健脾活血消水汤联合康柏西普治疗糖尿病性黄斑水肿的临床观察  

Therapeutic effects of traditional Chinese medicine combined with Conbercept on diabetic macular edema

作　　者：孙虹[1,2] 任红苗[3] 赵军[4] 于小玲[1] SUN Hong;REN Hongmiao;ZHAO Jun(School of Basic Medicine,Qingdao University,Qingdao 266021,Shandong,China)

机构地区：[1]青岛大学基础医学院,山东省青岛市260021 [2]郯城县第一人民医院,山东省郯城276000 [3]临沂市中医医院眼科,山东省临沂市276002 [4]临沂市人民医院博爱眼科,山东省临沂市276002

出　　处：《中国中医眼科杂志》2018年第3期170-174,共5页China Journal of Chinese Ophthalmology

摘　　要：目的观察自拟方健脾活血消水汤,玻璃体腔注射康柏西普,以及健脾活血消水汤联合玻璃体腔注射康柏西普治疗糖尿病性黄斑水肿(DME)的临床效果。方法 DME患者87例(90只眼),随机分为3组。健脾活血消水汤组29例(30只眼),予口服健脾活血消水汤3个疗程(用药20 d,停药10 d为1个疗程)。康柏西普组29例(30只眼),玻璃体腔注射0.5 mg,每个月注射1次,共3次。联合用药组29例(30只眼)按前述方法予口服健脾活血消水汤并玻璃体腔注射康柏西普。治疗结束后随访3个月,以视力、眼底出血、黄斑中心视网膜厚度(CMT)及闪光视网膜电图(F-ERG)明适应3.0 ERG b波、闪烁光反应P1波振幅变化情况为观察指标,比较各组疗效差异。结果依照黄斑水肿疗效标准,健脾活血消水汤组显效9只眼,有效14只眼,无效7只眼,总有效率76.67%;康柏西普组显效12只眼,有效12只眼,无效6只眼,总有效率80.00%;联合用药组,显效21只眼,有效5只眼,无效4只眼,总有效率86.67%。健脾活血消水汤组与康柏西普组疗效接近(P=0.474),联合用药组的疗效好于其他两组(与健脾活血汤组比较,P=0.006,与康柏西普组比较,P=0.044)。联合用药组在患眼视力、眼底出血、CMT数值以及F-ERG波形改善方面也均明显好于其他两组。结论健脾活血消水汤可明显减轻糖尿病性黄斑水肿,改善患眼视功能;健脾活血消水汤联合康柏西普玻璃体腔内注射后的效果优于单用康柏西普或单用健脾活血消水汤。OBJECTIVE To observe the clinical effects of different methods on diabetic macular edema（DME）. Three methods were included for treatment in our study： a self-composed Traditional Chinese medicine（TCM） formula; intravitreal injection of Conbercept; combination of both Conbercept and TCM formula. METHODS Eighty-seven cases（90 eyes） with diabetic macular edema were randomly divided into three groups： 29 cases in TCM group（30 eyes）, 29 cases in Conbercept group（30 eyes）, and 29 cases in combination group which were treated with both TCM formula and Conbercept（30 eyes）. Patients in TCM group were treated with TCM for 3 courses（20 days on medication consecutively after 10 days without drug administration as a course）. Patients in Conbercept group were injected intravitreally with 0.5 mg Conbercept once a month for three months. Patients in TCM and Conbercept group were treated with TCM and Conbercept for three months. After 3 courses of treatment, the patients were followed up for 3 months. The best corrected vision acuity（BCVA）, macular hemorrhage area, macular edema area,central macular retinal thickness（CMT）and flash-electroretinogram（F-ERG） amplitude changes were evaluated as the curative effects 3 months after treatment. RESULTS The final evaluation was made according to the common standard for the effectiveness of macular edema treatment, In the TCM group, 9 eyes were marked effective, 14 eyes were effective and 7 eyes showed no effects. The total effective rate was 76.67%. In Conbercept group, 12 eyes showed marked effects, 12 eyes were effective and 6 eyes showed no effects. The total effective rate was 80.00%. While in combination group, 21 eyes were marked effective, 5 eyes were effective and 4 eyes showed no effects and the total effective rate was 86.67%. The clinical effectiveness of single TCM and single Conbercept were nearly the same（P=0.474）, while the combined group had much better clinical result（compared with TCM group, P=0.006; compared with Conberc

关 键 词：糖尿病性黄斑水肿 中药 康柏西普注射液 视力 疗效 

分 类 号：R774.5[医药卫生—眼科]