黄斑变性方药治疗脉络膜新生血管的临床疗效观察

Treatment of Choroidal Neovascularization with Chinese Medicine Huangban Bianxing Recipe

目的观察黄斑变性方药治疗脉络膜新生血管(choroidal neovasculazation,CNV)的临床疗效。方法将80例97只眼符合脉络膜新生血管患者分为两组,治疗组采用黄斑变性方药每天1剂口服,对照组采用银杏叶片(19.2mg/粒)1粒,每天3次口服,疗程3个月;记录两组患者治疗前及治疗后最佳矫正视力、眼底出血面积、眼底血管荧光造影(FFA)新生血管渗漏面积和光学相干断层扫描(OCT)外层高反光带厚度(OHRBT)。结果两组治疗前后比较:治疗组最佳矫正视力提高,有效率为67.12%,而对照组为33.33%,治疗组疗效明显优于对照组(P<0.05);治疗组治疗后眼底出血面积减少,有效率为85.11%,对照组为47.62%,治疗组疗效优于对照组(P<0.05);治疗组治疗后黄斑区荧光渗漏面积也有改善,有效率为67.50%,而对照组为37.50%,治疗组疗效明显优于对照组(P<0.05);治疗组治疗后OHRBT测量值较治疗前缩小(P<0.01)。结论黄斑变性方药可以改善CNV患者视力,减少黄斑区CNV荧光渗漏,促进出血吸收。

Objective To investigate the efficacy of Chinese medicine Huangban Bianxing Recipe （HBR） for treatment of choroidal neovascularization （CNV）. Methods Eighty patients （97 eyes） suffered from CNV were assigned to two groups, the treated group treated by HBR orally taken one dose every day and the control group treated with ginkgo leaf tablet 1 tablet （ 19.2 mg） thrice a day, all for 3 months. The best corrected visual acuity （BCVA）, fundus hemorrhagic area were measured; the neo-genetic vascular leakage area determined by fluorescent fundus angiography （FFA） ; and the out-layer high reflective band thickness （OHRBT） estimated by optical coherent tomography （OCT） were recorded before and after treatment. Results After treatment, in the treated group, BCVA was improved, with an effective rate of 67. 12%, while in the control group, it was 33.33%, the former was better than the latter significantly （ P 〈 0.05）. The effective rate in reducing fundus hemorrhagic area in the two groups （85. 11% vs 47. 62%） and that in the CNV closure showed by FFA （67.50% vs 37.50%） were also superior in the treated group （P 〈0.05）. Besides, OCT showed that the OHRBT reduced significantly after treatment in the treated group （ P 〈0.01 ）. Conclusion HBR can improve the vision, reduce the CNV leakage in the macular region, and advance the absorption of fundus hemorrhage in CNV patients.