益气固肾明目方治疗脾肾阳虚型难治性葡萄膜炎黄斑水肿的临床研究
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摘要
目的研究益气固肾明目方治疗脾肾阳虚型难治性葡萄膜炎黄斑水肿(RUME)的临床疗效。方法收集2013年1月至2016年12月间确诊为脾肾阳虚型RUME患者90例(90眼)为研究对象,随机分为3组,每组均30例(30只眼),中药治疗组予益气固肾明目方汤剂口服;西医对照组予球旁注射曲安奈德注射液(TA)40 mg;中西医治疗组予益气固肾明目方汤剂口服联合TA球旁注射。治疗3个月,随访6个月,观察视力、黄斑水肿变化及复发率。结果治疗3个月后,3组视力有效率分别为,中药组80%,联合治疗组86.7%,西医对照组66.7%,3组间比较差异统计学意义(P<0.05)。3组黄斑水肿消退有效率分别为,中药组76.7%,联合治疗组93.3%,西医对照组86.7%,治疗后黄斑水肿程度减轻,治疗前后比较有统计学意义(P<0.05),中西医结合组效果最好。3组黄斑水肿复发率比较,西医对照组30%,中药组13.4%,联合治疗组6.7%,联合治疗组与西医对照组比较有统计学意义(P<0.05)。结论益气固肾明目方治疗RUME有一定的临床疗效,联合TA球旁注射治疗,可更好的达到标本兼治、多靶点治疗的效果。
OBJECTIVE To study the clinical effect of Yiqi Gushen Mingmu recipe on refractory uveitis related macular edema(RUME) of spleen-kidney Yang deficiency type. METHODS Ninety patients(90 eyes) with RUME diagnosed as yang deficiency of spleen and kidney from January 2013 to December 2016 were randomly divided into three groups. Thirty patients(30 eyes) in the traditional Chinese medicine treatment group were given Yiqi Gushen Mingmu recipe orally. In the control group, 30 cases(30 eyes) were given triamcinolone acetonide injection(TA) 40 mg by periocular injection; in the treatment group, 30 cases(30 eyes) were given Yiqi Gushen Mingmu decoction combined with TA by periocular injection. Visual acuity, macular edema and recurrence rate were observed. The treatment lasted for 3 months and follow-up lasted for 6 months.RESULTS After 3 months of treatment, the visual acuity effective rates were 80% in traditional Chinese medicine group, 86.7% in treatment group and 66.7% in control group.There were significant differences among the three groups(P<0.05). The macular edema effective rates were 76.7% in the traditional Chinese medicine group, 93.3% in treatment group and 86.7% in the control group. After treatment, the degree of macular edema was alleviated, and there was statistical significance before and after treatment(P<0.05). The effect of treatment group was better than counterparts in the other two groups. During the follow-up period, the recurrence rate of macular edema were 30% in the control group, 13.4% in the traditional Chinese medicine group and 6.7% in treatment group. There was statistical significance between treatment group and control group(P <0.05).Conclusion Yiqi Gushen Mingmu recipe had a certain clinical effect on RUME. Combined with TA periocular injection, it received better effects by treating both the symptoms and root causes and towards multiple-targets.
OBJECTIVE To study the clinical effect of Yiqi Gushen Mingmu recipe on refractory uveitis related macular edema(RUME) of spleen-kidney Yang deficiency type. METHODS Ninety patients(90 eyes) with RUME diagnosed as yang deficiency of spleen and kidney from January 2013 to December 2016 were randomly divided into three groups. Thirty patients(30 eyes) in the traditional Chinese medicine treatment group were given Yiqi Gushen Mingmu recipe orally. In the control group, 30 cases(30 eyes) were given triamcinolone acetonide injection(TA) 40 mg by periocular injection; in the treatment group, 30 cases(30 eyes) were given Yiqi Gushen Mingmu decoction combined with TA by periocular injection. Visual acuity, macular edema and recurrence rate were observed. The treatment lasted for 3 months and follow-up lasted for 6 months.RESULTS After 3 months of treatment, the visual acuity effective rates were 80% in traditional Chinese medicine group, 86.7% in treatment group and 66.7% in control group.There were significant differences among the three groups(P<0.05). The macular edema effective rates were 76.7% in the traditional Chinese medicine group, 93.3% in treatment group and 86.7% in the control group. After treatment, the degree of macular edema was alleviated, and there was statistical significance before and after treatment(P<0.05). The effect of treatment group was better than counterparts in the other two groups. During the follow-up period, the recurrence rate of macular edema were 30% in the control group, 13.4% in the traditional Chinese medicine group and 6.7% in treatment group. There was statistical significance between treatment group and control group(P <0.05).Conclusion Yiqi Gushen Mingmu recipe had a certain clinical effect on RUME. Combined with TA periocular injection, it received better effects by treating both the symptoms and root causes and towards multiple-targets.
引文
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[3] SoheilianM,EskandariA,Ramezani A,et al.A pilot study of intravitreal diclofenac versus intravitreal triamcinolone for uveitic cystoid macular edema[J].Ocul Immunol Inflamm,2013,21(2):124-129.
[4] Oliveira F, Oliveira Motta AC, Muccioli C. Corneal specular microscopy in infectious and noninfectious uveitis[J]. Arq Bras Oftalmol,2009,72(4):457-461.
[5]孙建西,黎莉.中西医结合治疗慢性前葡萄膜炎性黄斑水肿[J].中西医结合眼科杂志,1998,16(3):171-172.
[6]杨培增,李绍珍.葡萄膜炎[M].北京:人民卫生出版社,2004.
[7]孙广仁,郑洪新.中医基础理论[M].北京:中国中医药出版社,2012.