黄斑复明汤联合针灸治疗年龄相关性黄斑变性的疗效及对黄斑区水肿、自觉症状、血清VEGF、PDGF和ES水平的影响  

Curative Effect of Using Huangban Fuming Decoction Combined with Acupuncture in the Treatment of AMD and the Inflence on Macular Edema,Subjective Symptoms,Serum VEGF,PDGF and ES Levels

作　　者：李桃[1] LI Tao(The First People's Hospital of Zigong City (Zigong Sichuan 643000,China))

机构地区：[1]自贡市第一人民医院

出　　处：《四川中医》2018年第12期174-177,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：四川省卫生厅科研课题(NO:120004)

摘　　要：目的:观察黄斑复明汤联合针灸治疗年龄相关性黄斑变性(AMD)疗效及对黄斑区水肿、自觉症状、血清血管内皮生长因子(VEGF)、血小板衍生生长因子(PDGF)、内皮抑制素(ES)水平的影响。方法:采用随机数字表法将80例AMD患者随机分为对照组和观察组,每组40例。对照组采用维生素C片、维生素E软胶囊口服及七叶洋地黄双苷滴眼液滴眼等治疗,观察组给予黄斑复明汤联合针灸治疗;治疗4周后,比较两组临床疗效、自觉症状积分、最佳矫正视力(BCVA)、黄斑区中心凹厚度(CMT)及血清VEGF、PDGF、ES水平。结果:观察组显效率、总有效率分别为25. 00%、92. 50%,均明显高于对照组的5. 00%、67. 50%,差异有统计学意义(P <0. 05)。治疗4周后,观察组较对照组视物变形、眼前暗影等自觉症状积分均明显降低(P <0. 05),BCVA明显提高(P <0. 05),CMT明显减小(P <0. 05)。治疗4周后,观察组较对照组血清VEGF、PDGF水平明显降低,ES水平明显升高,差异均有统计学意义(P <0. 05)。结论:黄斑复明汤联合针灸治疗AMD疗效确切,能够有效改善患者自觉症状,提高视力,减轻黄斑水肿,其机制可能与显著下调VEGF、PDGF水平、上调ES水平有关。Objective: To observe the curative effect of using Huangban Fuming Decoction combined with acupuncture in the treatment of age-related macular degeneration( AMD) and the effect on macular edema,subjective symptoms,serum vascular endothelial growth factor( VEGF),platelet derived growth factor( PDGF) and endostatin( ES) levels. Methods: 80 patients with AMD were randomly divided into controlled group and observation group by random number table method,with 40 cases in each group. The controlled group was treated with oral Vitamin C Tablets,oral Vitamin E Soft Capsule and Esculin and Digitalis Glycosides Eye Drops while the observation group was treated with Huangban Fuming Decoction combined with acupuncture. After 4 weeks of treatment,the clinical efficacy,subjective symptom scores,the best corrected visual acuity( BCVA),central macular thickness( CMT) and serum VEGF,PDGF and ES levels were compared between the two groups. Results: The markedly effective rate and the total effective rate in the observation group( 25. 00% and 92. 50%) were significantly higher than those in the controlled group( 5. 00% and 67. 50%)( P < 0. 05). After 4 weeks of treatment,scores of subjective symptoms such as metamorphopsia and shadow before the eyes in the observation group were significantly lower than those in the controlled group( P <0.05). The BCVA of the the observation group was significantly higher and CMT was significantly smaller than that of the control group( P < 0. 05). After 4 weeks of treatment,serum VEGF and PDGF levels in the observation group were significantly lower than those in the controlled group,and the level of ES was significantly higher than that in the controlled group( P < 0. 05).Conclusion: Huangban Fuming Decoction combined with acupuncture is effective in treating AMD. It can effectively relieve subjective symptoms in patients,improve their visual acuity and alleviate macular edema. The mechanism may be related to significant down-regulation of VEGF and PDGF levels and up-regulation of the ES level.

关 键 词：年龄相关性黄斑变性 黄斑复明汤 针灸 黄斑区水肿 血清VEGF 

分 类 号：R774.13[医药卫生—眼科]