逍遥散加减联合玻璃体腔注射雷珠单抗治疗Coats病患儿临床疗效分析  

Clinical Efficacy of Modified Xiaoyao Powder Combined with Intravitreal Injection of Ranibizumab in the Treatment of Coats′o Disease in Children

作　　者：裴玉喜[1] 崔红培 吕海江[3] PEI Yu-xi;CUI Hong-pei;LYU Hai-jiang(Women&Infants Hospital of Zhengzhou,Zhengzhou Henan 450000;Henan Provincial Eye Hospital,Zhengzhou Henan 450000;The Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan 450000)

机构地区：[1]郑州市妇幼保健院,河南郑州450000 [2]河南省立眼科医院,河南郑州450000 [3]河南中医药大学第三附属医院,河南郑州450000

出　　处：《世界中西医结合杂志》2022年第8期1667-1670,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：2017年河南省科技研发专项项目(172102310094)。

摘　　要：目的探讨Coats病患儿经逍遥散加减联合雷珠单抗玻璃体腔注射治疗的临床疗效。方法选取2017年1月—2019年12月期间郑州市妇幼保健院收治的60例Coats病患儿为研究对象,以简单随机化法分为对照组和联合组,每组各30例。对照组采用玻璃体腔注射雷珠单抗治疗,联合组在对照组基础上应用逍遥散加减。观察比较两组患儿治疗前后的视力、黄斑中心凹视网膜厚度(Central Macular Thickness,CMT)、渗出灶面积,并统计末次随访时的视网膜复位率。结果两组患儿治疗后视力等级分布比较,差异有统计学意义(P<0.05);且联合组视力改善率高于对照组,差异有统计学意义(P<0.05)。两组患儿治疗3、6、12个月后CMT均低于治疗前,差异有统计学意义(P<0.05);且联合组CMT明显低于对照组,差异有统计学意义(P<0.05)。末次随访时两组患儿渗出灶面积均低于治疗前,差异有统计学意义(P<0.05);且联合组明显低于对照组,差异有统计学意义(P<0.05)。末次随访时,联合组视网膜复位18例,复位率为60.00%(18/30),对照组视网膜复位13例,复位率为43.33%(13/30),两组患儿视网膜复位率比较,差异无统计学意义(χ^(2)=1.669,P=0.196,P>0.05)。结论以逍遥散加减联合玻璃体腔注射雷珠单抗治疗Coats病,可有效改善患儿视力,降低CMT,减轻渗出性病变,值得临床推广。Objective To analyze the clinical efficacy of modified Xiaoyao Powder combined with intravitreal injection of ranibizumab in the treatment of Coats′disease in children.Methods Sixty children with Coats′disease treatedin Women&Infants Hospital of Zhengzhou from January 2017 to December 2019 were enrolled and divided into a control group(30)and a combination group(30)using a simple randomization method.All patients were treated with intravitreal injection of ranibizumab,and those in the combination group received additional modified Xiaoyao Powder.The visual acuity,central macular thickness(CMT),and exudate area were compared between the two groups before and after treatment,and the retinal reattachment rate at the last follow-up was calculated.Results The difference in the post-treatment distributions of visual acuity grades between the two groups was statistically significant(P<0.05),and the improvement rate of visual acuity in the combination group was higher than that in the control group(P<0.05).After 3,6,and 12 months of treatment,the CMT in the two groups was lower than that before treatment(P<0.05),and the CMT in the combination group was lower than that in the control group(P<0.05).At the last follow-up,the exudate areas in the two groups were smaller than those before treatment(P<0.05),and the combination group was smaller than that in the control group(P<0.05).At the last follow-up,the retinal reattachment rate in the combination group was 60.00%(18/30),higher than 43.33%(13/30)in the control group(χ^(2)=1.669,P=0.196,P>0.05).Conclusion Modified Xiaoyao Powder combined with intravitreal injection of ranibizumab in the treatment of Coats′disease can effectively improve children's vision,reduce CMT,and relieve exudative lesions,which is worthy of clinical promotion.

关 键 词：COATS病 逍遥散 玻璃体腔注射 雷珠单抗 

分 类 号：R774.1[医药卫生—眼科]