中医辨证论治联合抗血管内皮生长因子疗法治疗息肉状脉络膜血管病变的临床疗效观察  

Clinical Observation on the Treatment of Polypoidal Choroidal Vascular Lesions by TCM Syndrome Differentiation and Anti-VEGF Therapy

作　　者：忻双华 缪萍 汪卓琼 董飞[1] XIN Shuanghua;MIAO Ping;WANG Zhuoqiong;DONG Fei(Eye Center of the People's Hospital Affiliated to Ningbo University,Ningbo 315000,Zhejiang,China;Department of Traditional Chinese Medicine,People's Hospital Affiliated to Ningbo University,Ningbo 315000,Zhejiang,China)

机构地区：[1]宁波大学附属人民医院眼科中心,浙江宁波315000 [2]宁波大学附属人民医院中医科,浙江宁波315000

出　　处：《中华中医药学刊》2023年第4期243-246,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划项目(2018ZA114);宁波市科技项目(2019C540085);宁波市重大科技攻关暨“揭榜挂帅”项目(2021Z054)。

摘　　要：目的观察中医辨证论治联合抗血管内皮生长因子(avascular endothelial growth factor,VEGF)疗法治疗息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)的有效性和安全性。方法将2017年3月—2020年12月在本科收治的44例(44眼)PCV患者随机分为对照组22眼和中医治疗组22眼。对照组给予玻璃体腔注射康柏西普抗VEGF治疗;中医治疗组在对照组的基础上加用槐花侧柏汤治疗,并随证加减。分别于治疗前、治疗后1周、1月、3月、半年对两组患者的最佳矫正视力、黄斑中心厚度、病灶区视网膜厚度及病灶高度进行检测及评定疗效。结果两组患者的最佳矫正视力及黄斑中心厚度在治疗前、治疗1周、治疗1月时差异无统计学意义(P>0.05);治疗3月及治疗6月时中医治疗组最佳矫正视力的改善情况明显优于对照组,且黄斑中心厚度小于对照组,差异有统计学意义(P<0.05);两组患者的病灶区视网膜厚度及病灶高度在治疗前和治疗1周时差异无统计学意义(P>0.05);治疗1月后中医治疗组的病灶区视网膜厚度及病灶高度均小于对照组,差异有统计学意义(P<0.05)。结论槐花侧柏汤联合康柏西普抗VEGF疗法较单纯康柏西普抗VEGF治疗能更好地促进视网膜水肿消退、网膜下积血和积液吸收,提高患者视力,安全性良好。Objective To observe the efficacy and safety of traditional Chinese medicine(TCM)syndrome differentiation and treatment combined with anti-VEGF therapy in the treatment of polypoidal choroidal vasculopathy(PCV).Methods 44 patients(44 eyes)with PCV treated from March 2017 to December 2020 were randomly divided into in the control group(22 eyes)and the TCM group(22 eyes).The control group was treated with intravitreal injection of anti-VEGF(Conbercept);The TCM group was treated with Sophora and Platycladus orientalis Decoction on the basis of the control group.The best corrected visual acuity,macular central thickness,lesion thickness and height of the two groups were measured and evaluated before treatment,1 week,1 month,3 months and 6 months after treatment.Results there was no significant difference in the best corrected visual acuity and macular central thickness between the two groups before treatment,one week after treatment and one month after treatment(P>0.05);At 3 months and 6 months of treatment,the improvement of the best corrected visual acuity in the TCM group was significantly better than that in the control group,and the central thickness of macula was less than that in the control group,the difference was statistically significant(P<0.05);There was no significant difference between the two groups in lesion thickness and height before and 1 week after treatment(P>0.05);After one month of treatment,the lesion thickness and height in the TCM group were less than those in the control group,and the difference was statistically significant(P<0.05).Conclusion comparing to the anti-VEGF(Conbercept)alone,Sophora and Platycladus orientalis Decoction combined with anti-VEGF therapy(Conbercept)promote the regression of retinal edema,and absorption of subretinal hematocele and effusion,then improve patients'visual acuity with good safety.

关 键 词：息肉状脉络膜病变 中医 槐花侧柏汤 抗VEGF治疗 

分 类 号：R246.82[医药卫生—针灸推拿学]