健脾利湿中药联合激光治疗中心性浆液性脉络膜视网膜病变  

Therapeutic Effect of Spleen-strengthening and Dampness-elimination Chinese Herbal Medicine Plus Laser Treatment for Central Serous Chorioretinopathy

作　　者：杨旸[1] 祁勇军[1] 刘婉君[1] 邓建华[1] 谢晓燕[1] 许懋[1] 

机构地区：[1]广东省中医院珠海医院眼科,广东珠海519015

出　　处：《广州中医药大学学报》2013年第4期481-483,487,608,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局"2011年建设中医药强省"科研项目(编号:20112037)

摘　　要：【目的】探讨健脾利湿中药在激光治疗中心性浆液性脉络膜视网膜病变(CSC)围手术期的应用。【方法】对30例中心性浆液性脉络膜视网膜病变患者经光学相关断层扫描(OCT)及眼底荧光血管造影检查(FFA)明确诊断,给予激光治疗,治疗后服用健脾利湿中药30 d。观察治疗前后视力情况、视网膜形态和神经上皮脱离高度变化,不同时间CSC患者治愈情况,FFA、吲哚青绿造影(ICGA)检查结果以及复发情况。【结果】(1)患者治疗前、后平均视力分别为0.54±0.21、0.80±0.19,治疗后平均视力较治疗前显著提高(P<0.05)。(2)治疗后OCT显示黄斑区视网膜神经上皮浆液性脱离吸收,神经上皮脱离高度治疗前为(543.39±132.33)μm,治疗后为(213.81±22.62)μm,治疗前后比较差异有统计学意义(P<0.05)。4周内治愈的有21例,占70%;4周以上9例,占30%。(3)治疗后FFA显示治疗后视网膜色素上皮(RPE)渗漏点消失,吲哚青绿造影(ICGA)显示脉络膜高通透性改善。(4)复发情况:1例在治疗后7个月时CSC复发,占3.3%。【结论】激光治疗围手术期应用健脾利湿中药是治疗CSC的一种有效方法。Objective To observe the therapeutic effect of spleen-strengthening and dampness-elimination Chinese herbal medicine for treatment of central serous chorioretinopathy（CSC）in perioperative period of laser treatment.Methods Thirty CSC patients confirmed by optical coherence tomography（OCT）and fundus fluorescein angiography（FFA） were given laser treatment,and then were treated with spleen-strengthening and dampness-elimination Chinese herbal medicine for 4 weeks.Before and after treatment,the changes of visual acuity,retinal morphology and the height of detached retina were monitored.The cure rate,the results of FFA and indocyanine green angiography（ICGA）,and the recurrence rate were also examined.Results The average visual acuity of 30 patients was 0.54±0.21 before treatment,and became 0.80 ± 0.19 after treatment,the difference being significant（P〈0.05）.The results of OCT showed that macular serous detachment of retina was gradually relieved,and the detachment height was 543.39 ± 132.33 μm before treatment and them became 213.81 ± 22.62 μm after treatment,the difference being significant（P〈0.05）.Twenty-one cases（accounting for 70%）were cured within 4 weeks,and 9（accounting for 30%）were cured over 4 weeks.The results of FFA showed the retinal pigment epithelium（RPE）leakage points disappeared,and choroidal hyperpermeability was improved shown by ICGA.Seven months after treatment,CSC recurred in only one case,accounting for 3.3%.Conclusion The application of spleen-strengthening and dampness-elimination Chinese herbal medicine is effective for the treatment of CSC in perioperative period of laser treatment.

关 键 词：中心性浆液性脉络膜视网膜病变 健脾利湿 激光治疗 

分 类 号：R276.7[医药卫生—中医五官科学]