中药联合康柏西普治疗肝肾不足型渗出型老年性黄斑变性患者的临床疗效观察

Treating the liver and kidney deficiency type of exudative senile macular degeneration with TCM medicine plus conbercept

目的:比较中药、康柏西普以及中西医联合治疗肝肾不足型渗出型老年性黄斑变性(Exudative Senile Macular Degeneration,ESMD)患者的临床疗效,为临床上本病的治疗提供客观依据。方法:回顾法收集90例(90只眼)肝肾不足型ESMD患者,每组30只眼,分为中药组、联合组和西药组各30例。中药组予中药治疗,西药组予康柏西普治疗,联合组在中药治疗的基础上联合康柏西普治疗,疗程均为61天。观察三组治疗前后最佳矫正视力(Best Corrected Visual Acuity,BCVA)、眼底出血、渗出及光学相干断层扫描(Optical Coherence Tomography,OCT)情况,比较总体疗效。结果:完成疗程后,三组BCVA均有提高、中央的黄斑区视网膜厚度(Central Macular Thickness,CMT)下降,差异均有统计学意义(P<0.05);治疗后三组间BCVA及CMT的比较,差异有统计学意义(P<0.05);联合组改善更为明显,三组比较差异均有统计学意义(P<0.05)。结论:联合组的治疗对肝肾不足型ESMD有更大的优势,主要表现在促进眼底出血的吸收、减少渗出的同时改善视功能。

Objective:To compare the clinical efficacy of TCM medicine,conbercept and the integrative medicine on exudative senile macular degeneration with the liver and kidney deficiency type,so as to provide an objective basis for the clinical treatment of the disease.Methods:90 cases(90 eyes)were equally divided into the Chinese materia medica group,the combination group and the Western medicine group,with 30 eyes in each group.The Chinese materia medica group was treated with TCM medicine,the Western medicine group was treated with conbercept,and the combination group was treated with conbercept plus TCM medicine.The course of treatment was 61 days.Results:After treatment,the best corrected vision in the three groups was all increased,the central macular thickness in the three groups was all decreased,and the difference between before and after treatment was statistically significant in each group(P<0.05).There were statistically significant differences between the groups in BCVA and CMT after treatment(P<0.05).The improvement in the combination group was more obvious(P<0.05).Conclusion:The therapy in the combination group shows greater advantages in treating the liver and kidney deficiency type of ESMD,which is mainly manifested in promoting the absorption of fundus hemorrhage,reducing exudation and improving visual function.