益气固肾明目方治疗脾肾阳虚型难治性葡萄膜炎黄斑水肿的临床研究  

Treatment of refractory uveitis related macular edema in yang deficiency of spleen and kidney type with Yiqi Gushen Mingmu recipe

作　　者：刘健[1] 邢凯[2] 周尚昆[1] 张励[1] 亢泽峰[1] 刘洁[1] 褚文丽 王元兴 张丛青 陈水灵 LIU Jian;XING Kai;ZHOU Shankun(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing100040,China)

机构地区：[1]中国中医科学院眼科医院,北京100040 [2]北京市昌平区中医医院,北京102200 [3]北京市海淀区公安司法鉴定中心,北京100142

出　　处：《中国中医眼科杂志》2018年第6期370-374,共5页China Journal of Chinese Ophthalmology

基　　金：北京市石景山区亢泽峰名中医传承工作室;中国中医科学院自主选题课题(ZZ0908017)

摘　　要：目的研究益气固肾明目方治疗脾肾阳虚型难治性葡萄膜炎黄斑水肿(RUME)的临床疗效。方法收集2013年1月至2016年12月间确诊为脾肾阳虚型RUME患者90例(90眼)为研究对象,随机分为3组,每组均30例(30只眼),中药治疗组予益气固肾明目方汤剂口服;西医对照组予球旁注射曲安奈德注射液(TA)40 mg;中西医治疗组予益气固肾明目方汤剂口服联合TA球旁注射。治疗3个月,随访6个月,观察视力、黄斑水肿变化及复发率。结果治疗3个月后,3组视力有效率分别为,中药组80%,联合治疗组86.7%,西医对照组66.7%,3组间比较差异统计学意义(P<0.05)。3组黄斑水肿消退有效率分别为,中药组76.7%,联合治疗组93.3%,西医对照组86.7%,治疗后黄斑水肿程度减轻,治疗前后比较有统计学意义(P<0.05),中西医结合组效果最好。3组黄斑水肿复发率比较,西医对照组30%,中药组13.4%,联合治疗组6.7%,联合治疗组与西医对照组比较有统计学意义(P<0.05)。结论益气固肾明目方治疗RUME有一定的临床疗效,联合TA球旁注射治疗,可更好的达到标本兼治、多靶点治疗的效果。OBJECTIVE To study the clinical effect of Yiqi Gushen Mingmu recipe on refractory uveitis related macular edema(RUME)of spleen-kidney Yang deficiency type.METHODS Ninety patients(90eyes)with RUME diagnosed as yang deficiency of spleen and kidney from January2013to December2016were randomly divided into three groups.Thirty patients(30eyes)in the traditional Chinese medicine treatment group were given Yiqi Gushen Mingmu recipe orally.In the control group,30cases(30eyes)were given triamcinolone acetonide injection(TA)40mg by periocular injection;in the treatment group,30cases(30eyes)were given Yiqi Gushen Mingmu decoction combined with TA by periocular injection.Visual acuity,macular edema and recurrence rate were observed.The treatment lasted for3months and follow-up lasted for6months.RESULTS After3months of treatment,the visual acuity effective rates were80%in traditional Chinese medicine group,86.7%in treatment group and66.7%in control group.There were significant differences among the three groups(P<0.05).The macular edema effective rates were76.7%in the traditional Chinese medicine group,93.3%in treatment group and86.7%in the control group.After treatment,the degree of macular edema was alleviated,and there was statistical significance before and after treatment(P<0.05).The effect of treatment group was better than counterparts in the other two groups.During the follow-up period,the recurrence rate of macular edema were30%in the control group,13.4%in the traditional Chinese medicine group and6.7%in treatment group.There was statistical significance between treatment group and control group(P<0.05).Conclusion Yiqi Gushen Mingmu recipe had a certain clinical effect on RUME.Combined with TA periocular injection,it received better effects by treating both the symptoms and root causes and towards multiple-targets.

关 键 词：益气固肾明目方 葡萄膜炎 黄斑水肿 脾肾阳虚 

分 类 号：R773[医药卫生—眼科]