凉血化瘀法治疗湿性年龄相关性黄斑变性的Meta分析及用药规律总结  

Meta-analysis of the method of cooling blood and removing blood stasis in the treat⁃ment of wet age-related macular degeneration and summary of medication rules

作　　者：李晓宇 梁丽娜[1,2] 田少磊 高云 潘红丽 杨海静[1] LI Xiaoyu;LIANG Lina;TIAN Shaolei;GAO Yun;PAN Hongli;YANG Haijing(Eye Hospital,Chinese Academy of Chinese Medical Sciences,Beijing 100040,China)

机构地区：[1]中国中医科学院眼科医院,北京100040 [2]中国中医药循证医学中心眼科疾病项目组,北京100040 [3]中国中医科学院中医药信息研究所,北京100700

出　　处：《中国中医眼科杂志》2022年第5期408-415,共8页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金(81973912);首都卫生发展科研专项(2020-2-4183);中央级公益性科研院所基本科研业务费专项资金资助(ZZ13-024-8)。

摘　　要：目的评价中医药凉血化瘀法治疗湿性年龄相关性黄斑变性(wAMD)的疗效,并总结该治法治疗wAMD的用药规律。方法检索中国知网、万方、维普、SinoMed、Pubmed、Cochrane Library中英文医学数据库,检索时间为数据库建库至2021年3月,根据纳入标准和排除标准确定文献后,对纳入的文献作Meta分析,并在此基础上,总结凉血化瘀法治疗wAMD的用药规律。结果本研究最终纳入15篇随机对照试验,共1,076例患者(1,116只眼)。(1)Meta分析:凉血化瘀法联合抗血管内皮生长因子(VEGF)药物治疗wAMD在提升国际标准视力MD=0.10,95%CI(0.05,0.15),Z=3.80,P<0.05;LogMAR视力MD=-0.13,95%CI(-0.19,-0.06),Z=3.90,P<0.05等方面总体上优于单纯抗VEGF药物组,差异具有统计学意义。但在改善中医证候MD=-5.80,95%CI(-11.54,-0.05),Z=1.98,P=0.05;减少出血、渗出面积MD=-0.19,95%CI(-0.38,0.00),Z=1.92,P=0.05等方面差异无统计学意义。(2)数据挖掘:凉血化瘀法治疗wAMD的核心配伍为当归、川芎、三七、丹参、牡丹皮、赤芍、茺蔚子、女贞子、山茱萸等。结论凉血化瘀法联合抗VEGF药物治疗wAMD有效,且优于单纯抗VEGF药物治疗,其核心配伍尚需临床实践进一步验证。OBJECTIVE To evaluate the efficacy of the method of cooling blood and removing blood stasis in the treatment of wet age-related macular degeneration(wAMD),and to summarize the medication rules of this treatment for wAMD.METHODS The Chinese and English medical databases such as CNKI,Wanfang,VIP,SinoMed,Pubmed,the Cochrane Library were searched.The retrieval time was from the establishment of the database to the present.After the literature was determined according to the inclusion and exclusion criteria,a Meta-analysis was performed on the included literature.On this basis,the medication rules of the method of cooling blood and removing blood stasis in the treatment of wet age-related macular degeneration were summarized.RESULTS This study finally included 15 randomized controlled trials with a total of 1,076 patients(1,116 eyes).(1)Meta-analysis:The combination of cooling blood and resolving stasis therapy combined with anti-VEGF drugs in the treatment of wAMD could improve the international standard visual acuity MD=0.10,95%CI(0.05,0.15),Z=3.80,P<0.05;LogMAR visual acuity MD=-0.13,95%CI(-0.19,-0.06),Z=3.90,P<0.05,the differences are statistically significant.However,in the improvement of TCM syndromes MD=-5.80,95%CI(-11.54,-0.05),Z=1.98,P=0.05;Reduction of bleeding and exudation area MD=-0.19,95%CI(-0.38,0.00),Z=1.92,P=0.05,the differences were not statistically significant.(2)The data mining:The core combination of the method of cooling blood and removing blood stasis in the treatment of wAMD is Angelica sinensis,Ligusticum chuanxiong Hort,Panax notoginseng,Salvia miltiorrhiza,Cortex Moutan,radix paeoniae rubra,motherwort fruit,Ligustrum lucidum,Cornus and so on.CONCLUSIONS The method of cooling blood and removing blood stasis method combined with anti-VEGF drugs is effective in the treatment of wAMD,and it is better than anti-VEGF drugs alone,and its core combination needs to be further verified in clinical practice.

关 键 词：凉血化瘀法 湿性年龄相关性黄斑变性 META分析 用药规律 

分 类 号：R276.7[医药卫生—中医五官科学]