益气活血利水中药辅助雷珠单抗联合激光光凝治疗黄斑水肿临床观察(1)
[摘要] 目的 观察益气活血利水中药辅助雷珠单抗联合激光光凝治疗黄斑水肿的临床疗效。 方法 回顾性研究视网膜分支静脉阻塞(BRVO)继发黄班水肿(ME)患者60例(60只眼)，随机分为两组。治疗组30例(30只眼)，采用雷珠单抗玻璃体腔注射联合视网膜激光光凝，再服用益气活血利水中药，每日1剂，水煎分2次服，14 d为1个疗程，根据患者情况，每疗程之间相隔3～5 d，连用3个月；对照组30例(30只眼)采用雷珠单抗玻璃体腔注射联合视网膜激光光凝，不服用中药煎剂。在治疗后1周、1个月、2个月、3个月、6个月观察比较患眼最佳矫正视力(BCVA)、黄斑中心区视网膜厚度(CMT)及并发症。 结果 在治疗1周、1个月时，治疗组与对照组的BCVA、CMT比较，差异均无统计学意义(P>0.05)。治疗2个月、3个月、6个月时，两组BCVA、CMT比较，差异均有统计学意义(P<0.05)。治疗后未出现明显并发症。 结论 益气活血利水中药辅助雷珠单抗联合激光治疗BRVO继发ME安全有效，具有改善视力、稳定视力、减轻或消除黄斑水肿、防止黄斑水肿复发的作用。
[关键词] 视网膜分支静脉阻塞；黄斑水肿；雷珠单抗；激光光凝；中药
[中图分类号] R774.5 [文献标识码] B [文章编号] 1673-9701(2016)21-0079-04
[Abstract] Objective To observe the clinical effect of Yiqi Huoxue Lishui Chinese medicine with ranibizumab and photocoagulation in the treatment of macular edema. Methods Retrospectively analyzed the 60 eyes of 60 patients who were diagnosed branch retinal vein occlusion(BRVO) related macular edema(ME)， they were divided into two groups randomly. The 30 eyes of 30 patients of the treatment group were treated with ranibizumab and photocoagulation， and with Yiqi Huoxue Lishui Chinese medicine. The prescription was daily dose， water frying and 2 times one day， 14 days was one treatment course. According to patients' condition， treatment courses interval was 3 to 5 days and lasted for 3 months. The 30 eyes of 30 patients in control group were treated with ranibizumab and photocoagulation. The best corrected visual acuity(BCVA)， central macular retinal thickness(CMT) and complications between the two groups were compared after treatment (1 week， 1 month， 2 months， 3 months， 6 months). Results At 1 week and 1 month after treatment， the difference of BCVA between two groups had no statistically significant(P>0.05)， and so did the CMT. At 2 months， 3 months and 6 months after treatment， the differences of BCVA and CMT between two groups had statistically significant(P<0.05). There were no obvious complications after treatment. Conclusion The treatment of Yiqi Huoxue Lishui Chinese medicine with ranibizumab and photocoagulation on BRVO related ME is safe and effective. And it can improve BCVA， reduce ME， and prevent the recurrence of ME.
[Key words] Branch retinal vein occlusion； Macular edema； Ranibizumab； Photocoagulation； Traditional Chinese medicine
视网膜静脉阻塞(retinal vein occlusion，RVO)是第二位常见视网膜血管性疾病，在国内40岁及以上人群中的发病率达1.6%[1]。临床主要表现为无痛性视力下降，引起视力下降的原因为RVO继发的黄斑水肿(macular edema，ME)[2]。长期ME可导致视网膜纤维化，引起永久性视力丧失[3]。对于ME的治疗，传统的黄斑格栅样光凝仍是主要的治疗手段，但对视力改善效果不明显；玻璃体腔注射雷珠单抗，可使ME明显减轻，患者视力提高，但雷珠单抗半衰期短，当药物作用时间过去后，ME又再次复发，患者需要重复注射，且即使多次注射，ME仍可再复发。针对此问题，本研究采用中西医结合的治疗方法，取得满意效果，现报道如下。, http://www.100md.com(陶荣三 陈梦平 荆文涛)
[关键词] 视网膜分支静脉阻塞；黄斑水肿；雷珠单抗；激光光凝；中药
[中图分类号] R774.5 [文献标识码] B [文章编号] 1673-9701(2016)21-0079-04
[Abstract] Objective To observe the clinical effect of Yiqi Huoxue Lishui Chinese medicine with ranibizumab and photocoagulation in the treatment of macular edema. Methods Retrospectively analyzed the 60 eyes of 60 patients who were diagnosed branch retinal vein occlusion(BRVO) related macular edema(ME)， they were divided into two groups randomly. The 30 eyes of 30 patients of the treatment group were treated with ranibizumab and photocoagulation， and with Yiqi Huoxue Lishui Chinese medicine. The prescription was daily dose， water frying and 2 times one day， 14 days was one treatment course. According to patients' condition， treatment courses interval was 3 to 5 days and lasted for 3 months. The 30 eyes of 30 patients in control group were treated with ranibizumab and photocoagulation. The best corrected visual acuity(BCVA)， central macular retinal thickness(CMT) and complications between the two groups were compared after treatment (1 week， 1 month， 2 months， 3 months， 6 months). Results At 1 week and 1 month after treatment， the difference of BCVA between two groups had no statistically significant(P>0.05)， and so did the CMT. At 2 months， 3 months and 6 months after treatment， the differences of BCVA and CMT between two groups had statistically significant(P<0.05). There were no obvious complications after treatment. Conclusion The treatment of Yiqi Huoxue Lishui Chinese medicine with ranibizumab and photocoagulation on BRVO related ME is safe and effective. And it can improve BCVA， reduce ME， and prevent the recurrence of ME.
[Key words] Branch retinal vein occlusion； Macular edema； Ranibizumab； Photocoagulation； Traditional Chinese medicine
视网膜静脉阻塞(retinal vein occlusion，RVO)是第二位常见视网膜血管性疾病，在国内40岁及以上人群中的发病率达1.6%[1]。临床主要表现为无痛性视力下降，引起视力下降的原因为RVO继发的黄斑水肿(macular edema，ME)[2]。长期ME可导致视网膜纤维化，引起永久性视力丧失[3]。对于ME的治疗，传统的黄斑格栅样光凝仍是主要的治疗手段，但对视力改善效果不明显；玻璃体腔注射雷珠单抗，可使ME明显减轻，患者视力提高，但雷珠单抗半衰期短，当药物作用时间过去后，ME又再次复发，患者需要重复注射，且即使多次注射，ME仍可再复发。针对此问题，本研究采用中西医结合的治疗方法，取得满意效果，现报道如下。, http://www.100md.com(陶荣三 陈梦平 荆文涛)