益气活血法为主治疗视网膜静脉阻塞性黄斑水肿疗效观察

Clinical effect of Yiqi Huoxue principle treating macular edema secondary to retinal vein occlusion

目的观察益气活血法治疗视网膜静脉阻塞(RVO)性黄斑水肿的疗效。方法将经检眼镜、荧光素眼底血管造影(FFA)以及光学相干断层扫描(OCT)检查确诊的RVO性黄斑水肿患者,随机分为对照组和治疗组。对照组34例(34只眼)予注射用血栓通450 mg静脉滴注,1次/d,每2周间隔2 d,治疗组34例(34只眼)在静脉用药同时口服益气活血方药,疗程8周。比较2组患者用药前后视力和黄斑水肿高度的变化。结果治疗组视力提高15只眼,稳定18只眼,降低1只眼,对照组视力提高1只眼,稳定26只眼,降低7只眼,治疗组好于对照组,差异有统计学意义(P<0.05)。治疗组黄斑中心凹水肿高度在治疗前、治疗后1、4、8周分别为(588±194)μm、(527±161)μm、(493±164)μm、(411±174)μm,对照组分别为(488±289)μm、(452±178)μm、(522±246)μm、(491±213)μm。治疗组黄斑中心凹水肿消退较对照组明显,2组差异在治疗前及治疗后1周无统计学意义(P>0.05),在治疗后4周及8周有统计学意义(P<0.05)。结论益气活血法治疗RVO性黄斑水肿有较好效果。

OBJECTIVE To observe the clinical effect of Yiqi Huoxue （YQHX, replenishing qi and promoting the blood circulation） principle treating macular edema secondary to retinal vein occlusion （RVO）. METHODS Sixty-eight patients （68 eyes） diagnosed with macular edema secondary to RVO according to examination of ophthalmoscope, fluorescein fundus angiography （FFA） and optical coherence tomography （OCT） were randomly divided into control and treatment groups. The control group of 34 eyes had intravenous injection of 450mg Xueshuantong once a day with an interval of 2 days every two weeks, and the treatment group of 34 eyes had intravenous injection therapy plus oral prescription of YQHX herbal drugs. The two groups of patients were followed up for 8 weeks, and the visual acuity and the macular thickness checked by OCT before and after treatment were compared and analyzed. RESULTS In the treatment group, the visual acuity improved in 15 eyes, stabilized in 18 eyes, and decreased in 1 eye. In the control group, the visual acuity improved in 1 eye, stabilized in 26 eyes, and decreased in 7 eyes. The result of the treatment group was better than that of the control group, and the difference was statistically significant （P〈0.05）. The macular edema heights were 588±194μm, 527±161μm, 493±164μm and 411±174μm before and 1, 4, 8 weeks after treatment in the treatment group. In the control group, those were 488±289μm, 452±178μm, 522± 246μm and 491±213μm. The maeular edema decreased better in the treatment group. There was no statistical significance between the two groups at baseline and 1 week after treatment （P〉0.05）, while the differences at 4 and 8 weeks after treatment were statistically significant （P〈0.05）. CONCLUSIONS YQHX principle had relatively well effect in treatment of macular edema secondary to RVO.