益气复明汤联合光动力疗法治疗老年性黄斑变性的疗效及对免疫炎性反应及氧化应激反应的影响  

Effects of Yiqi Fuming Decoction Combined with Photodynamic Therapy in Senile Macular Degeneration and Its Effects on Immune Inflammation and Oxidative Stress

作　　者：王玉 马晓婕 王素娜 张宏 Wang Yu;Ma Xiaojie;Wang Suna;Zhang Hong(Department of Ophthalmology,Xi′an Hospital of Traditional Chinese Medicine,Xi′an 710021,China)

机构地区：[1]西安市中医医院眼科

出　　处：《世界中医药》2019年第10期2698-2701,2706,共5页World Chinese Medicine

基　　金：陕西省科技计划项目(2015K02-11-01)

摘　　要：目的:探讨益气复明汤联合光动力疗法治疗老年性黄斑变性(AMD)的疗效,评估机体免疫炎性反应及氧化应激反应的变化情况。方法:选取2015年9月至2018年2月西安市中医医院收治的AMD患者181例作为研究对象,回顾性分析治疗方案并分为对照组(n=95、接受光动力疗法治疗)、观察组(n=86、接受益气复明汤联合光动力疗法治疗)。比较2组治疗后近期疗效及血清免疫炎性反应、氧化应激指标水平、药物不良反应的差异。结果:治疗后,观察组患者的治疗有效率高于对照组患者,差异有统计学意义(P<0.05)。观察组患者外周血中Treg的比例高于对照组患者,Th17的比例低于对照组患者;血清中炎性反应递质白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的水平低于对照组患者;血清中氧化应激指标活性氧(ROS)、丙二醛(MDA)的水平低于对照组患者,过氧化氢酶(CAT)、谷胱甘肽过氧化酶(GSH-Px)的水平高于对照组患者,差异有统计学意义(P<0.05)。2组患者的药物不良反应比较,差异无统计学意义(P>0.05)。结论:AMD患者在光动力疗法基础上加入益气复明汤进行联合治疗,可进一步提升治疗效果并优化机体免疫炎性反应、氧化应激等微环境,对最终良好治疗结局的获得有重要意义。Objective:To investigate the effects of Yiqi Fuming Decoction combined with photodynamic therapy on age-related macular degeneration(AMD),and to evaluate the changes of immune inflammation and oxidative stress.Methods:A total of 181 patients with AMD underwent treatment in Xi′an Hospital of Traditional Chinese Medicine during September 2015 to February 2018 were chosen as research subject.The treatment plans were retrospectively analyzed,and all patients were divided into a control group(n=95,treated with photodynamic therapy)and an observation group(n=86,treated with Yiqi Fuming Decoction combined with photodynamic therapy).The short-term curative effect,difference of serum immune inflammation,oxidative stress indexes between the 2 groups after treatment were compared.Results:After treatment,the effective rate of the observation group was higher than that of the control group(P<0.05).Proportion of Treg in peripheral blood in the observation group was higher than that of the control group,and proportion of Th17 was lower than that of control group;serum contents of inflammatory factors such as IL-1,IL-6 and TNF-αin the observation group were lower than that in the control group;serum contents of oxidative stress indexes such as ROS,MDA were lower than those in the control group;serum contents of CAT and GSH-Px were higher than those in the control group(P<0.05).There were no significant difference in the incidence of adverse drug reactions between the 2 groups(P>0.05).Conclusion:Adding Yiqi Fuming Decoction to AMD patients on the basis of photodynamic therapy can further enhance the therapeutic effect,and optimize the microenvironment of immune inflammation and oxidative stress,which is of great significance to final good treatment outcome.

关 键 词：老年性黄斑变性 益气复明汤 光动力疗法 免疫状态 炎性反应 氧化应激 

分 类 号：R774.5[医药卫生—眼科]