摘要
目的观察自拟糖明组方联合康柏西普玻璃体腔注射治疗糖尿病性黄斑水肿的临床疗效。方法将确诊糖尿病性黄斑水肿并辨证为气阴两虚络脉瘀阻型的患者120例随机分为对照组、中药组、实验组。对照组康柏西普玻璃体腔注射,首次注射后4周、8周重复注射;中药组予自拟糖明组方每日1剂,早晚分服,共3个月;实验组予康柏西普玻璃体腔注射(同对照组)联合糖明组方口服(同中药组)。观察视力、黄斑部视网膜厚度、中医证候积分变化,综合评价疗效,并继续随访3个月。结果实验组和对照组视力改善率、黄斑部视网膜厚度变化优于中药组;实验组、中药组的证候积分改善优于对照组;实验组和对照组综合疗效中显效率高于中药组,停药3个月后实验组复发率更低,差异均具有统计学意义(P<0.05)。结论糖明组方联合康柏西普玻璃体腔注射治疗气阴两虚络脉瘀阻型糖尿病性黄斑水肿可提高视觉质量,改善全身症状,疗效肯定持久安全。
OBJECTIVE To observe the clinical effect of Tangmingzu prescription combined with conbercept intravitreal injection on diabetic macular edema. METHODS One hundred and twenty patients with diabetic macular edema diagnosed as syndromes of deficiency of both qi and yin, stasis obstructing collaterals were randomly divided into control group, traditional Chinese medicine group and experimental group. The control group was given intravitreal injections of conbercept, and other two shots were given at 4 th and 8 th week after the first injection. The Chinese medicine group was given Tangmingzu prescription one dose daily and the decoction was taken half in the morning and half in the evening for 3 months. The experimental group was given intravitreal injections of conbercept(same protocol as the control group) and Tangmingzu prescription( same regimen as the Chinese medicine group). Visual acuity, macular retinal thickness, changes of TCM syndrome score were observed and efficacy was evaluated comprehensively. The follow-up lasted for 3 months. RESULTS The visual acuity improvement rate and macular retinal thickness in experimental group and control group were better than those in traditional Chinese medicine group;the improvement of the syndrome score in the experimental group and the Chinese medicine group was better than that in the control group; the significant effective rate was higher in the experimental group and the control group than it in the Chinese medicine group. The recurrence rate of the experimental group 3 months afterward was lower than the other two groups and the difference was significant(P <0.05); CONCLUSIONS Tangmingzu prescription combined with conbercept intravitreal injection was effective on diabetic macular edema with deficiency of both qi and yin, stasis obstructing collaterals syndrome, in terms of visual quality and constitutional symptoms. The curative effect was definite and durable, moreover, it was a safe treatment.
引文
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