芪明颗粒联合格栅样激光光凝治疗糖尿病性黄斑水肿的疗效及安全性研究

Study on the efficacy and safety of the Qi-ming granule combined with laser treating on macular edema of diabetic retinopathy

目的观察芪明颗粒联合激光治疗对糖尿病性黄斑水肿的临床疗效和安全性。方法将患者随机分为2组,治疗组51例72眼,对照组50例69眼。2组患者均行激光光凝治疗,治疗组同时加服芪明颗粒。观察2组患者在治疗前后的眼压、最佳矫正视力、黄斑中心凹的厚度,同时检测患者的不良反应。结果 2组治疗前后及组间比较,眼压无明显变化,差异无统计学意义(P>0.05)。2组患者治疗后第1个月、第3个月BVCA和CMT平均值与治疗前比较,均显著提高(P<0.05),2组间比较,差异亦有统计学意义(P<0.05)。2组患者黄斑格栅样激光光凝治疗3个月后黄斑中心凹mf ERG与治疗前相比,a波、b波的振幅密度均增加,差异均有统计学意义(P<0.05),治疗后2组之间比较,差异亦有统计学意义(P<0.05)。治疗期间治疗组有2例(2.78%)出现了轻度胃部不适,未予任何治疗措施自行缓解;余无严重不良药物反应和后遗症发生。结论芪明颗粒与黄斑格栅样激光光凝联合应用,治疗可以更有效地减轻糖尿病性黄斑水肿,改善患者视力,巩固疗效,而且安全性高,值得在临床中推广应用。

Objective To study the efficacy and safety of the Qi-ming granule combined with laser treating on macular edema of diabetic retinopathy. Methods Patients were randomly divided into treatment group（ 51 patients with 72 studied eyes） and control group（ 50 patients with 69 studied eyes）. Both groups were given photo-coagulation treatment while the treatment group was additionally given the Qi-ming granule. To observe the changes of the intraocular pressure,best corrected vision and the thickness of the central fovea of macula,at the same time detect the adverse effect. Results There were no significant differences between the two groups in intraocular pressure before and after therapy（ P〈0. 05）. The average value of BVCA and CMT in two groups both significantly increased after 1,3 months therapy（ P〈0. 05）; Compared in the two groups,the differences were statistically significant（ P〈0. 05）. The amplitude density of a-wave and b-wave at macular area in two groups were statistically larger after 3 months treatment（ P〈0. 05）. There were statistical differences in the two treatment groups（ P〈0. 05）. During the treatments,2 patients（ 2. 78%） suffered from stomach discomfort,while both were spontaneous remission without any therapeutic measure,there were no adverse effect and sequela occurred in other patients.Conclusion Compared with the traditional laser treatment,the treatment of combined the Qi-ming granule with laser has a better effect on treating macular edema of diabetic retinopathy,it is worth of clinical application for highly improving the visual acuity and consolidating the therapeutic effect with high safety.