益气养阴活血利水法联合康柏西普治疗糖尿病性黄斑水肿的临床研究  

Clinical study of Yiqi-Yangyin-Huoxue-Lishui combined with Conbercept in the treatment of diabetic macular edema

作　　者：王桃[1] 贺小张[1] 兰婷[1] 何琼[1] 何建中[1] 赖伟[1] 邱艳飞[1] 黄俊武[2] WANG Tao;HE Xiaozhang;LAN Ting;HE Qiong;HE Jianzhong;IAI Wei;QIU Yanfei;HUANG Junwu(Department of Pediatric Surgery,Pingxiang People's Hospital,Jiangxi Province,Pingxiang337000,China;Department of Ophthalmology,Pingxiang People's Hospital,Jiangxi Province,Pingxiang337000,China)

机构地区：[1]江西省萍乡市人民医院眼科,江西萍乡337000 [2]江西省萍乡市人民医院中医科,江西萍乡337000

出　　处：《中国当代医药》2024年第14期78-82,87,共6页China Modern Medicine

基　　金：江西省中医药科技计划项目(2020B0019)。

摘　　要：目的评估益气养阴活血利水法联合康柏西普治疗糖尿病性黄斑水肿(DME)的安全性和有效性,为中西医结合治疗DME提供更多的临床手段和思路。方法选取2019年6月至2022年6月在萍乡市人民医院眼科住院的70例DME患者作为研究对象,每治疗周期中行单眼药物注射,均为单眼入组。随访脱失6例,共64例患者计入统计。按入院先后分为治疗组(29例)与对照组(35例),治疗组采用玻璃体腔注射康柏西普1次联合口服益气养阴活血利水中药组方3个月;对照组采用单纯玻璃体腔注射康柏西普1次。比较两组治疗前及治疗后1、3、6个月的最佳矫正视力(BCVA)、中心视网膜厚度(CRT)、中医证候评分、需要重复眼内药物注射次数的差异。结果两组患者治疗前后的BCVA、CRT及中医证候评分的时点比较,差异有统计学意义(P<0.05),两组患者治疗前后的BCVA、CRT及中医证候评分的组间、交互作用比较,差异无统计学意义(P>0.05),治疗组治疗后1、3个月以及对照组治疗后1个月的BCVA、CRT及中医证候评分均高于治疗前,差异有统计学意义(P<0.05)。对照组治疗后3个月及两组治疗后6个月的BCVA、CRT及中医证候评分治疗前后比较,差异无统计学意义(P>0.05)。治疗后3月检查CRT较治疗后1个月反弹,其中治疗组有5例需要再次注射康柏西普,少于对照组的15例(χ^(2)=4.844,P=0.033),差异有统计学意义;两组治疗后的BCVA、CRT及中医证候评分与治疗前的平均变化比较,治疗组BCVA、CRT及中医证候评分的改善始终优于对照组。此外,治疗期间两组均没有发生重大的安全问题。结论益气养阴活血利水中药组方联合康柏西普治疗DME,有助于提高BCVA,延缓黄斑水肿复发,疗效优于单独康柏西普治疗。Objective To evaluate the safety and effectiveness of Yiqi-Yangyin-Huoxue-Lishui combined with Conbercept in the treatment of diabetic macular edema(DME),and to provide more clinical means and ideas for the treatment of DME by the combination of traditional Chinese and Western medicine.Methods A total of 70 DME patients hospitalized in the Department of Ophthalmology,Pingxiang People's Hospital from June 2019 to June 2022 were selected as the research objects.Monocular drug injection was performed in each treatment cycle,only one eye was enrolled in the study.Six patients were followed up,and 64 patients were included in the statistics.They were divided into treatment group(29 cases)and control group(35 cases)according to admission.The treatment group was given intravitreal injection of Compaercept once combined with oral Yiqi-Yangyin-Huoxue-Lishui Chinese medicine set for 3 months.The control group was given intravitreal injection of Compacept once.The best corrected visual acuity(BCVA),central retinal thickness(CRT),traditional Chinese medicine syndrome score and the number of repeated intraocular drug injection were compared between the two groups before treatment and 1,3 and 6 months after treatment.Results The comparison of BCVA,CRT and traditional Chinese medicine syndrome score before and after treatment between the two groups showed statistically significant differences(P<0.05),while the comparison of BCVA,CRT and traditional Chinese medicine syndrome score between the two groups and their interaction before and after treatment showed no statistically significant differences(P>0.05).BCVA,CRT and traditional Chinese medicine syndrome score of the treatment group 1 and 3 months after treatment and the control group 1 month after treatment were higher than those before treatment,and the differences were statistically significant(P<0.05).There was no significant difference in BCVA,CRT and traditional Chinese medicine syndrome scores 3 months after treatment in the control group and 6 months after treatment in

关 键 词：益气养阴活血利水法 康柏西普 黄斑水肿 糖尿病 

分 类 号：R587.1[医药卫生—内分泌]