摘要
探讨自拟活血利水中药方联合抗VEGF药物(雷珠单抗眼内注射液)治疗对视网膜静脉阻塞黄斑水肿(retinal vein occlusion-macular edema,RVO-ME)患者血清组织型纤溶酶原激活剂-抑制剂复合体(serum tissue plasminogen activator-inhibitor complex,tPAI-C)、纤维蛋白原(fibrinogen,FIB)及黄斑中心凹视网膜厚度(central macular thickness,CMT)的影响.将符合纳入和排除标准的RVO-ME患者79例(共79只眼),采用随机数字表法随机分为观察组39例(39只眼)及对照组40例(40只眼).对照组每月给予1次玻璃体腔注射雷珠单抗眼内注射液治疗,连续治疗并观察3个月.观察组在对照组的治疗基础上同时予活血利水中药方(当归10 g,丹参15 g,三七10 g,茯苓15 g,猪苓15 g,泽泻10 g,薏苡仁30 g,决明子15 g,枸杞子15 g.每日一剂,水煎后分早晚2次温服,以7天为一疗程,每月服用两个疗程,共服用三个月)治疗.两组均治疗并随访观察3个月.收集并比较两组RVO-ME患者治疗前及治疗满3个月后患眼最佳矫正视力(best corrected visual acuity,BCVA)、CMT、血清tPAI-C及FIB等数据变化情况,观察两组临床治疗疗效.经治疗后,两组的BCVA、CMT、血清tPAI-C、FIB均改善,且观察组临床疗效更好(P<0.05);tPAI-C值分别与LogMAR视力、CMT呈显著的正相关性;观察组的治疗总有效率为84.62%,优于对照组的总有效率57.5%(P<0.05).表明活血利水中药方联合抗VEGF治疗RVO-ME能更好地改善患者CMT、血清tPAI-C、FIB等指标,从而减轻黄斑水肿,提高视力.
The purpose of the study was to explore the effect of Huoxue Lishui decoction combined with anti-VEGF drugs on serum tissue plasminogen activator-inhibitor complex(tPAI-C),fibrinogen(FIB)and central macular thickness(central macular thickness)in retinal vein occlusion-macular edema(RVO-ME)patients.A total of 79 eyes of RVO-ME patients who met the inclusion criteria were collected and randomly divided into the observation group(39 eyes)and the control group(40 eyes).Both groups were treated with intravitreal injection of anti-VEGF drugs(Ranibizumab)once a month for continuous treatment and observation for three months.The observation group was treated with Huoxue Lishui decoction(Angelica 10 g,Salvia 15 g,Panax 10 g,Poria 15 g,Polyporus 15 g,Alisma orientalis 10 g,Coix seed 30 g,Cassia 15 g,Lycium barbarum 15 g,1 dose per day,7 days as a course of treatment,2 courses per month,a total of 3 months of treatment).The best corrected visual acuity(BCVA),CMT,serum tPAI-C,FIB and other indicators of the two groups before treatment and after 3 months of treatment were compared to observe the efficacy of the two groups.After the treatment,the improvement of BCVA,CMT,serum tPAI-C and FIB in the observation group was significantly better than that in the control group(P<0.05).The total effective rate of the observation group was 84.62%,which was higher than that of the control group(57.5%)(P<0.05).The tPAI-C values were significantly positively correlated with LogMAR vision and CMT.Huoxue Lishui decoction combined with intravitreal injection of anti-VEGF drugs(Ranibizumab)treatment for RVO-ME can better improve CMT,serum tPAI-C,FIB,thereby reducing macular edema and improving vision.
作者
张芮
庞龙
ZHANG Rui;PANG Long(The Second Clinical School,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Ophthalmology,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China)
出处
《西南民族大学学报（自然科学版）》
CAS
2022年第2期166-171,共6页
Journal of Southwest Minzu University(Natural Science Edition)
基金
国家自然科学基金项目(编号:82074499)。
