枸杞茯苓汤治疗黄斑前膜剥离术后黄斑水肿的临床观察
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摘要
目的观察中药治疗黄斑前膜剥离术后黄斑水肿临床疗效。方法观察2014年6月-2016年9月在中国中医科学院眼科医院就诊的黄斑前膜术后黄斑水肿患者81例(81只眼),患者被随机分为两组,治疗组42例给予唐由之研究员经验方"枸杞茯苓汤",对照组39例给予银杏叶片口服,治疗2个月,随访1个月。观察患者治疗前后的最佳矫正视力(BCVA)、黄斑中心视网膜厚度(CRT)、黄斑水肿复发情况。结果治疗组和对照组治疗总有效率分别为83.33%,76.92%,差异没有统计学意义(χ~2=0.524,P=0.469)。两组患者最佳矫正视力治疗前后比较没有统计学差异(F=1.463,P=0.258);各组治疗前后和治疗前相比均有统计学差异(P<0.05)。两组治疗前后患者CRT比较,均有统计学差异(P=0.000)。不同时间点CRT比较:术后1个月两组CRT比较,t=0.989,P=0.327,两组之间没有明显差异;术后2个月,两组CRT比较,t=4.980,有统计学差异(P=0.000)。随访1个月,两组均黄斑水肿无复发。结论中药枸杞茯苓汤是治疗黄斑前膜剥离术后黄斑水肿的有效方法。
OBJECTIVE To observe the clinical efficacy of Chinese medicine on macular edema secondary to macular epiretinal membrane surgery. METHODS Eighty-one cases(81 eyes)with macular edema were observed from June 2014 to September 2016 in eye hospital, China academy of Chinese medical sciences. The patients were divided randomly into 2 groups. The treatment group consisted of 42 patients which were treated with Gouqi Fuling decoction; the control group consisted of 39 patients which were given Ginkgo biloba extract tablets. They were all treated for 2 months, followed up for 1 month. Observation indicators included best corrected visual acuity(BCVA), fundus, central macular thickness, macular edema recurrence before and after treatment. RESULTS The total effective rate was 83.33% in the Gouqi Fuling decoction group and 76.92% in the control group. There was no significant statistical difference(χ~2=0.524,P=0.469). There were no statistical differences(F=1.463, P=0.258)in terms of BCVA between two groups before and after treatment, but there was statistical variation(P<0.05)in each group after treatment. There were statistical variations(P =0.000) in the aspect of central macular thickness of the patients before and after treatment in two groups; There was no statistical significance 1 month after treatment(t=0.989, P=0.327), but there was statistical significance 2 months after intervention(t=4.980, P=0.000) in terms of central macular thickness between the two groups. One month follow up showed no recurrent case. CONCLUSIONS The Gouqi Fuling decoction was effective on macular edema after macular epiretinal membrane surgery which eased central macular edema,improved visual acuity of patients, and the efficacy of Gouqi Fuling decoction was related to duration of medication, the longer the better.
OBJECTIVE To observe the clinical efficacy of Chinese medicine on macular edema secondary to macular epiretinal membrane surgery. METHODS Eighty-one cases(81 eyes)with macular edema were observed from June 2014 to September 2016 in eye hospital, China academy of Chinese medical sciences. The patients were divided randomly into 2 groups. The treatment group consisted of 42 patients which were treated with Gouqi Fuling decoction; the control group consisted of 39 patients which were given Ginkgo biloba extract tablets. They were all treated for 2 months, followed up for 1 month. Observation indicators included best corrected visual acuity(BCVA), fundus, central macular thickness, macular edema recurrence before and after treatment. RESULTS The total effective rate was 83.33% in the Gouqi Fuling decoction group and 76.92% in the control group. There was no significant statistical difference(χ~2=0.524,P=0.469). There were no statistical differences(F=1.463, P=0.258)in terms of BCVA between two groups before and after treatment, but there was statistical variation(P<0.05)in each group after treatment. There were statistical variations(P =0.000) in the aspect of central macular thickness of the patients before and after treatment in two groups; There was no statistical significance 1 month after treatment(t=0.989, P=0.327), but there was statistical significance 2 months after intervention(t=4.980, P=0.000) in terms of central macular thickness between the two groups. One month follow up showed no recurrent case. CONCLUSIONS The Gouqi Fuling decoction was effective on macular edema after macular epiretinal membrane surgery which eased central macular edema,improved visual acuity of patients, and the efficacy of Gouqi Fuling decoction was related to duration of medication, the longer the better.
