芪明颗粒联合格栅样激光光凝治疗视网膜分支静脉阻塞合并黄斑水肿疗效观察

Qi Ming Granule and Grid Laser Photocoagulation for Branch Retinal Vein Occlusion with Macular Edema

目的观察芪明颗粒联合格栅样激光光凝治疗视网膜分支静脉阻塞(BRVO)合并黄斑水肿疗效。方法临床确诊为BRVO合并黄斑水肿的患者80例80只眼纳入本研究。所有患者均常规行矫正视力、裂隙灯显微镜、直接检眼镜、眼压、眼底彩色照相、荧光素眼底血管造影及光学相干断层扫描检查。根据不同的治疗方法,将患者随机分为单纯激光光凝组(激光组)和芪明颗粒联合激光光凝治疗组(联合组),分别为40只眼。随访期间采用治疗前相同的设备和方法行相关检查。以12个月为疗效判定时间点,对比分析两组患者治疗前后视力、黄斑中心视网膜厚度(CRT)的变化情况。结果 12个月随访时,激光组、联合组激光光凝的平均次数分别为1.9、1.4次,联合组激光光凝次数少于激光组,差异有统计学意义(P<0.05);激光组、联合组患者较治疗前视力预后有效率分别为40%、62.5%,差异有统计学意义(P<0.05);激光组、联合组患者CRT较治疗前分别减少了(90.7±19.6)、(126.2±30.6)um,与治疗前的CRT相比,差异均有统计学意义(t=29.27,26.085,P<0.01)。结论芪明颗粒联合黄斑格栅样激光光凝治疗BRVO合并黄斑水肿可以减少重复激光光凝次数,减轻黄斑水肿,提高视力。

Objective To investigate the effectiveness of combined therapy of Qi Ming granule and macular grid laser photocoagulation for branch retinal vein occlusion（ BRVO） with macular edema（ ME）. Methods 80 patients（ 80 eyes）of BRVO with ME were enrolled in this study. All the patients were examined for visual acuity,slit lamp microscope,direct opthalmoscope,intraocular pressure,fundus color photography,fundus fluorescein angiography（ FFA） and optical coherence tomography（ OCT）. The patients were divided into two groups by different treatments： laser group（ 40 eyes）received laser photocoagulation only,joint group（ 40 eyes） received Qi Ming granule combined with grid laser photocoagulation. The same equipment and methods were used to return visit in follow-up period. The visual acuity,macular retinal thickness（ CRT） were followed up. The time of 12mon was considered as the judgment time for the therapeutic effects. Results The mean time of laser in laser group was 1. 9,which more than that in the joint group1. 4（ P〈 0.05）. The difference of effective rate in visual acuity between laser group（ 40%） and joint group（ 62. 5%） was significant（ χ^2= 4. 05,P〈 0.05）. CRT of laser group and joint group decreased by（ 90. 7 ± 19. 6） 、（ 126. 2 ± 30. 6） um respectively after treatment,with statistically significant differences（ t = 29. 27,26. 085,P〈 0.01）. Conclusions In the treatment of BRVO with ME,Qi Ming granule combined with macular grid laser photocoagulation could reduce repeat time of laser,improve visual function and relieve ME.