贝伐单抗联合益气复明汤治疗wAMD的临床观察  

Clinical observation on efficacy of bevacizumab combined with qi-tonifying decoction in treatment of exudative age-related macular degeneration

作　　者：黄艳[1] 

机构地区：[1]广东省中山市中医院,中山528400

出　　处：《中国中医眼科杂志》2017年第1期30-33,共4页China Journal of Chinese Ophthalmology

摘　　要：目的观察玻璃体腔注射抗血管内皮生长因子(VEGF)单克隆抗体贝伐单抗联合益气复明汤治疗湿性年龄相关性黄斑变性患者(wAMD)的疗效和安全性。方法前瞻性研究。经荧光素眼底血管造影(FFA)和吲哚菁绿血管造影(ICGA)检查确诊的wAMD患者76例87眼纳入研究,其中观察组38例44眼行贝伐单抗玻璃体腔注射联合益气复明汤治疗。对照组38例43眼单纯用贝伐单抗玻璃体腔注射治疗。于治疗后1周、1个月、3个月、6个月复查,检查两组患者的视力、眼压及黄斑中心凹厚度变化和并发症的发生率,并对两组患者的康复情况进行比较。结果观察组接受联合治疗6个月后视力平均值由(0.89±0.16)升至(3.17±1.15),差异有统计学意义(P<0.05);眼压值由(14.26±4.98)mm Hg升至(17.98±8.45)mm Hg,差异有统计学意义(P<0.05);黄斑中心凹厚度值由(358.32±104.65)μm下降至(218.97±11.68)μm,差异有统计学意义(P<0.01)。与对照组比较,观察组治疗6个月后视力提高更明显,黄斑中心凹厚度更趋于正常,并发症比对照组少,差异均有统计学意义(P<0.05);然而两组眼压变化差异无统计学意义(P>0.05)。结论抗VEGF药物贝伐单抗联合益气复明汤治疗wAMD,能显著提高患者视力,降低黄斑中心凹厚度,减少并发症,疗效优于单纯抗VEGF治疗。OBJECTIVE To investigate the efficacy and safety of intravitreal injection of bevacizumab, an an- ti-vascular endothelial growth factor （VEGF） drug, combined with qi-tonifying decoction on exudative age-related macular degeneration （eAMD）. METHODS A total of 76 patients （87 eyes） with eAMD diagnosed by fundus fluores- cein angiography （FFA）and indocyanine green angiography （ICGA） were included and divided into observation group and control group in this prospective study. Patients in observation group were treated by bevacizumab com- bined with qi-tonifying decoction, and those in control group received bevacizumab intravitreal injection only. Data of visual acuity, intraocular pressure and central foveal thickness in macular before and after treatment （1 week, 1 month, 3 months and 6 months respectively） of the two groups were observed and compared together with complica- tions incidence rate as well as recovery situation. RESULTS Six months after treatment in observation group, the vi- sual acuity increased to 3.17±1.15 from 0.89±0.16; the intraocular pressure increased to 17.98±8.45 mmHg from 14.26±4.98 mmHg; the central foveal thickness decreased to 218.97±11.68 μm from 358.32±104.65 μm. These variations were all of statistical differences （P〈0.05）. Comparisons between groups six months after treatment showed that visual acuity improved more dramatically, central foveal thickness thickened up to normal level and complica- tions were less in observation group （P〈0.05）. However, comparison involving intraocular improvements indicated no significant difference （P〉0.05）. CONCLUSIONS Intravitreal injection of bevacizumab combined with qi-tonifying decoction on exudative eAMD was more effective and safer than single bevacizumab therapy. Specifically, it im-proved the visual acuity, decreased central fovea of macular thickness and reduced complications more significantly.

关 键 词：黄斑变性 血管内皮生长因子 贝伐单抗 益气复明汤 

分 类 号：R774.5[医药卫生—眼科]