化裁四物五子汤治疗年龄相关性黄斑变性疗效及对中医证候积分、视力、眼底情况的影响

Efficacy of Using Modified Siwu Wuzi Decoction in the Treatment of Age⁃related Macular Degeneration and Its In⁃fluence on Traditional Chinese Medicine Syndromes Scores,Visual Activity and Fundus Status

目的:探究化裁四物五子汤治疗年龄相关性黄斑变性(ARMD)疗效及对中医证候积分、视力、眼底情况的影响。方法:将2019.01-2020.01期间于我院就诊的82例ARMD患者采用随机分为对照组41例41眼和观察组41例41眼,对照组选择雷珠单抗常规治疗,观察组在对照组基础上口服化裁四物五子汤,比较治疗3个月后两组中医证候疗效差异,比较治疗前及治疗3个月后两组中医症状积分、视力情况[最佳矫正视力(BCVA)]、眼底情况[黄斑中央区平均视网膜厚度(CMT)、平均病灶区视网膜厚度(CLT)、平均病灶隆起最高点视网膜厚度(HLT)]、眼动脉血流动力学[收缩期最大血流速度峰值(PSV)、舒张期血流速度(EDV)]、生活质量[低视力者生活质量量表(CLVQOL)评分]变化。结果:治疗3个月后,观察组总有效率显著高于对照组(P<0.05);两组中医症状积分及BCVA、CMT、CLT、HLT水平均较治疗前显著降低,且观察组明显低于同一时间对照组(P<0.05);两组眼动脉PSV、EDV水平及CLVQOL各项评分均较治疗前显著升高,且观察组显著高于对照组(P<0.05)。结论:化裁四物五子汤治疗ARMD疗效显著,可有效缓解患者各项症状,并改善其视力、眼底情况、眼部血流动力学及生活质量,临床应用价值较高。

Objective:To explore the efficacy of using Modified Siwu Wuzi Decoction in the treatment of agerelated macular degeneration(ARMD)and its influence on TCM syndromes scores,visual activity and fundus status.Methods:A total of 82 patients with ARMD who were treated in our hospital from January 2019 to January 2020 were randomly divided into a controlled group(41 cases,41 eyes)and an observation group(41 cases,41 eyes).The controlled group was given Ranibizumab conventional treatment,and the observation group was given oral Modified Siwu Wuzi Decoction on the basis of the controlled group.The efficacy of TCM syndromes was compared between the two groups after 3 months of treatment,and the scores of TCM symptoms,visual acuity[best corrected visual acuity(BCVA)],fundus status[central macular average retinal thickness(CMT),average focal retinal thickness(CLT),average retinal thickness at the highest point of lesions bulge(HLT)],ocular artery hemodynamics[peak systolicvelocity(PSV),end diastolic velocity(EDV)]and quality of life[Chineseversion of Low Vision Quality of Life Questionnaire(CLVQOL)score]were compared between the two groups before treatment and after 3 months of treatment.Results:After 3 months of treatment,the total effective rate of the observation group was significantly higher than that of the controlled group(P<0.05).The TCM symptoms scores and levels of BCVA,CMT,CLT and HLT in the two groups were significantly lower than those before treatment,and the scores and levels in the observation group were significantly lower than those in the controlled group at the same time point(P<0.05).The levels of ophthalmic artery PSV and EDV and scores of items of CLVQOL in the two groups were significantly higher than those before treatment,and the levels and scores in the observation group were significantly higher than those in the controlled group(P<0.05).Conclusion:Modified Siwu Wuzi Decoction has a significant efficacy in the treatment of ARMD,and it can effectively alleviate the symptoms,and improve the visual activity,fundus status,ocular hemodynamics and quality of life,with high clinical application value.