏南通226000 [2]南京中医药大学附属南京中医院眼科,江苏南京210000

出　　处：《四川中医》2022年第10期188-191,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：2019年南通市市级科技计划(指导性)项目(编号:MSZ19094);2019年南通市中医医疗联盟课题(编号:TZYK201903)

摘　　要：目的:探讨自拟化瘀利水方联合雷珠单抗治疗视网膜静脉阻塞(RVO)及糖尿病视网膜病变(DR)引起的继发性黄斑水肿临床疗效。方法:选择2019年8月~2020年12月在南京中医药大学附属南通市中医院眼科就诊的视网膜静脉阻塞和糖尿病视网膜病变继发黄斑水肿的患者56例,随机分为观察组与对照组各28例。对照组采取玻璃体腔注射雷珠单抗注射液治疗,观察组在对照组基础上加用自拟化瘀利水方治疗。比较2组治疗效果,治疗前及治疗后1周、4周、8周及12周最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)、中心凹下脉络膜厚度(SFCT)。结果:(1)BCVA(LogMAR):观察组和对照组在治疗后1周、4周、8周、12周时与同组治疗前相比有显著提高(P<0.05),且治疗后12周观察组(0.45±0.25)较对照组(0.65±0.33)的视力更好(P<0.05);(2)CMT:治疗后1周、4周、8周及12周,观察组和对照组CMT值与同组治疗前相比均显著下降,且治疗后12周两组CMT值比较有差异(P=0.017);(3)SFCT:治疗后1周、4周、8周及12周,观察组、对照组SFCT值与同组治疗前相比均显著下降,且治疗后8周(P=0.011)、12周(P=0.006)两组SFCT值比较有差异。结论:自拟化瘀利水方联合雷珠单抗治疗视网膜静脉阻塞继发性黄斑水肿,疗效较好,可明显改善患者视力、降低CMT和SFCT,在改善视力、促进黄斑水肿吸收、改善脉络膜循环等方面有明显优势。Objective:To observe the clinical efficacy of using Huayu Lishui Decoction combined with intravitreal injection of Lucentis in the treatment of secondary macular edema caused by retinal vein occlusion or diabetic retinopathy.Methods:From August 2019 to December 2020,we selected 56 patients with retinal vein occlusion or diabetic retinopathy secondary to macular edema who were treated at the Department of Ophthalmology,Nantong Hospital of Traditional Chinese Medicine,Nanjing University of Traditional Chinese Medicine,were randomly divided into an observation group and a controlled group.The controlled group was treated by intravitreal injection of Lucentis Injection,and the observation group was treated with Xuefu Zhuyu Decoction on the basis of the controlled group.To compare the treatment effects of the two groups,the best corrected visual acuity(BCVA),central retinal thickness(CMT),and subfoveal choroidal thickness(SFCT)before treatment and 1 week,4 weeks,8 weeks and 12 weeks after treatment.Results:(1)BCVA(LogMAR):The observation group and the controlled group were significantly improved at 1,4,8,and 12 weeks after treatment compared with the same group before treatment(P<0.05),and observed at 12 weeks after treatment.The visual acuity of the group(0.45±0.25)was better than that of the controlled group(0.65±0.33)(P<0.05);(2)CMT:1 week,4 weeks,8 weeks and 12 weeks after treatment,the CMT values of the observation group and the controlled group,both decreased significantly,compared with the same group before treatment.And there was a difference in CMT values between the two groups at 12 weeks after treatment(P=0.017);(3)SFCT:1 week,4 weeks,8 weeks and 12 weeks after treatment,the SFCT values of the observation group and the controlled group were all decreased significantly,compared with the same group before treatment.And 8 weeks after treatment(P=0.011),12 weeks(P=0.006).There is a difference in SFCT values between the two groups.Conclusion:Huayu Lishui Decoction combined with intravitreal injection of Lucent

关 键 词：自拟化瘀利水方 黄斑水肿 化瘀利水 雷珠单抗 

分 类 号：R774.5[医药卫生—眼科]