自拟益气利水方联合康柏西普治疗糖尿病患者白内障术后黄斑水肿的临床观察  

Clinical Effects Observation on Conbercept Injection Combining with Self-made Tonify Qi and Induce Diuresis Decoction for Macular Edema after Phacoemulsification Surgery in Diabetic Patients

作　　者：朱晶[1] 吴超琼[1] 鲁铭[1] 肖泽锋 ZHU Jing;WU Chao qiong;LU Ming;XIAO Ze-feng(Ophthalmology Department,Wuhan Integrated Traditional Chinese and Western Medicine Hospital,Wuhan,430022,Chin)

机构地区：[1]武汉市中西医结合医院眼科,湖北武汉430022

出　　处：《南京中医药大学学报》2018年第3期253-256,共4页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：武汉市卫生局卫计委科研基金(WX14B05)

摘　　要：目的探讨自拟益气利水方联合玻璃体腔内注射康柏西普治疗糖尿病患者白内障术后黄斑水肿的临床疗效。方法选取2015年至2017年间就诊于我院行白内障超声乳化术后3月仍出现黄斑水肿的糖尿病患者92例(92眼)纳入研究,其中有糖尿病但无糖尿病视网膜病变患者44例(44眼)为A组,有糖尿病伴非增殖期糖尿病视网膜病变患者48例(48眼)为B组,将A、B2组患者分别随机分为治疗组和对照组。对照组(A组22眼和B组24眼)给予玻璃体腔内注射康柏西普,每月1次,连续3月之后根据病情需要决定是否重复治疗。治疗组(A组22眼和B组24眼)在对照组治疗基础上加用自拟益气利水方,每日1剂,疗程均为3月。观察治疗前及术后1月、3月、6月的最佳矫正视力(BCVA)、眼压及黄斑中心凹视网膜厚度(CMT)的改变,并观察并发症的发生情况。结果治疗前各组患者的BCVA及CMT差异无统计学意义(P>0.05)。治疗后1月、3月、6月各时间点,2组BCVA及CMT的改善程度较术前均有显著好转,差异有统计学意义(P<0.05);术后各时间点对照A组与治疗A组,对照B组与治疗B组间BCVA及CMT差异均有统计学意义(P<0.05),术后3月及6月CMT治疗B组与治疗A组间差异有统计学意义(P<0.05)。各组患者治疗后眼压正常,均未见严重并发症。结论采用自拟益气利水方联合玻璃体腔内注射康柏西普治疗糖尿病患者白内障术后的黄斑水肿效果显著,能明显提高患者的视力,减轻黄斑水肿,尤其是对合并糖尿病视网膜病变的患者,其术后视力恢复有较大影响。OBJECTIVE To investigate the clinical effects of intravitreal injection of conbercept combined with self-made tonify qi and induce diuresis decoction for macular edema after phacoemulsification surgery in diabetic patients.METHODS 92 diabetic patients（92 eyes）with macular edema after 3 months of phacoemulsification surgery visited our hospital from 2015 to2017 were enrolled,among which 44 patients（44 eyes）had diabetes but without diabetic retinopathy（group A）,and 48 patients（48 eyes）had diabetes with non-proliferative diabetic retinopathy（group B）.Patients in group A and group B were randomly divided into the control group and the treatment group.Intravitreal injection of conbercept were given to the control group（group A,22 eyes;group B,24 eyes）for 1 time/month.And after treated for three months continuously,to repeat the treatment or not should be based on the disease condition.On the basis of the control group,intravitreal injection of conbercept combined with self-made tonify qi and induce diuresis decoction were given to the treatment group（group A,22 eyes;group B,24 eyes）,1 decoction/day,3 months were taken as one course.The best corrected visual acuity（BCVA）,changes of intraocular pressure and central macular retinal thickness（CMT）before the treatment and 1-month,3-month and 6-month after the treatment were observed,and the occurrence of complications was also observed.RESULTS Before the treatment,the differences of BCVA and CMT between each group had no statistical significance（P〈0.05）.The BCVA and CMT at 1-month,3-month and 6-month after the treatment in in two groups were significantly improved than those of the pre-treatment,and the difference was statistically significant（P〈0.05）.The differences of BCVA and CMT in the control A and the treatment A group,the control B group and the treatment B group at each postoperative time point were statistically significant（P〈0.05）.The CMT differences between the treatment B group and the treatment A group afte

关 键 词：自拟益气利水方 白内障术后 黄斑水肿 康柏西普 玻璃体腔注射 

分 类 号：R276.7[医药卫生—中医五官科学]