桃红四物汤加减联合雷珠单抗玻璃体腔注射治疗湿性老年性黄斑变性的临床疗效观察

Clinical Observation on the Curative Effect of Taohong Siwu Decoction Combined with Ralizumab Intravitreal Injection in the Treatment of Wet Age-Related Macular Degeneration

目的探讨桃红四物汤加减联合雷珠单抗玻璃体腔注射治疗湿性老年性黄斑变性(AMD)的临床效果.方法选取本院2020年9月—2021年9月收治的湿性AMD患者74例(85眼),根据治疗方法不同分为对照组37例(41眼)、观察组37例(44眼).对照组采用雷珠单抗玻璃体腔注射治疗,观察组在此基础上服用桃红四物汤加减,连续用药2个月.比较两组的临床疗效、最佳矫正视力(BCVA)、脉络膜厚度、血管渗漏情况及不良反应发生情况.结果观察组的治疗总有效率为97.73%、渗漏减少率为77.27%,高于对照组的80.49%、53.66%,组间差异有统计学意义(P<0.05).两组治疗前的BCVA、脉络膜厚度比较,组间差异无统计学意义(P>0.05);治疗后,观察组的BCVA为(0.68±0.12),高于对照组的(0.60±0.15),脉络膜厚度为(165.79±20.14)μm,薄于对照组的(177.48±17.33)μm,组间差异有统计学意义(P<0.05).治疗期间两组均未见不良反应.结论桃红四物汤加减联合雷珠单抗玻璃体腔注射治疗湿性AMD的疗效确切,可改善患者脉络厚度及视力,减少血管渗漏,且安全性高.

Objective To investigate the clinical effect of Taohong Siwu Decoction combined with ralizumab intravitreal injection in the treatment of wet age-related macular degeneration(AMD).Methods 74 patients(85 eyes)with wet AMD admitted to our hospital from September 2020 to September 2021 were selected,and they were divided into a control group of37 cases(41 eyes)and an observation group of 37 cases(44 eyes)according to different treatment methods.The control group was treated with ralizumab intravitreal injection,and the observation group was treated with Taohong Siwu Decoction on this basis.Both groups were treated for 2 months.The clinical efficacy,best corrected visual acuity(BCVA),choroid thickness,vascular leakage and the incidence of adverse reactions were compared between the two groups.Results The total effective rate and leakage reduction rate of the observation group were 97.73%and 77.27%,respectively,higher than 80.49%and53.66%of the control group,and the differences between the two groups were statistically significant(P<0.05).There were no significant differences in BCVA and choroid thickness between the two groups before treatment(P>0.05);after treatment,the BCVA of the observation group was(0.68±0.12),higher than(0.60±0.15)of the control group,and the choroid thickness was(165.79±20.14)μm,thinner than(177.48±17.33)μm of the control group,and the differences between the two groups were statistically significant(P<0.05).There were no adverse reactions in the two groups during treatment.Conclusion Taohong Siwu Decoction combined with ralizumab intravitreal injection is effective in the treatment of wet AMD,which can improve the thickness of the patient’s vein and vision,reduce vascular leakage,and has high safety.