消肿方联合康柏西普对糖尿病黄斑水肿患者视功能的影响

Preliminary research of Xiaozhong decoction combined with Conbercept on visual function of diabetic macular edema

目的:初步评估消肿方联合康柏西普治疗糖尿病黄斑水肿(DME)对视网膜敏感度及固视特征的影响。方法:选取2017-01/10在我院确诊为DME的患者40例40眼,随机双盲分为两组,治疗组患者20例20眼采用康柏西普联合消肿方治疗3mo,对照组患者20例20眼采用康柏西普联合安慰剂治疗3mo。观察两组患者BCVA(ETDRS视力表检查)、CRT(OCT检查)情况,并采用MAIA微视野计检测视网膜敏感度和固视稳定性(P1、P2)。结果:治疗3mo时,治疗组和对照组患者BCVA分别较基线提高4(-1,11.5)、0(-4,0.75)字母(P<0.05),CRT分别较治疗前下降123.5±42.61、18.1±12.84μm(P<0.05)。治疗后两组患者视网膜敏感度均轻度增加,但两组间无差异,且对照组治疗后视网膜敏感度与治疗前无差异(P>0.05),而治疗组治疗2mo时视网膜敏感度(20.11±4.98dB)最高。治疗后两组患者P1、P2值均显著增加,且治疗2mo时治疗组P1变化值显著高于对照组(P<0.05),但两组治疗后P2变化值无差异(P>0.05)。结论:玻璃体腔注射康柏西普治疗可提高DME患者固视稳定性,联合消肿方治疗有助于维持固视稳定性。

AIM:To preliminary evaluate retinal sensitivity and the fixation alterations in patients with diabetic macular edema(DME)under Xiaozhong decoction combined intravitreal conbercept therapy.METHODS:The 40 patients with DME were randomly divided into two groups.Treatment group:20 patients(20 eyes),Xiaozhong decoction combined with conbercept group and treatment group;20 patients(20 eyes),placebo combined with conbercept group in our hospital from January to October in 2017.The two groups were taken oral Chinese medicinals or placebo for 3mo respectively.BCVA(ETDRS visual acuity test)and CRT(OCT)of the two groups were observed,and the retinal sensitivity and fixation stability(P1,P2)were measured by MAIA microperimetry.RESULTS:After 3mo of treatment,BCVA of treatment group and control group increased by 4(-1,11.5)and 0(-4,0.75)letters compared with baseline(P<0.05),and CRT decreased by 123.5±42.61 and 18.1±12.84μm respectively(P<0.05).The retinal sensitivity increased slightly after treatment in the two groups,but there was no significant difference between the two groups and over the course of treatment in control group(P>0.05).The sensitivity of retina in treatment group was the highest(20.11±4.98dB)at 2mo.P1 and P2 in the two groups increased significantly after treatment.The increase of P1 in the treatment group was significantly higher than that in the control group at 2mo(P<0.05).But there was no difference in the increase of P2 between the two groups after treatment(P>0.05).CONCLUSION:Intravitreal conbercept could improve the fixation stability in DME patients,combined with Xiaozhong decoction was conducive to maintain fixation stability.