益气聪明汤加味联合雷珠单抗治疗糖尿病黄斑水肿的临床观察  

Observation of Yiqi Congming decoction combined with intravitreal Ranibizumab on diabetic macular edema

作　　者：宋莉[1] 金伟孝[2] 郑瑜[1] 沙翔垠[1] 段明明[1] 杨瑞明[1] SONG Li;JIN Weixiao;ZHENG Yu;et al(The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China)

机构地区：[1]广东省广州市广州医科大学附属第二医院眼科,广州510260 [2]广东省广州市广州医科大学附属第二医院中医内科,广州510260

出　　处：《中国中医眼科杂志》2017年第6期355-359,共5页China Journal of Chinese Ophthalmology

基　　金：广州市中医药和中西医结合科技项目(20142A010016);广东省中医药局科技项目(20141178)

摘　　要：目的观察益气聪明汤加味联合雷珠单抗玻璃体腔注射治疗糖尿病黄斑水肿(DME)的临床效果。方法 DME患者35例(35只眼)随机分为两组,对照组18例(18只眼)玻璃体腔内每个月注射雷珠单抗1次,连续3个月,治疗组17例(17只眼)则在此治疗基础上加用益气聪明汤加味,口服早晚各1次,疗程3个月。观察两组治疗后1、3、6个月时患眼最佳矫正视力(BCVA)及黄斑中心视网膜厚度(CMT)的变化情况。结果 1.视力疗效:治疗组治疗后1个月、3个月、6个月时的视力有效率分别为88.2%(15/17),94.1%(16/17),94.1%(16/17);对照组的视力有效率分别为88.9%(16/18),83.3%(15/18),61.1%(11/18)。治疗组视力疗效基本保持稳定,对照组则有下降趋势,治疗后6个月时两组差异明显(P=0.041)。2.CMT:治疗组治疗前,治疗后1、3、6个月时被观察眼的CMT分别为(498.06±98.85)μm,(280.59±86.32)μm,(223.59±74.54)μm,(244.82±111.18)μm。对照组相应时点的CMT分别为(488.61±112.64)μm,(292.00±82.18)μm,(276.50±72.29)μm,(313.17±85.39)μm。治疗后各时点的CMT数值均低于治疗前(P<0.05),且均以第1次注射后的下降幅度最大,治疗后6个月时两组CMT较前一时点均有不同程度的增加,对照组CMT增加较为明显,大于同期的治疗组(P<0.05)。结论益气聪明汤加味联合雷珠单抗或雷珠单抗单一玻璃体腔注射治疗糖尿病黄斑水肿以第1次注射后的疗效最明显,联合治疗在改善或稳定视力,减轻黄斑水肿方面的效果更好,并可延迟复发时间。OBJECTIVE To evaluate the effect of Yiqi Congming decoction combined with intravitreal Ranibizumab on diabetic macular edema. METHODS Thirty-five patients（35 eyes） with diabetic macular edema were randomly divided into two groups. Eighteen eyes of 18 patients in the control group were treated with intravitre-al Ranibizumab alone once a month, three times a row, while seventeen eyes of 17 patients in the treatment group were treated with Yiqi Congming decoction two times a day for three months in addition to same intravitreal Ranibizumab regimen. The best corrected visual acuity（BCVA）, central macular thickness（CMT） were observed 1, 3 and 6 months after treatment respectively. RESULTS 1. Visual effect： The visual efficiency of the treatment group was 88.2 %（15/17）, 94.1 %（16/17） and 94.1 %（16/17） respectively in the three time points while the result of the control group was 88.9%（16/18）, 83.3%（15/18） and 61.1%（11/18） respectively. The visual effect basically re-mained stable in the treatment group, while it in the control group showed a decreasing trend. Statistical significant difference was observed 6 months after treatment（P=0.041）. 2. CMT： The CMT of the treatment group before and 1, 3,6 months after treatment was（498.06±98.85） μm,（280.59±86.32） μm,（223.59±74.54） μm,（244.82±111.18） μm, respectively. While these parameters of the control group was（488.61±112.64） μm,（292.00±82.18） μm,（276.50±72.29） μm,（313.17±85.39） μm. The CMT of both group decreased significantly（P〈0.05）. And it dropped most sharply after the first injection. Six months after treatment, CMT increased in both group, and the variation in control group was more significant than it in treatment group（P〈0.05）. CONCLUSIONS Yiqi Congming decoction combined with intravitreal Ranibizumab and intravitreal Ranibizumab alone were both effective on diabetic macular edema, and the effect was most obvious after the first injection. The combination treatme

关 键 词：益气聪明汤 雷珠单抗 糖尿病黄斑水肿 

分 类 号：R774.5[医药卫生—眼科]