活血利水法联合康柏西普玻璃体腔注射及激光治疗糖尿病黄斑水肿的临床观察

Clinical Observation on Diabetic Macular Edema Treatment by Activating Blood and Promoting Diuresis Combined with Conbercept Injection and Laser Therapy

目的:观察活血利水法联合康柏西普玻璃体腔注射及激光治疗糖尿病黄斑水肿(DME)的临床疗效。方法:将糖尿病黄斑水肿患者45例(52眼)随机分成观察组和对照组,每组各26眼。对照组采用康柏西普玻璃体腔注射联合激光治疗,观察组在对照组治疗基础上加用活血利水方剂(血府逐瘀汤化裁方)口服。观察两组患者治疗后1、3、6个月的最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)和不良反应等情况。结果:观察组在随访1、3、6个月的BCVA(ETDRS字母数)分别为:30.3±11.6、35.7±12.3、36.2±11.7,CMT(μm)为:304.1±110.6、272.3±97.3、277.8±89.3;而对照组在上述时间点的BCVA(ETDRS字母数)为:25.2±10.2、29.7±12.9、30.2±12.5,CMT(μm)为:358.1±119.6、320.3±101.0、338.0±93.2。两组间BCVA、CMT在各时间点的比较均有统计学差异(P<0.05),观察组均优于对照组。各组均未出现明显不良反应。结论:活血利水法联合康柏西普玻璃体腔注射及激光治疗对DME疗效良好,可以进一步提高视力,减轻黄斑水肿,是一种安全有效的治疗方案。

Objective： To discuss the clinical efficacy of activating blood and promoting diuresis combined with conbercept injection and laser. Methods： Selected 45 patients（ 52 eyes） with DME. They were randomly divided into two groups： observation group and control group,26 eyes in each group. The control group was given conbercept injection and laser therapy,and the observation group was given traditional Chinese medicine by activating blood and promoting diuresis combined with western medicine therapy. The best corrected visual acuity,macular thickness,and untoward effect after treatment in the 1 st、3 rd and 6 th months were recorded. Results： The BCVA of observation group in the 1 st、3 rd and 6 th months： 30. 3 ± 11. 6、35. 7 ± 12. 3、36. 2 ± 11. 7; CMT（ μm） ： 304. 1 ± 110. 6、272. 3 ± 97. 3、277. 8 ± 89. 3; The BCVA of The control group in those days： 25. 2 ± 10. 2、29. 7 ± 12. 9、30. 2 ± 12. 5; CMT（ μm） 为： 358. 1 ± 119. 6、320. 3 ± 101. 0、338. 0 ± 93. 2. In the same period,the result of BCVA and CMT between two groups were statistically significant（ P〈0. 05）. The result in the observation group was significantly better than that of control group. There was no obvious adverse reactions in each group. Conclusion： Activating blood and promoting diuresis combined with conbercept injection and laser has good curative effect on DME,lighten the macular edema and visual acuity. The treatment is safe and reliable.