化瘀消肿方联合玻璃体腔注射治疗糖尿病性黄斑水肿的临床疗效观察  

Clinical Efficacy of Huayu Xiaozhong Fang Combined with Intravitreal Injection in Treatment of Diabetic Macular Edema

作　　者：冯琳 郑笑荣 王伟 王君兰 冯玉明 庞午 郭哲 张凤梅 FENG Lin;ZHENG Xiaorong;WANG Wei;WANG Junlan;FENG Yuming;PANG Wu;GUO Zhe;ZHANG Fengmei(Hebei Eye Hospital/Hebei Key Laboratory of Ophthalmology/Clinical Medicine Research Center for Ophthalmic Diseases in Hebei Province,Xingtai 054001,China)

机构地区：[1]河北省眼科医院/河北省眼科学重点实验室/河北省眼部疾病临床医学研究中心,河北邢台054001

出　　处：《河北中医药学报》2025年第2期18-22,共5页Journal of Hebei Traditional Chinese Medicine and Pharmacology

基　　金：河北省医学科学研究课题(20231996)。

摘　　要：目的:观察化瘀消肿方联合玻璃体腔注射康柏西普治疗糖尿病性黄斑水肿(diabetic macular edema,DME)的临床疗效。方法:选取2021年1月至2024年3月间确诊为DME患者142例210只眼,分为2组,治疗组74例106只眼,采用玻璃体腔注射康柏西普联合化瘀消肿方口服治疗;对照组68例104只眼,单行玻璃体腔注射康柏西普,2组治疗周期均为6个月。对比分析2组治疗前后临床疗效、中医证候积分、患眼最佳矫正视力(BCVA)、黄斑区中心凹视网膜厚度、糖化血红蛋白(HbAIC)、血脂水平、不良反应发生情况。结果:治疗组的临床疗效优于对照组(P<0.05);与治疗前相比,2组患者在治疗后中医证候积分均下降(P<0.05),视力水平提高,黄斑区中心凹视网膜厚度降低(P<0.05);治疗组在治疗后HbAIC、甘油三脂(TG)和胆固醇(TC)低于治疗前(P<0.05),高密度脂蛋白(HDL)较治疗前升高(P<0.05);治疗后,治疗组证候积分低于对照组(P<0.05),BCVA水平高于对照组(P<0.05),黄斑区中心凹视网膜厚度低于对照组(P<0.05),HbAIC、TG、TC低于对照组,HDL水平高于对照组(P<0.05),同时治疗组不良反应低于对照组(P<0.05)。结论:中药化瘀消肿方联合康柏西普玻璃体腔注射治疗DME,能够改善患者症状,提高视力水平,减轻黄斑水肿,调节血脂代谢,减少不良反应,疗效优于单纯康柏西普玻璃体腔注射。Objective:To observe the clinical efficacy of Huayu Xiaozhong Fang(formula for resolving stasis and alleviating edema)combined with intravitreal injection of Conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 142 patients(210 eyes)diagnosed with DME from January 2021 to March 2024 were selected and divided into two groups.Seventy-four patients(106 eyes)in the treatment group were treated with intravitreal injection of Conbercept combined with Huayu Xiaozhong Fang while 68 patients(104 eyes)in the control group were treated with intravitreal injection of Conbercept alone.The treatment cycle for both groups was 6 months.The clinical efficacy before and after treatment,traditional Chinese medicine(TCM)syndrome scores,best corrected visual acuity(BCVA)of the affected eyes,central foveal retinal thickness in the macular area,glycosylated hemoglobin,blood lipid levels,and the occurrence of adverse reactions were compared and analyzed between the two groups.Results:The clinical efficacy of the treatment group was better than that of the control group(P<0.05).Compared with that before treatment,the TCM syndrome scores of patients in both groups decreased after treatment(P<0.05),the visual acuity levels increased,and the central foveal retinal thickness in the macular area decreased(P<0.05).The levels of glycosylated hemoglobin,triglyceride,and cholesterol in the treatment group were lower(P<0.05),and the level of high-density lipoprotein was higher(P<0.05).After treatment,compared with the control group,the TCM syndrome score of the treatment group was lower(P<0.05),the BCVA level was higher(P<0.05),the central foveal retinal thickness in the macular area was lower(P<0.05),the levels of glycosylated hemoglobin,triglyceride,and cholesterol were lower,and the level of high-density lipoprotein was higher(P<0.05).Meanwhile,the adverse reaction in the treatment group was lower than that in the control group(P<0.05).Conclusion:The combination of Chinese Huayu Xiaozhong Fang and intravitreal injection

关 键 词：糖尿病性黄斑水肿 化瘀消肿方 康柏西普 玻璃体腔注射 

分 类 号：R276.7[医药卫生—中医五官科学]