地奥司明治疗非缺血型RVO的疗效观察

Therapeutic efficacy of diosmin on non-ischemic retinal vein occlusion

目的:探讨地奥司明治疗非缺血型视网膜静脉阻塞(retinal vein occlusion,RVO)的临床疗效。方法:将符合非缺血型RVO诊断的48例48眼随机分为治疗组和对照组。治疗组27例27眼,给予地奥司明0.9g,po,bid,4wk为一疗程,连续三个疗程。对照组21例21眼,先给予丹香冠心注射液16mL加入5g/L葡萄糖注射液(或者9g/L氯化钠注射液)500mL中,iv,qd,1wk后改为丹参片3片,po,tid,连续服用11wk。观察治疗前后最佳矫正视力和眼底病变的动态改变、视网膜电流图的变化、黄斑水肿的发生率及黄斑水肿厚度变化。结果:治疗后4,8,12wk治疗组最佳矫正视力提高均显著高于对照组(P<0.05)。治疗后4wk,治疗组渗出、出血吸收率为63%,高于对照组的33%(P<0.05)。治疗后12wk,治疗组暗适应眼最大电反应的b波振幅(231±39)μV与治疗前(184±65)μV相比明显提高(P<0.05),且与对照组(207±49)μV相比有差异(P<0.05)。治疗组并发黄斑水肿17例,对照组14例,治疗组黄斑水肿的发生率与对照组相比没有明显差异(P>0.05)。治疗后12wk黄斑中心凹厚度,治疗组为298±54μm,低于对照组的369±76μm(P<0.05)。结论:对于非缺血型RVO,地奥司明能够有效的减轻黄斑水肿,降低视网膜的功能损伤,从而改善视功能,效果优于丹参治疗。

· AIM： To evaluate the therapeutic efficacy of diosmin in treating non-ischemic retinal vein occlusion. · METHODS： Forty-eight eyes of 48 cases of nonischemic retinal vein occlusion were randomly divided into two groups. Twenty-seven eyes of 27 cases were enrolled in treatment group, receiving diosmin, 0.9g, po, bid, 4 weeks as a course altogether for 12 weeks. Twenty-one eyes of 21 cases in control group receiving danxiang guanxin injection 16mL ＋ 5g/L glucose injection （or sodium chloride injection） 500mL, iv, qd for 1 week followed Salvia miltiorrhiza tablets, 3 tablets, po, tid, for 11 weeks. The best-corrected visual acuity, variation of eye fundus, electroretinogram, incidence rate of macular edema, and the thickness of macular were observed before and 4, 8, 12 weeks after the treatment. · RESULTS： The improvement of best-corrected visual acuity in treatment group was much better than that in control group with statistical difference between two groups at the end of 4, 8, 12 weeks （P〈0.05）. At the end of 4 weeks after treatment, the absorbency of bleeding and exudation of treatment group was 63%, higher than that of control group （33%, P〈0.05）. In dark adaptation eyes, the maximum amplitude of b wave in treatment group were meliorated 12 weeks later （231±39μ V versus 184±65μ V, P〈 0.05）, also showing more improvement than those in control group （207±49μ V, P〈0.05）. There was no significant difference in incidence rate of macular edema between the two groups （17 in treatment group versus 14 in control group, P〈O. 05）. The thickness ot macular in treatment group was 298±54μm, which was much less than that in control group （369±76μm, P〈 0.05）.