复方血栓通胶囊联合曲安奈德注射液球旁注射治疗白内障术后黄斑囊样水肿患者的疗效分析

Efficacy analysis of compound xueshuantong capsules combined with triamcinolone acetonide injection ruby ball in treating cystoid macular edema after cataract surgery

目的探讨复方血栓通胶囊联合曲安奈德注射液治疗白内障术后黄斑囊样水肿的临床治疗效果。方法收集2012年8月至2014年5月山东省寿光市人民医院眼科收治的91例(182只眼)白内障术后黄斑囊样水肿患者的临床资料。按照数字表法随机将患者分为对照组45例(90只眼)和观察组46例(92只眼)。对照组患者采用曲安奈德注射液进行治疗,观察组患者在对照组的基础上加用复方血栓通胶囊进行治疗。治疗后1,4周两组患者的平均眼压、平均视力及黄斑区视网膜厚度以均数±标准差(珚x±s)的形式表示,并采用独立样本t检验的方法进行组间比较,采用配对t检验的方法进行组内比较。结果治疗前及治疗后1,4周观察组患者的平均眼压分别为(14.52±4.21),(16.21±4.84),(17.62±4.36)mmHg;对照组患者的平均眼压分别为(14.51±4.19),(15.11±4.26),(15.47±4.62)mmHg。治疗前两组患者的平均眼压比较,差异无统计学意义(t1=1.02,P1>0.05);治疗后1周两组患者的平均眼压比较,差异无统计学意义(t1=1.15,P1>0.05);治疗后4周两组患者的平均眼压比较,差异有统计学意义(t1=6.84,P1<0.05)。治疗后1周观察组患者的平均眼压与治疗前比较,差异无统计学意义(t2=1.78,P2>0.05);治疗后4周观察组患者的平均眼压与治疗前比较,差异有统计学意义(t2=3.47,P2<0.05)。治疗后1,4周对照组患者的平均眼压与治疗前比较,差异无统计学意义(t3=0.67,1.03;P3>0.05)。治疗前及治疗后1,4周观察组患者的平均视力分别为(0.13±0.26),(0.39±0.29),(0.68±0.31);对照组患者的平均视力分别为(0.12±0.24),(0.28±0.23),(0.52±0.28)。治疗前两组患者的平均视力比较,差异无统计学意义(t1=0.31,P1>0.05);治疗后1周两组患者的平均视力比较,差异有统计学意义(t1=4.62,P1<0.05);治疗后4周两组患者的平均视力比较,差异有统计学意义(t1=5.30,P1<0.05)。治疗后1,4周观察组患者的平均视力与治疗前比较,差异有统计学意义(t2=4.52,9.22;P2<0.05);治疗后1,4周对照组患者的平均视力与治疗前比较,差异有统计学意义(t3=3.93,7.27;P3<0.05)。治疗前及治疗后1,4周观察组患者的黄斑区视网膜厚度分别为(487.52±78.51),(311.25±32.14),(216.58±15.63)mm;对照组患者的黄斑区视网膜厚度分别为(485.63±74.89),(401.52±35.67),(286.46±18.94)mm。治疗前两组患者的黄斑区视网膜厚度比较,差异无统计学意义(t1=1.21,P1>0.05);治疗后1周两组患者的黄斑区视网膜厚度比较,差异有统计学意义(t1=8.95,P1<0.05);治疗后4周两组患者的黄斑区视网膜厚度比较,差异有统计学意义(t1=9.51,P1<0.05)。治疗后1,4周观察组患者的黄斑区视网膜厚度与治疗前比较,差异有统计学意义(t2=13.94,22.96;P2<0.05);治疗后1,4周对照组患者的黄斑区视网膜厚度与治疗前比较,差异有统计学意义(t3=6.87,17.49;P3<0.05)。结论复方血栓通胶囊联合曲安奈德治疗白内障术后的黄斑囊样水肿,可有效控制病情发展,对快速消退黄斑、保持视网膜适当厚度均有显著效果,有利于患者的视力和眼压恢复,值得临床推广。

Objective To investigate the clinical efficacy of compound xueshuantong capsules combined with triamcinolone acetonide injection ruby ball in treating cystoid macular edema after cataract surgery.Methods Selected 91 patients with cystoid macular edema after cataract surgery（182eyes）from Shouguang People′s Hospital of Shandong Province and randomly divided them into control group and observation group,each with 46cases（92eyes）.The control group was given triamcinolone acetonide injection and the observation group was treated with compound xueshuantong capsules on the basis of the control group.The two groups′average intraocular pressure,average eyesight and macular thickness were all showed with mean standard deviation（）,the comparison between groups by adopting independent samples t-test and the comparison in groups by adopting paired t test.Results The observation group patient′s average intraocular pressure 1 week and 4weeks before and after the treatment were（14.52±4.21）,（16.21±4.84）,（17.62±4.36）mmHg,and the control group′s were（14.51±4.19）,（15.11±4.26）,（15.47±4.62）mmHg,there was no statistic significance in these two groups′average pressure before the treatment（t1=1.02,P1〉0.05）;there was no statistic significance in these two groups′average intraocular pressure 1 week after the treatment,（t1=1.15,P1〉0.05）.The comparison of two groups′average intraocular pressure 4weeks after the treatment has statistic significance（t1=6.84,P1〈0.05）.The comparison of the observation group′s average intraocular pressure before and after the treatment has statistic significance（t2=3.47,P2〈0.05）.The comparison of the control group′s average intraocular pressure 1week and 4weeks after treatment has no statistic significance（t3 =0.67,1.03;P3〉 0.05）.The observation group′s average eyesight 1week and 4weeks before and after the treatment were（0.13±0.26）,（0.39±0.29）,（0.68±0.31）,the control groups were（0.12±0.24）,（0.28±0.23）,（0.52±0.28）.The comparison of these two groups′average eyesight has no statistic significance（t1=0.31,P1〈0.05）;1weeks after the treatment,the difference has statistic significance（t1 =4.62,P1 0.05）;the comparison of two groups′average eyesight 4weeks after the treatment has statistic significance（t1=5.30,P1〈0.05）.The comparison of the observation groups′average eyesight 1week and 4week after the treatment has statistic significance（t2=4.52,9.22;P2 0.05）,1 week and 4 weeks later,the difference still has statistic significance（t3=3.93,7.27;P3〈0.05）.The observation group′s macular thickness before and after the treatment were（487.52±78.51）,（311.25±32.14）,（216.58±15.63）mm;and the control group′s were（485.63±74.89）,（401.52±35.67）,（286.46±18.94）mm.The comparison of these two groups′macular thickness before the treatment has no statistic significance（t1=1.21,P1〈0.05）;1week after the treatment,the comparison has statistic significance（t1=8.95,P1〈0.05）.The comparison of these two groups′macular thickness 4 weeks after the treatment has statistic significance（t1 =9.51,P1 0.05）.These was statistic significance in the comparison of observation group′s macular thickness 1week and 4weeks after the treatment and before treatment（t2=13.94,22.96;P2〈0.05）,which was the same with the control group（t3=6.87,17.49;P3〈0.05）.Conclusion Triamcinolone acetonide combined with Compound Xueshuantong Capsule can effectively control progression,recovery eyesight and intraocular pressure,and can decrease macular retinal thickness,which should be widely applied in clinic.