健脾活血方联合康柏西普治疗糖尿病白内障超声乳化术后黄斑水肿的疗效观察

Clinical Observation of Jianpi Huoxue Decoction Combined with Conbercept in the Treatment of Diabetic Macular Edema after Phacoemulsification

目的观察健脾活血方联合康柏西普治疗糖尿病白内障超声乳化术后黄斑水肿的临床疗效。方法将2016年9月—2019年2月收治的糖尿病白内障超声乳化术后黄斑水肿患者90例随机分为两组。对照组45例在控制血糖等常规治疗的基础上,给予康柏西普眼部注射,观察组45例则在常规治疗及康柏西普眼部注射的同时加用健脾活血方治疗。比较两组患者治疗前后眼压、最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)、中医证候积分以及白细胞介素-6(IL-6)和血管内皮生长因子(VEGF)水平,同时记录术后并发症发生情况。结果两组患者治疗后眼压、CMT、中医证候积分、IL-6及VEGF水平与本组治疗前比较均显著降低,BCVA水平提高(P <0.05),且观察组优于对照组(P <0.05);两组患者术后并发症发生率比较差异无统计学意义(P> 0.05)。结论健脾活血方联合康柏西普治疗糖尿病白内障超声乳化术后黄斑水肿可有效降低眼压水平,改善最佳矫正视力,缓解黄斑水肿,且安全性良好;而该方案疗效优势可能与其对IL-6、VEGF水平调节作用密切相关。

Objective To observe the clinical effect of Jianpi Huoxue Decoction Combined with conbercept on macular edema after phacoemulsification for diabetic cataract. Methods 90 cases of diabetic cataract patients with macular edema after phacoemulsification admitted from September 2016 to February 2019 were randomly divided into two groups. The 45 cases in the control group were given eye injections of Conbercept on the basis of conventional treatments such as blood sugar control,while the 45 cases in the observation group were treated with Jianpi Huoxue Decoction in addition to the conventional treatment and the eye injection of Conbercept. Comparison of intraocular pressure,best corrected visual acuity( BCVA),foveal retinal thickness( CMT),TCM syndrome scores,and levels of interleukin-6( IL-6) and vascular endothelial growth factor( VEGF) before and after treatment between the two groups of patients. Results After treatment,the levels of intraocular pressure,CMT,TCM syndrome score,IL-6 and VEGF levels of the two groups of patients were significantly reduced compared with those of this group before treatment,and the BCVA level increased( P <0. 05),and the observation group was better than the control group( P < 0. 05);There was no significant difference in the incidence of postoperative complications between the two groups( P > 0. 05). Conclusion Jianpi Huoxue Decoction Combined with conbercept in the treatment of diabetic cataract with macular edema after phacoemulsification can effectively reduce the level of intraocular pressure,improve the best corrected visual acuity,relieve macular edema,relieve symptoms and signs,and the safety is good. And the curative effect advantage of the scheme may be closely related to the better regulation of IL-6 and VEGF levels.