引文
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[10]李志强,张国明,苏康进,等.膜剥离联合玻璃体腔注射贝伐单抗治疗黄斑前膜[J].南方医科大学学报,2014,34(8):1207-1209.
[11] Chen CH,Wu PC,Liu YC. Intravitreal bevacizumab injection therapy for persistent macular edema after idiopathic macular epiretinal membrane surgery[J]. J Ocul Pharmacol Ther,2011,27(3):287-292.
[12]张春霞,刘早霞.特发性黄斑前膜术后视力的相关因素研究进展[J].新医学,2016,47(7):430-432.
[13]尹小磊,袁容娣,叶剑.复方血栓通胶囊治疗黄斑区视网膜前膜剥膜术后黄斑囊样水肿的疗效观察[J].临床眼科杂志,2011,19(3):236-238.
[14]王炜,秦伟,李雪菁,等.视网膜内界膜剥除联合参苓白术散加味治疗特发性黄斑前膜伴黄斑水肿20例临床研究[J].四川中医,2014,32(1):99-100.
[2]游志鹏,赵菊莲,汪昌运.特发性黄斑前膜的手术疗效初步探讨[J].眼外伤职业病杂志,2007,29(5):356-357.
[3]黎晓新,王宁利.眼科学[M].北京:人民卫生出版社,2006,1:230-231.
[4]中华医学会编著.临床诊疗指南.眼科分册[M].北京:人民卫生出版社,2006,12:168-169.
[5]董方田.协和眼科光学相干断层扫描OCT图谱[M].北京:中国协和医科大学出版社,2009,5:32-35.
[6] Fraser-Bell S, Ying-Lai M, Klein R, et al. Prevalence and associations of epiretinal membranes in latinos:the Los Angeles Latino Eye Study[J].Invest Ophthalm ol Vis Sci,2004,45(6):1732-1736.
[7] Byon IS,Pak GY,Kwon HJ, et al. Natural history of idiopathic epiretinal membrane in eyes with good vision assessed by spectraldomain optical coherence tomography[J]. Ophthalmologica,2015,234(2):91-100.
[8]张少冲,冷云霞,佘洁婷.特发性黄斑前膜的手术效果及评价[J].中国实用眼科杂志,2005,23(8):825-827.
[9] Lai CC,Wang NK,Wu WC,et al. The long-term anatomical and visual effect of intravitreal triamcinolone injection during vitrectomy for the treatment of idiopathic macular epiretinal membrane[J]. Cutan Ocul Toxicol,2011,30(4):292-297.
[10]李志强,张国明,苏康进,等.膜剥离联合玻璃体腔注射贝伐单抗治疗黄斑前膜[J].南方医科大学学报,2014,34(8):1207-1209.
[11] Chen CH,Wu PC,Liu YC. Intravitreal bevacizumab injection therapy for persistent macular edema after idiopathic macular epiretinal membrane surgery[J]. J Ocul Pharmacol Ther,2011,27(3):287-292.
[12]张春霞,刘早霞.特发性黄斑前膜术后视力的相关因素研究进展[J].新医学,2016,47(7):430-432.
[13]尹小磊,袁容娣,叶剑.复方血栓通胶囊治疗黄斑区视网膜前膜剥膜术后黄斑囊样水肿的疗效观察[J].临床眼科杂志,2011,19(3):236-238.
[14]王炜,秦伟,李雪菁,等.视网膜内界膜剥除联合参苓白术散加味治疗特发性黄斑前膜伴黄斑水肿20例临床研究[J].四川中医,2014,32(1):99-100.