中药联合雷珠单抗及激光治疗视网膜静脉阻塞性黄斑水肿的临床观察

Traditional Chinese Medicine combined with intravitreal ranibizumab injection and retinal laser surgery treating macular edema due to retinal vein occlusion

目的观察自拟培土消水方治疗视网膜静脉阻塞性黄斑水肿的临床疗效。方法收集2014年1月至2015年12月在上海市宝山区中西医结合医院确诊为视网膜静脉阻塞,并经OCT及FFA检查明确存在黄斑水肿的患者共82例90眼,随机分为联合治疗组42例45眼及对照组40例45眼。对照组采用雷珠单抗玻璃体腔注射联合激光光凝治疗,联合治疗组在对照组治疗的基础上口服培土消水方治疗。于治疗后1周及1、3、6个月检测所有患眼的最佳矫正视力(BCVA)以及黄斑中心凹厚度(CMT),并进行统计分析。结果在治疗后各时间点2组病例的BCVA及CMT比治疗前均有明显的改善(P<0.05),在治疗后1周及1个月时,2组间的BCVA及CMT无明显差别(P>0.05),而在3个月及6个月时联合治疗组BCVA及CMT的改善程度均优于对照组,差异有统计学意义(P<0.05)。结论采用培土消水方联合雷珠单抗及激光治疗视网膜静脉阻塞性黄斑水肿能够明显提高临床疗效,其在减轻黄斑水肿、改善患者视力及延迟复发时间等方面优于对照组。

OBJECTIVE To investigate the clinical efficacy of traditional Chinese medicine in the treat- ment of macular edema due to retinal vein occlusion. METHODS The 82 patients （90 eyes） diagnosed with maeular edema owing to retinal vein occlusion in Baoshan District Traditional Chinese and Western Medicine Hospitalwere randomly divided into two groups （combined treatment group and control group）. The combined treatment group （42 cases, 45 eyes） was treated with intravitreal injection of ranibizumah,retinal laser surgery and privately composed Peitu Xi- aoshui formula. While the control group （40cases, 45 eyes） was treated with intravitreal injection of ranibizumab combined with retinal laser surgery. The changes of best corrected visual acuity （BCVA） and central macular thickness （CMT） were observed to assess the effects at thelst week, 1st month, 3rd month, 6th month after treatment. RESULTS The BCVA and CMT values of the two groups were significantly improved after treatment at each time point （P〈0.05）. There was no statistical difference of the BCVA and CMT values between two groups at the 1st week and 1st month after treatment （P〉05）. The BCVA and CMT values of the combined treatment group were improved more signif- icantly than counterparts of control group （P〈0.05） at the 3rd and 6th month after treatment. CONCLUSION Com- bined therapeutic plan for macular edema due to retinal vein occlusion could significantly enhance the clinical effi- cacy. Specifically, it had certain effects in relieving macular edema, improving visual acuity and delaying recurrent rate.