明目消朦片联合雷珠单抗治疗湿性年龄相关性黄斑变性的临床及机制研究  

Research on Clinical Efficacy and Mechanism of Mingmu Xiaomeng Tablets Combined with Ranibizumab in Treatment of Wet Age-related Macular Degeneration

作　　者：秦霖[1] 庞龙[1] 欧扬[1] 罗保华[1] 罗艳华 QIN Lin;PANG Long;OU Yang;LUO Bao-hua;LUO Yan-hua(Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广东省中医院眼科

出　　处：《食品与药品》2019年第3期222-226,共5页Food and Drug

基　　金：广东省中医药局2017年度科研项目(项目编号:20171124)

摘　　要：目的观察明目消朦片联合玻璃体腔注射抗血管内皮生长因子(VEGF)药物雷珠单抗治疗湿性年龄相关性黄斑变性(wAMD)的临床疗效及作用机制。方法将80例wAMD患者随机分为两组,对照组40例予雷珠单抗玻璃体腔注射治疗,治疗组40例在对照组治疗基础上加明目消朦片治疗。两组患者均每月玻璃体腔注射雷珠单抗一次,连续治疗3个月。比较两组治疗前后视力、视网膜黄斑区中心凹厚度(CMT)、血清VEGF、外周血单核细胞Toll样受体3(toll-like receptor 3,TLR3)mRNA、TLR4 mRNA的表达水平及视功能相关的生存质量量表评分变化。结果治疗后,两组视力、生存质量评分均较本组治疗前升高(P<0.05),CMT、血清VEGF水平、TLR3 mRNA、TLR4 mRNA的表达水平降低(P<0.05),且两组组间比较差异有统计学意义(P<0.05)。结论明目消朦片联合雷珠单抗玻璃体腔注射治疗有助于改善wAMD患者的视功能,降低患者CMT,其机制可能是由TLR3、TLR4介导的抗炎及抗VEGF作用。Objective To observe the clinical efficacy and mechanism of Mingmu Xiaomeng Tablets combined with intravitreal injection of anti-vascular endothelial growth factor(VEGF)drug ranibizumab in the treatment of wet agerelated macular degeneration(wAMD).Methods Eighty patients with wAMD were randomly divided into two groups.40 patients in the control group were treated with intravitreal injection of ranibizumab,and 40 patients in the treatment group were treated with Mingmu Xiaomeng Tablets on the basis of treatment with ranibizumab.The two groups of patients received intravitreal injection of ranibizumab once a month for 3 months.The visual acuity,central macular thickness(CMT),serum level of VEGF,expression levels of toll-like receptor 3(TLR3)mRNA and TLR4 mRNA of peripheral blood mononuclear cell,as well as visual function-related quality of life score were compared before and after treatment.Results After treatment,the visual acuity and quality of life scores of the two groups were higher than those before treatment(P<0.05),and the expression levels of CMT,serum VEGF,TLR3 mRNA and TLR4 mRNA decreased(P<0.05).The difference between the two groups was statistically significant(P<0.05).Conclusion Mingmu Xiaomeng Tablets combined with intravitreal injection of ranibizumab can improve the visual function of patients with wAMD and reduce the CMT of patients.The mechanism may be related to anti-inflammatory and anti-VEGF effects mediated by TLR3 and TLR4.

关 键 词：明目消朦片 雷珠单抗 湿性年龄相关性黄斑变性 

分 类 号：R285.6[医药卫生—中药学]