血府逐瘀汤合四苓散加减治疗视网膜静脉阻塞伴黄斑水肿的临床研究

Clinical Study on Retinal Vein Occlusion Complicated with Macular Edema Treated by Xuefu Zhuyu Decoction Plus Siling Powder

【目的】探讨血府逐瘀汤合四苓散加减治疗视网膜静脉阻塞伴黄斑水肿的临床疗效。【方法】将60例(60眼)气滞血瘀型视网膜静脉阻塞伴黄斑水肿患者随机分为治疗组和对照组,每组各30例(30眼)。对照组给予视网膜激光光凝术治疗,治疗组给予血府逐瘀汤合四苓散加减治疗,15 d为1个疗程,共观察6个疗程。观察2组患者治疗前后平均视力水平及视力分布的变化情况,评价2组患者的总体疗效、中医证候疗效、荧光素血管造影(FFA)疗效和光学相干层析成像(OCT)疗效。【结果】(1)治疗后,2组患者的视力分布情况及平均视力水平均较治疗前明显改善(P<0.05),且治疗组的改善作用均明显优于对照组,差异均有统计学意义(P<0.05)。(2)治疗3个月后,治疗组在总体疗效、中医证候疗效、FFA疗效和OCT疗效方面的总有效率分别为83.3%(25/30)、90.0%(27/30)、83.3%(25/30)和83.3%(25/30),对照组分别为50.0%(15/30)、60.0%(18/30)、53.3%(16/30)和50.0%(15/30),组间比较,治疗组的总体疗效、中医证候疗效、FFA疗效和OCT疗效均明显优于对照组,差异均有统计学意义(P<0.05)。【结论】血府逐瘀汤合四苓散加减治疗气滞血瘀型视网膜静脉阻塞伴黄斑水肿疗效显著,可有效改善患者视力和促进黄斑水肿、视网膜出血的吸收。

Objective To investigate the clinical effect of Xuefu Zhuyu Decoction plus Siling Powder for the treatment of retinal vein occlusion complicated with macular edema.Methods Sixty patients(involving 60 eyes)suffering from retinal vein occlusion complicated with macular edema and differentiated as the syndrome of qi stagnation and blood stasis were randomly divided into treatment group and control group,30 cases(involving 30 eyes)in each group.The control group was treated with retinal laser photocoagulation,while the treatment group was treated with Xuefu Zhuyu Decoction plus Siling Powder.Fifteen days constituted one course of treatment,and the treatment lasted for 6 courses.Before and after treatment,the changes in mean vision and eyesight distribution in the two groups were observed.After treatment,the overall efficacy,efficacy for traditional Chinese medicine(TCM)syndrome,efficacy for fundus fluorescein angiography(FFA)and efficacy for optical coherence tomography(OCT)in the two groups were compared.Results(1)After treatment,obvious improvement has been achieved in the eyesight distribution and mean vision level of the two groups(P<0.05 compared with that before treatment),and the improvement in the treatment group was superior to that in the control group,the difference being statistically significant(P<0.05).(2)After treatment for 3 months,the overall efficacy,efficacy for TCM syndrome,efficacy for FFA and efficacy for OCT in the treatment group were 83.3%(25/30),90.0%(27/30),83.3%(25/30)and 83.3%(25/30)respectively,and those in the control group were 50.0%(15/30),60.0%(18/30),53.3%(16/30)and 50.0%(15/30)respectively.The intergroup comparison showed that the overall efficacy,efficacy for TCM syndrome,efficacy for FFA and efficacy for OCT in the treatment group were superior to those in the control group,and the differences were statistically significant(P<0.05).Conclusion Xuefu Zhuyu Decoction plus Siling Powder exerts certain effect in treating retinal vein occlusion complicated with macular edema and differentiated as the syndrome of qi stagnation and blood stasis.The combined therapy is effective on improving the vision of the patients and promoting the relief of macular edema and retinal hemorrhage.