杞菊地黄丸联合施图伦治疗肝肾不足型近视萎缩性黄斑病变临床研究  

Efficacy of Qi Ju Dihuang Pills combined with Stullen on myopic atrophic maculopathy of liver and kidney deficiency type

作　　者：朱聪 张有花 蒋文君[1,2,3] 张金木[1] 王兴荣 ZHU Cong;ZHANG Youhua;JIANG Wenjun;ZHANG Jinmu;WANG Xingrong((International)Medical College of Ophthalmology and Optometry,Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China;Experimental Center of Shandong Academy of Eye Disease Prevention and Therapy,Jinan 250002,Shandong,China;Shandong Key Laboratory of Eye Disease Prevention and Therapy of Integrated Traditional Chinese and Western Medicines,Jinan 250002,Shandong,China;Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250002,Shandong,China)

机构地区：[1]山东中医药大学(国际)眼科与视光医学院,山东济南250014 [2]山东省眼病防治研究院实验中心,山东济南250002 [3]山东省中西医结合眼病防治重点实验室,山东济南250002 [4]山东中医药大学附属眼科医院,山东济南250002

出　　处：《现代中西医结合杂志》2024年第9期1231-1235,1284,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家重点研发计划项目(2021YFC2702103);山东省中西医结合专病防治项目(YXH2019ZXY001)。

摘　　要：目的观察杞菊地黄丸联合施图伦治疗肝肾不足型近视萎缩性黄斑病变(MAM)患者的临床疗效。方法选择2021年1月—2022年12月于山东中医药大学附属眼科医院眼底外科门诊就诊的60例肝肾不足型MAM患者为研究对象,采用随机数字表法分为对照组和治疗组各30例(30只眼)。对照组给予施图伦点患眼,治疗组在施图伦点眼基础上口服杞菊地黄丸,2组疗程均为30 d。比较2组患者治疗前后中医证候评分和相关眼参数(裸眼及最佳矫正视力、等效球镜度、光敏感度、视野平均缺损、黄斑中心凹视网膜厚度、黄斑中心凹下脉络膜厚度),并比较2组不同近视性黄斑病变(MMD)分级[弥漫性脉络膜视网膜萎缩(C2级)、斑片状脉络膜视网膜萎缩(C3级)、黄斑萎缩(C4级)]患者相关眼参数。结果治疗后,2组中医证候积分均较治疗前明显降低(P均<0.05),且治疗组明显低于对照组(P<0.05)。治疗后,2组裸眼及最佳矫正视力与治疗前比较及组间比较差异均无统计学意义(P均>0.05),但治疗组C2级患者裸眼及最佳矫正视力均明显高于治疗前及对照组(P均<0.05);治疗组总体光敏感度明显高于治疗前及对照组(P均<0.05),其中C2和C3级患者(其中C2级疗效最佳)光敏感度明显高于治疗前及同级对照组(P均<0.05);2组等效球镜度、黄斑中心凹视网膜厚度、黄斑中心凹下脉络膜厚度与治疗前比较及组间比较差异均无统计学意义(P均>0.05),且不同分级患者比较差异均无统计学意义(P均>0.05)。结论杞菊地黄丸联合施图伦治疗肝肾不足型MAM患者疗效确切,可有效改善患者中医证候和光敏感度,有效提高病变早期(C2级)患者的裸眼及最佳矫正视力。Objective It is to observe the clinical efficacy of Chinese patent medicine for tonifying and replenishing liver and kidney Qi Ju Dihuang Pills combined with Stullen in the treatment of patients with myopic atrophic maculopathy(MAM)of liver and kidney deficiency type.Methods Sixty patients with MAM of liver and kidney deficiency type treated in the outpatient clinic of Fundus Surgery Department of Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine from January 2021 to December 2022 were selected as the study subjects,and were divided into control group and treatment group by random number table method,with 30 cases(30 eyes)in each group.The control group was given Stullen to the affected eyes by eye drop,and the treatment group was orally administered with Qi Ju Dihuang Pills on the basis of treatment with Stullen,both groups were treated for 30 days.The scores of traditional Chinese medicine syndrome and related ocular parameters[(uncorrected and best corrected visual acuity,spherical equivalent,light sensitivity,mean defect,central macular thickness(CMT),subfoveal choroidal thickness(SFCT)]of patients in the two groups before and after the treatment were compared,and the related ocular parameters of patients with different classifications of myopic maculopathy degeneration(MMD)[diffuse chorioretinal atrophy(C2),patchy chorioretinal atrophy(C3),macular atrophy(C4)]in the two groups were compared.Results After treatment,the scores of traditional Chinese medicine syndrome of the two groups were significantly lower than those before treatment(both P<0.05),and the treatment group was significantly lower than the control group(P<0.05).After treatment,the difference in uncorrected and best corrected visual acuity between before and after treatment in each group and between the two groups were not statistically significant(all P>0.05),but the uncorrected and best corrected visual acuity of patients of C2 in the treatment group were significantly higher than those before treatment and in the

关 键 词：近视萎缩性黄斑病变 杞菊地黄丸 施图伦 中医证候 光敏感度 最佳矫正视力 

分 类 号：R778.11[医药卫生—眼科]