中西医结合治疗中心性浆液性脉络膜视网膜病变疗效观察

Efficacy Observation of Central Serous Chorioretinopathy Treated with Integrated Chinese and Western Medicine

目的探究中医辨证施治结合眼底激光光凝封闭荧光渗漏点治疗中心性浆液性脉络膜视网膜病变的疗效。方法观察49例53只眼中心性浆液性脉络膜视网膜病变辨证为水湿上泛证、痰湿化热证、肝肾不足证三种证型的患者,分别用四苓散、三仁汤及四物五子丸加减治疗;对其中有荧光素渗漏且渗漏点位于黄斑颞侧及上、下方的40只眼行眼底激光光凝荧光渗漏点治疗。结果治愈42眼(79.24%),好转9眼(16.98%),总有效率96.23%,未愈2眼(3.77%)。治疗前后视力比较,差异有统计学意义(P<0.05)。治疗疗程17～45 d,平均(26.45±11.00)d。结论中医辨证施治结合眼底激光光凝治疗中心性浆液性脉络膜视网膜病变,安全、有效,疗程短,治愈率高。

Objective To explore the efficacy on central serous chorioretinopathy（CSC）treated with the integration of traditional Chinese medicine in terms of pattern/syndrome differentiation and the closure of fluorescent leakage with retinal laser photocoagulation.Methods 49 cases of CSC,including 53 eyes were differentiated into three patterns/syndromes,named upward flooding of damp,phlegm damp transforming into heat and insufficiency of liver and kidney.They were treated with modified herbal formulas separately,named siling san,sanren tang and siwu wuzi wan.For 40 eyes with fluorescent leakage and the leakage sites located on the temple side of,superior or inferior to the macula lutea,the closure of fluorescent leakage with retinal laser photocoagulation was applied.Results 42 eyes（79.24%）were cured,9 eyes（16.98%）were improved and the total effective rate was 96.23%.2 eyes were failed（3.77%）.The difference in the vision comparison before and after treatment was significant statistically（P0.05）.The duration of treatment was ranged from 17 to 45 days,averagely（26.45±11.00）days.Conclusion The integration of traditional Chinese medicine in terms of pattern/syndrome differentiation and the closure of fluorescent leakage with retinal laser photocoagulation is the safe and effective therapy for CSC,characterized as short duration of treatment and high curative rate.