灵杞黄斑颗粒治疗视网膜静脉阻塞继发黄斑水肿的疗效观察  

Clinical Study of Lingqi Huangban granule in Treating Macular Edema Secondary to Retinal Vein Occlusion

作　　者：陆秉文[1] 吴星伟[2] LU Bingwen, WU Xingwei.(Department of Ophthalmology, AffiliatedSeventh People＇s Hospital of Shanghai University of TCM, Shanghai 200000, China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200235 [2]上海交通大学附属第一人民医院,上海200080

出　　处：《中国中医眼科杂志》2018年第2期102-106,共5页China Journal of Chinese Ophthalmology

基　　金：上海市科委面上项目2014.7.1-2017.9.30(14401972600);浦东新区卫生和计划生育委员会卫生计生科研项目2018.1.1-2020.12.31(PW2017B-8)

摘　　要：目的探讨灵杞黄斑颗粒与联合抗血管内皮生长因子(VEGF)药物玻璃体腔内注射治疗视网膜静脉阻塞(RVO)继发黄斑水肿(ME)的临床疗效。方法 RVO继发ME患者90例(90只眼),随机分为3组。中药治疗组30例(30只眼),予口服灵杞黄斑颗粒;西医治疗组30例(30只眼),予玻璃体腔注射雷珠单抗;中西医治疗组30例(30只眼),予口服灵杞黄斑颗粒联合雷珠单抗玻璃体腔注射。治疗观察6个月,治疗前后进行视力、眼底照相、光学相干断层扫描(OCT)、闪光视网膜电图(F-ERG)及荧光素眼底血管造影(FFA)检查,评价疗效。结果治疗6个月后,中药治疗组30只眼,显效5只眼,有效12只眼,无效13只眼,总有效率56.7%;西医治疗组30只眼,显效9只眼,有效9只眼,无效12只眼,总有效率60.0%;中西医治疗组30只眼,显效15只眼,有效9只眼,无效6只眼,总有效率80.0%。中西医治疗组疗效好于其他两组(与中药治疗组比较,P=0.023,与西医治疗组比较,P=0.177),中药治疗组与西医治疗组的疗效接近(P=1.000)。中西医治疗组在视力改善、眼底出血吸收及降低中央视网膜厚度(CRT)方面明显好于其他两组(P<0.05);中医治疗组的眼底出血吸收情况好于西医对照组(P<0.05),在改善视力、减少CRT方面与西医治疗组大致相当(P>0.05)。各组治疗后ERG视锥细胞反应b波振幅均较治疗前明显增加(P<0.05),但组间差异无统计学意义(P>0.05)。结论灵杞黄斑颗粒治疗RVO继发的ME有一定的临床疗效,联合抗VEGF药物治疗可更好的达到标本兼治、多靶点治疗的效果。OBJECTIVE To study the therapeutic effects of Lingqi Huangban granule combined with intravitreal injection of vascular endothelial growth factor（VEGF） for macular ede-ma（ME） secondary to retinal vein occlusion（RVO）. METHODS Ninety eyes of ninety RVO patients with ME were randomized into 3 groups. Traditional Chinese medicine（TCM） group（30 eyes of 30 patients） was orally given Lingqi Huangban granule. Western medicine（WM） group（30 eyes of 30 patients） was treated with intravitreal injection of ranibizumab（IVR） alone. TCM plus WM therapy group（30 eyes of 30 patients） was treated with IVR combined with Lingqi Huangban granule. After treatment for 6 months,changes of best corrected visual acuity（BCVA） were recorded. Fundus photograph, optical coherence tomography（OCT）, flash electroretinogram（F-ERG） and fluorescein fundus angiography（FFA） were done to evaluate the clinical effects. RESULTS After treatment for 6 months, the total effective rate of TCM group was 56.7%, with 5 eyes in 30 eyes being markedly effective, 12 eyes in 30 eyes being effective and 13 eyes in 30 eyes being invalid. The total effective rate of WM group was60.0%, with 9 eyes in 30 eyes being markedly effective, 9 eyes in 30 eyes being effective and 12 eyes in 30 eyes being invalid. The total effective rate of TCM plus WM group was 80.0%, with 15 eyes in 30 eyes being markedly effective, 9 eyes in 30 eyes being effective and 6 eyes in 30 eyes being invalid. The combined TCM and WM therapy achieved a better therapeutic efficacy in treating ME secondary to RVO（P=0.023, compared to TCM group; P=0.177, compared to WM group）,while the therapeutic effects of TCM group and WM group showed no significant difference（P =1.000）. The combined TCM and WM therapy could significantly improve visual acuity, help absorb fundus hemorrhage and decrease central retinal thickness（CRT） when compared to the other two groups（P〈0.05）. In addition, although TCM group and WM group showed no remarkable diff

关 键 词：视网膜静脉阻塞 黄斑水肿 灵杞黄斑颗粒 血管内皮生长因子 雷珠单抗 联合治疗 

分 类 号：R774.5[医药卫生—眼科]