枸杞茯苓汤治疗黄斑前膜剥离术后黄斑水肿的临床观察

Clinical effect of Chinese medicine Gouqi Fuling decoction on macular edema sec-ondary to operation of macular epiretinal membrane

目的观察中药治疗黄斑前膜剥离术后黄斑水肿临床疗效。方法观察2014年6月-2016年9月在中国中医科学院眼科医院就诊的黄斑前膜术后黄斑水肿患者81例（81眼），患者被随机分为两组，治疗组42例给予唐由之研究员经验方“枸杞茯苓汤”，对照组39例给予银杏叶片口服，治疗2个月，随访1个月。观察患者治疗前后的最佳矫正视力（BCVA）、黄斑中心视网膜厚度（CRT）、黄斑水肿复发情况。结果中药组和对照组治疗总有效率分别为83．33％，76．92％，差异没有统计学意义（X^2=0．524，P=0．469）。两组患者最佳矫正视力治疗前后比较没有统计学差异（F=1．463，P=0．2581；各组治疗前后和治疗前相比均有统计学差异（P〈0．05）。两组治疗前后患者CRT比较，均有统计学差异（P=0．000）。不同时间点CRT比较：术后1个月两组CRT比较，t=0．989，P=0．327．两组之间没有明显差异；术后2个月，两组CRT比较，t=4．980，有统计学差异（P=0．000）。随访1个月，两组均黄斑水肿无复发。结论中药枸杞茯苓汤是治疗黄斑前膜剥离术后黄斑水肿的有效方法。

OBJECTIVE To observe the clinical efficacy of Chinese medicine on macular edema secondary to macular epiretinal membrane surgery. METHODS Eighty-one cases （81 eyes） with macular edema were observed from June 2014 to September 2016 in eye hospital, China academy of Chinese medical sciences. The patients were divided randomly into 2 groups. The treatment group consisted of 42 patients which were treated with Gouqi Fuling decoction; the control group consisted of 39 patients which were given Ginkgo biloba extract tablets. They were all treated for 2 months, followed up for 1 month. Observation indicators included best corrected visual acuity （BCVA）, fundus, central macular thickness, macular edema recurrence before and after treatment. RESULTS The total effective rate was 83.33% in the Gouqi Fuling decoction group and 76.92% in the control group. There was no significant statistical difference 0（2=0.524,P= 0.469）. There were no statistical differences （F=1.463, P=0.258）in terms of BCVA between two groups before and after treatment, but there was statistical variation （P〈0.05）in each group after treatment. There were statistical variations （P=0.000） in the aspect of central macular thickness of the patients before and after treatment in two groups; There was no statistical significance 1 month after treatment （t=0.989, P=0.327）, but there was statistical significance 2 months after intervention （t=4.980, P=0.000） in terms of central maeular thickness between the two groups. One month follow up showed no recurrent ease. CONCLUSIONS The Gouqi Fuling decoction was effective on maeular edema after maeular epiretinal membrane surgery which eased central maeular edema, improved visual acuity of patients, and the efficacy of Gouqi Fuling decoction was related to duration of medication, the longer the better.