柔肝健脾、滋阴明目法治疗萎缩性老年性黄斑变性的随机对照临床研究

Treatment of senile macular degenertation by softening liver to fortify spleen and nourishing yin to improve eyesight methods: A randomized controlled clinical study

目的观察柔肝健脾、滋阴明目法治疗肝肾亏损、气血亏虚型萎缩性老年性黄斑变性的临床疗效。方法将60例萎缩性老年性黄斑变性患者随机分为治疗组、对照组,各30例60只眼。治疗组予柔肝健脾、滋阴明目中药口服,对照组用杞菊地黄丸合逍遥丸治疗,两组均治疗3个月。观察主要症状、远视力、中心暗点变化情况,并评价临床疗效。结果治疗组、对照组总有效率分别为73.3%、46.7%;组间临床疗效比较,差异有统计学意义(P<0.05)。治疗组治疗前后组内比较,中心暗点分布情况、远视力及视物模糊、头晕耳鸣和腰膝酸软症状积分差异均有统计学意义(P<0.05);对照组治疗前后组内比较,仅视物模糊、眼干涩、头晕耳鸣和腰膝酸软等症状积分差异有统计学意义(P<0.05)。组间治疗后比较,中心暗点分布情况、远视力及视物模糊、头晕耳鸣和腰膝酸软症状积分差异均有统计学意义(P<0.05)。结论柔肝健脾、滋阴明目法对改善肝肾亏损、气血亏虚型萎缩性老年性黄斑变性患者的中心视力、中心暗点分布情况及临床症状疗效显著。

Objective To observe the clinical efficacy for atrophic senile macular degenertation （consumption of liver and kidney pattern, deficiency of qi and blood pattern）by softening liver to fortify spleen and nourishing yin to improve eyesight methods. Methods Sixty cases were randomized into two groups： treat- ment group in which 30 cases （60 eyes） were treated by Chinese medicine with liver-softening spleen-fortify and yin-nourishing eyesight improvement effects, and control group in which 30 cases （60 eyes） were treated by ＂Qiju Dihuang Pill＂ combined “Xiaoyao Pill” , with the course of 3 months. The main symptoms, dis- tant vision, central scotoma were detected, and the clinical efficacy was evaluated. Results The overall effective rate was 73.3% in the treatment group and 46.7% in the control group; there was significant difference in clinical efficacy between the two groups （P 〈 0.05 ）. In treatment group, there were significant differences in distribution of central scotoma, distant vision and scores of blurred vision, dry eyes, dizziness, tinnitus and weak waist between before and after treat- ment （ P 〈 0.05 ） ; in control group, there were significant differences in blulTed vision, dry eyes, dizziness, tinnitus and weak waist between before and after treat- ment （ P 〈 0.05 ） ; after treatment, there were significant differences in distribution of central scotoma, distant vision and scores of blurred vision, dry eyes, dizzi- ness, tinnitus and weak waist between the two groups （P 〈 0.05 ）. Conclusion Softening liver to fortify spleen and nourishing yin to improve eyesight methods can improve the central vision, distribution of central scotoma and clinical efficacy in patients with senile macular degenertation of consumption of liver and kidney pattern and deficiency of qi and blood pattern.