桃红四物汤合六味地黄汤联合雷珠单抗玻璃体内注射治疗糖尿病性黄斑水肿疗效观察

Therapeutic Effect of Taohong Siwu Decoction and Liuwei Dihuang Decoction Combined with Intravitreal Injection for Ranibizumab on Diabetic Macular Edema

目的:探讨桃红四物汤合六味地黄汤联合雷珠单抗玻璃体内注射治疗糖尿病性黄斑水肿(DME)的疗效。方法:选取2017年1月~2020年1月我院收治的124例DME患者,根据治疗方式不同分为对照组和观察组,对照组(n=62,117眼)接受雷珠单抗玻璃体内注射治疗,观察组(n=62,121眼)在对照组基础上接受桃红四物汤合六味地黄汤治疗,对比两组患者的临床疗效和治疗后中医症候积分、黄斑厚度、视力、血清指标[血管内皮生长因子(VEGF)、白介素-6(IL-6)水平、一氧化氮合酶(NOS)]及不良反应。结果:观察组临床疗效明显高于对照组(P<0.05);治疗后观察组中医证候积分、黄斑厚度、血清VEGF、IL-6水平明显低于对照组,视力和血清NOS水平明显高于对照组(P<0.05);两组不良反应发生率对比无差异(P>0.05)。结论:桃红四物汤合六味地黄汤联合雷珠单抗玻璃体内注射治疗DME疗效确切,可明显降低黄斑厚度,改善视力,且使用安全,其作用可能与抑制炎症反应和改善血管内皮功能有关。

Objective:To investigate the efficacy of using Taohong Siwu Decoction and Liuwei Dihuang Decoction combined with intravitreal injection of Ranibizumab in the treatment of diabetic macular edema(DME).Methods:124 DME patients admitted to our hospital(January 2017 to January 2020)were selected and divided into two groups according to the random number table method.The controlled group(n=62,117 eyes)received intravitreal injection of Ranibizumab,the observation group(n=62,121 eyes)received Taohong Siwu Decoction and Liuwei Dihuang Decoction on the basis of the controlled group.The clinical efficacy and TCM syndrome scores,macular thickness,visual acuity,serum indexes[vascular endothelial growth factor(VEGF),interleukin-6(IL-6)levels,nitric oxide synthase(NOS)]and adverse effects were compared between the two groups of patients after treatment.Results:The clinical efficacy of the observation group was significantly higher than that of the controlled group(P<0.05).After treatment,the observation group’s TCM syndrome score,macular thickness,serum VEGF and IL-6 levels were significantly lower than those of the controlled group,and the visual acuity and serum NOS levels were significantly higher than those of the controlled group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Taohong Siwu Decoction combined with intravitreal injection of Ranibizumab in the treatment of DME has a definite effect.It can significantly reduce macular thickness,improve vision,and is safe to use.Its effect may be related to inhibiting inflammation and improving vascular endothelial function.