复方血栓通胶囊对视网膜分支静脉阻塞病灶微循环的影响

Effects of Fufang Xueshuan Tong Capsule on the retinal microcirculation in branch retinal vein occlusion

目的评价复方血栓通胶囊治疗视网膜分支静脉阻塞的临床效果及其对病变区视网膜微循环的影响。设计临床对照研究。研究对象连续收集自然病程为3～6个月的视网膜分支静脉阻塞患者90例,随机分为复方血栓通治疗组和对照组各45例。方法治疗组患者接受复方血栓通胶囊1.5 g每日3次和卵磷脂络合碘1.5 mg每日3次;对照组接受曲克芦丁120 mg每日3次和卵磷脂络合碘1.5 mg每日3次。所有患者连续观察6个月,每3个月复查一次荧光素眼底血管造影,定性描述病变区毛细血管无灌注区(NPA)及侧枝循环的形成情况。当患者NPA>5 PD时给予病变区激光光凝。主要指标患者激光治疗率(NPA形成率),侧枝循环形成率。结果观察期内,治疗组中31例(68.89%)因FFA显示NPA>5 PD或发现视网膜新生血管而接受激光治疗,对照组中33人(73.33%)接受激光治疗,两组间激光治疗率差异无统计学意义(P=0.816)。至随访期结束,治疗组中34例(75.56%)FFA显示侧枝循环建立,而对照组中24例(53.33%)FFA显示侧枝循环建立,两组间侧枝循环形成率差异具有统计学意义(P=0.047)。结论复方血栓通胶囊有助于视网膜分支静脉阻塞病灶视网膜血管与正常视网膜血管间建立侧枝循环。

Objective To evaluate the value of Fufang Xueshuan Tong Capsule for branch retinal vein occlusion （BRVO） and its effect on the formation of collateral vessels. Design Clinical comparing study. Participants 90 cases with a defined natural BRVO history of 3-6 months were enrolled. Methods 90 cases were randomly divided into two group： treatment group （45 cases） and control group （45 cases）. All the patients in treatment group were prescribed Fufang Xueshuan Tong Capsule （1.5 g, t/d） and iodizedlecithin （1.5 mg, tid）, while troxerutin （120 mg, tid） and iodizedlecithin （1.5 rag, tid） for the controls. All the patients received a monthly visual acuity and fundus examination using indirect ophthalmoscope, and received fundus fluorescein angiography （FFA） per 3 months. When the nonperfusion area revealed by FFA was more than 5 PD or neovascularisation, the laser photoeoagulation was performed. Evaluation on the formation of the collateral vessels at the 6th month. Main Outcome Measures The prevalence of laser treatment and the formation of the collateral vessels. Results In treatment group, 31 （68.89%） patients received laser treatment, while 33 （73.33%） patients were treated by laser in control group. The difference between the two groups showed no significance （P=0.37）. At the 6th month, collateral vessels could be detected in 34 （75.56%） patients in treatment group, while 24 （53.33%） patients in control group. There was a significant difference between the two groups （P=0.047）. Conclusions Fufang Xueshuan Tong Capsule might be helpful to the formation of the collateral vessels in BRVO.