散血明目片联合康柏西普眼用注射液对湿性老年性黄斑变性患者视网膜厚度的影响  

Effects of Sanxue Mingmu Tablets (散血明目片) Combined with Conbercept Injection on Retinal Thickness in Patients with Wet Age-related Macular Degeneration

作　　者：蒋鹏飞 彭俊 曾志成 姚小磊 沈志华[4] 陈向东 彭清华 JIANG Pengfei;PENG Jun;ZENG Zhicheng;YAO Xiaolei;SHEN Zhihua;CHEN Xiangdong;PENG Qinghua(School of Chinese Medicine,Hunan University of Chinese Medicine,Changsha,410208;First Affiliated Hospital of Hunan University of Chinese Medicine;The First People's Hospital of Guiyang County,Hunan Province;Shenzhen Eye Hospital,Guangdong Province)

机构地区：[1]湖南中医药大学中医学院,湖南省长沙市410208 [2]湖南中医药大学第一附属医院 [3]湖南省桂阳县第一人民医院 [4]广东省深圳市眼科医院

出　　处：《中医杂志》2020年第2期136-141,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(30772824,81574031);中医药防治五官科疾病湖南省重点实验室建设项目(2017TP1018);国家中医药管理局中医眼科学重点学科建设项目(ZK1801YK015);湖南省研究生科研创新项目(CX2018B497)

摘　　要：目的观察散血明目片联合康柏西普眼用注射液对湿性老年性黄斑变性(wAMD)患者的疗效。方法70例wAMD患者随机分为治疗组35例(51眼)和对照组35例(50眼)。对照组予以玻璃体腔注射康柏西普眼用注射液0.05ml治疗,每个月1次,共3次;治疗组在对照组治疗基础上予以口服散血明目片,每次2.4g,每日3次,共服用3个月。分别于治疗前及治疗1、2、3个月观察两组患者最佳矫正视力(BCVA)、视网膜电图(a波、b波振幅及潜伏时),超声检测两组患者眼部睫状后短动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI),光学相干断层成像(OCT)检测两组患者黄斑中心凹厚度(CMT)。观察术后并发症及治疗后随访6个月的复发情况。结果与本组前一时间点比较,两组治疗1、2、3个月后BCVA均明显改善(P<0.05);治疗1、2、3个月两组患者BCVA比较,治疗组均优于对照组(P<0.05)。两组组内各时间点a波、b波振幅,RI、CMT两两比较,差异均有统计学意义(P<0.05)。两组治疗1、2、3个月a波、b波振幅及RI、CMT比较,差异均有统计学意义(P<0.05)。与本组治疗前比较,除对照组治疗1个月PSV外,两组治疗1、2、3个月PSV、EDV差异均有统计学意义(P<0.05);两组治疗2、3个月PSV及治疗1、2、3个月EDV比较,差异均有统计学意义(P<0.05)。术后治疗组出现结膜充血1眼,对照组出现结膜充血2眼,两组并发症情况比较差异无统计学意义(P>0.05)。随访时治疗组复发4例(5眼),复发率为11.11%,对照组复发11例(15眼),复发率为34.09%,治疗组复发率低于对照组(P<0.05)。结论散血明目片联合康柏西普眼用注射液治疗能促进wAMD患者视网膜渗出及出血的吸收,提高视力,对wAMD有很好的改善作用。Objective To observe the effects of Sanxue Mingmu Tablets(散血明目片)combined with conbercept on patients with wet age-related macular degeneration(wAMD).Methods A total of 70 patients with wAMD were randomly divided into a treatment group with 35 cases(51 eyes)and a control group with 35 cases(50 eyes).The control group was treated with intravitreal injection of conbercept 0.05 ml once a month for three times.The treatment group was additionally treated with oral Sanxue Mingmu Tablets 2.4 g each time,three times a day for three months.The best corrected visual acuity(BCVA),electroretinogram(ERG)amplitude and latency of a wave and 6 wave of the 2 groups were observed before treatment and 1 month,2 months,3 months after treatment.Ultrasound was used to detect the peak systolic short-velocity(PSV),end-diastolic flow(EDV),and resistance index(RI)of the posterior ciliary short arteries in the 2 groups of patients.Optical coherence tomography(OCT)was used to detect the macular foveal thickness(CMT).The postoperative complications and the recurrence of 6 months follow-up after treatment were observed.Results Compared with the previous time point within group,the BCVA in both groups was significantly decreased after 1,2,and 3 months of treatment(P<0.05).When the amplitudes of a wave and b wave,RI,and CMT were compared at all time point in the 2 groups,the differences were statistically significant(P<0.05).There was a statistically significant difference in the EPG a-wave,b-wave amplitude,RI,and CMT between groups after 1,2,and 3 months of treatment(P<0.05).Compared with in group before treatment,except for PSV after 1 month in the control group,there was a statistically significant difference in PSV and EDV after treatment for 1,2,and 3 months between groups(P<0.05).The differences between PSV at 2 and 3 months after treatment and EDV at 1,2,and 3 months after treatment were statistically significant(P<0.05).Conjunctival hyperemia occurred in 1 eye in the treatment group and 2 eyes in the control group after surger

关 键 词：湿性老年性黄斑变性 散血明目片 视网膜厚度 视力 

分 类 号：R276.7[医药卫生—中医五官科学]