玻璃腔内注射曲安奈德联合真武汤加减治疗视盘血管炎继发黄斑水肿的临床疗效观察

Clinical Effects of Intravitreal Injection of Triamcinolone Acetonide Combined with Zhenwu Decoction in the Treatment of Macular Edema Combined with Optic Disc Vasculitis

目的:探讨玻璃腔内注射曲安奈德结合真武汤加减治疗视盘血管炎继发黄斑水肿的临床疗效及安全性。方法:选择2013年12月到2017年4月在我院诊治的视盘血管炎继发黄斑水肿患者142例(142眼)作为研究对象,根据信封随机抽签法分为观察组与对照组,每组各71例。对照组给予玻璃腔内注射曲安奈德治疗,观察组在对照组治疗的基础上给予真武汤加减治疗。治疗1个月后,比较两组治疗前后视力、黄斑中心凹厚度的变化情况及不良反应的发生情况。结果:治疗后,观察组与对照组的视力均明显优于治疗前(P<0.05),且观察组视力明显优于对照组(P<0.05)。治疗后,观察组与对照组的黄斑中心凹厚度分别为168.34±22.19μm和267.35±34.11μm,均明显低于治疗前[516.35±45.20μm和522.14±23.01μm](P<0.05),且观察组治疗后黄斑中心凹厚度明显低于对照组(P<0.05)。两组治疗后发生玻璃体积血、新生血管性青光眼、瞳孔区模性渗出等并发症,发生率对比差异无统计学意义(P>0.05)。结论:与单用玻璃腔内注射曲安奈德治疗相比,玻璃腔内注射曲安奈德结合真武汤加减治疗视盘血管炎继发黄斑水肿的安全性更高,且能有效减轻黄斑水肿,缩小黄斑区域,提高视力。

Objective： To investigate the effects of intravitreal injection with triamcinolone acetonide combined with Zhenwu Decoction in the treatment ofmacular edema combined with optic disc vasculitis. Methods： From December 2013 to April 2017, 142 cases （142 eyes） of macular edema combined with optic disc vasculitis patients in our hospital were selected as the research object, all cases were divided into the observation group and the control group with 71 cases in each group according to the envelope randomly lottery method. The control group was given intravitreal injection of triamcinolone acetonidc, the observation group was given Zhenwu Decoc- tion based on the treatment of control group, both groups were treated for 1 month, the changes of visual acuity and macular edema were compared bwteen two groups. Results： After treatment, the visual acuity of both groups were significantly better than those before treat- ment （P〈0.05）, and the visual acuity of observation group after treatment was significantly better than that of the control group （P〈0.05）. The foveal thickness after treatment in the observation group and the control group were 168.34±22.19 μm and 267.35± 34.11μm, which were significantly lower than those before treatment [516.35±45.20 and 522.14±23.01μm]（P〈0.05）, while the macular foveal thickness of observation group after treatment was significantly lower than that of the control group （P〈 0,05）. After treatment, the incidence rate of complications such as vitreous hemorrhage, neovaseular glaucoma, and pupil area effusion showed no significant difference between the two groups （P〉0.05）. Conclusion： The intravitreal injection of triamcinolone acetonide combined with Zhenwu Decoction was effective and safe in the treatment of macular edema combined optic disc vasculitis, which could relieve the macular edema, reduce the macular area and promote the improvement of visual acuity.