灵杞黄斑颗粒治疗不伴黄斑水肿的缺血型RVO的疗效观察

The study of the effect of Chinese medicine Lingqi Huangban granules in the treatment of patients with ischemic retinal vein occlusion without macular edema

目的研究视网膜激光光凝联合灵杞黄斑颗粒口服治疗不伴有黄斑水肿的缺血型视网膜静脉阻塞(RVO)的临床疗效。方法收集2014年5月—2015年5月就诊于上海市第一人民医院北院眼科门诊的不伴有黄斑水肿的缺血型RVO患者40例40眼,随机分为对照组和治疗组,治疗组为采取激光光凝联合口服黄斑颗粒治疗;对照组采取激光光凝治疗,分别于治疗前及治疗后1周、1个月、3个月、6个月进行随访,收集患者患眼最佳矫正视力、ERG、FFA无灌注区改变等数据,进行统计分析。结果治疗后两组的视力均有明显提高,治疗前后比较有统计学差异(P<0.05),其中治疗组视力优于对照组,差异有统计学意义(P<0.05)。在治疗后3个月及6个月,对照组a波振幅较治疗前有所下降(P<0.05),治疗组a波振幅较之前无明显下降(P>0.05);在治疗3个月、6个月时,两组的b波振幅均较治疗前有所增加,潜伏期有所缩短(P<0.05),其中治疗组b波振幅增加大于对照组,b波潜伏期缩短多于对照组(P<0.05);两组OPs波振幅在治疗3个月、6个月时,均有所增加,其中治疗组增加的幅度显著大于对照组(P<0.05)。在治疗至3个月及6个月时,治疗组出现新生血管比例均低于对照组,该差异不具有临床意义(P>0.05);在治疗至6个月时,治疗有效患者比例差异无统计学意义,在有效病例中,治疗组显效患者比例高于对照组,二者差异有统计学意义(P<0.05)。结论灵杞黄斑颗粒治疗不伴有黄斑水肿的缺血型RVO,可以减少激光能量对正常视网膜组织的损伤,改善视网膜循环,抑制新生血管的产生,减少并发症,提高患者的临床预后,具有一定的临床应用前景与推广价值。

Objective To study the curative effect of the treatment of retinal branch vein occlusion without macular edema by laser photocoagulation combined with Lingqi Huangban gran-ules（LQHB）.Methods From May 2014 to May 2015 in Shanghai general hospital, 40 cases of retinal vein occlusion without macular edema（40 eyes） were collected and randomly divided into control group and treatment group, patients in former group were treated by laser photocoagulation while subjects in latter group were treated by combination of LQHB and laser photocoagulation.Before treatment and 1 week, 1 month, 3 months, 6 months after treatment, patients were examined by BCVA, ERG, FFA and the result were statistical analyzed. Results After the treatment, the visual acuity of both groups was significantly improved（P〈0.05）, and the visual acuity of the treatment group was better than that of the control group,which ment the difference was statistically significant（P 0.05）.Three months and 6 months after treatment, the amplitude of a wave in the control group was decreased（P〈0.05）,and in the treatment group the variation was of no significant difference（P〈0.05）. Three months, 6 months after treatment, amplitude of b wave in two group both increased, the incubation period were shortened（P〈0.05）, the increased amplitude of b wave in treatment group was greater than it in the control group, while the incubation period of b wave in the treatment group was shorter than it in the control group（P〈0.05）. The amplitude of the OPs wave in both groups increased after the treatment at the third month and the sixth month, and the increase of treatment group was significantly greater than that in the control group（P〈0.05）. In the treatment group, the proportion of new blood vessels was less than that in the control group, however it was not statistically significant（P〈0.05）. There was no significant difference in effective rate between two groups at the sixth month.The proportion of marked cases in the treatment group was higher than that in the control group,and the difference was statistically significant（P〈0.05）. Conclusions For patients with RVO without macular edema, the combined therapy of LQHB with laser photocoagulation reduced the damage of laser energy on normal retina tissue, improved the visual function and the visual prognosis of patients. It also improved retinal circulation, inhibited the generation of new blood vessels, and reduced the complications such as macular edema, improved the clinical outcomes of patients which had certain clinical application prospect and promotion value.