银杏叶滴丸联合康柏西普注射液治疗非缺血型BRVO继发ME的临床观察

Clinical observation on ginkgo biloba dripping pills combined with Conbercept in treatment of macular edema due to non-ischemic branch retinal vein occlusion

目的观察银杏叶滴丸联合康柏西普注射液治疗非缺血型视网膜分支静脉阻塞(BRVO)继发黄斑水肿(ME)的临床疗效。方法选取2018年2月-2020年2月河北省衡水市人民医院符合纳入标准的非缺血型BRVO患者80例(80只眼),中医辨证为瘀血阻络证,随机分为对照组和联合组,每组各40例(40只眼)。对照组予康柏西普注射液玻璃体腔注射,根据病情采用“1+按需治疗(PRN)”的治疗方法,联合组在对照组的基础上联合口服银杏叶滴丸。2组均观察6个月。记录2组患者的最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)及注射次数,比较2组的临床总有效率。结果(1)BCVA:与治疗前比较,对照组治疗后1、6个月均有提高,差异均有统计学意义(t_(1个月)=5.933,t_(6个月)=7.641,均P=0.000);联合组治疗后1、6个月均有提高,差异均有统计学意义(t_(1个月)=9.895,t_(6个月)=10.704,均P=0.000)。2组治疗后1、6个月比较,联合组均较对照组提高,差异均有统计学意义(t_(1个月)=2.214,P=0.030;t_(6个月)=3.268,P=0.002)。(2)CMT:与治疗前比较,对照组治疗后1、6个月均降低,差异均有统计学意义(t_(1个月)=16.666,t_(6个月)=16.600,均P=0.000);联合组治疗后1、6个月均降低,差异均有统计学意义(t_(1个月)=13.057,t_(6个月)=13.644,均P=0.000)。2组治疗后1、6个月比较,联合组均较对照组降低,差异均有统计学意义(t_(1个月)=2.732,P=0.008;t_(6个月)=4.827,P=0.000)。(3)注射次数:治疗6个月后,对照组平均注射次数(2.40±1.08)次多于联合组(1.53±0.51)次,差异有统计学意义(t=4.636,P=0.000)。(4)总有效率:对照组总有效率(80.00%)低于联合组(97.50%),差异有统计学意义(c2=6.602,P=0.037)。结论银杏叶滴丸联合康柏西普注射液治疗证候为瘀血阻络的非缺血型BRVO继发ME患者的疗效优于单纯玻璃体腔注射康柏西普注射液,且能减少注射次数。

OBJECTIVE To observe the clinical efficacy of ginkgo biloba dripping pills combined with Conbercept for macular edema(ME)due to non-ischemic branch retinal vein occlusion(BRVO).METHODS A total of 80 patients(80 eyes)with non-ischemic BRVO meeting the inclusion criteria treated in HengShui People’s Hospital of Hebei Province from February 2018 to February 2020,manifesting the syndrome of blood stasis in Traditional Chinese Medicine,were randomly divided into the control group and the combined group with 40 patients(40 eyes)in each group.The control group were treated with intravitreal injection of Conbercept with a regimen of one shot plus additional doses when needed(1+PRN).The combined group were treated with ginkgo biloba dripping pills in addition to treatment of the control group.Both groups were observed for 6 months.The best-corrected visual acuity(BCVA),central macular thickness(CMT)and number of intravitreal injections were recorded.The total clinical effective rate was compared between the two groups.RESULTS(1)BCVA:One month and six months after treatment,scores of the control group improved in contrast to counterparts before intervention,and the difference was statistically significant(t_(1mon)=5.933,t_(6mons)=7.641,all P=0.000).Scores of the combined group improved too,and the difference was statistically significant(t_(1mon)=9.895,t_(6mons)=10.704,all P=0.000).The symptoms of the combined group were better than those of the control group,the difference between the two groups was statistically significant(t_(1mon)=2.214,P=0.030;t_(6mons)=3.268,P=0.002).(2)CMT:One month and six months after treatment,results of the control group improved,and the difference was statistically significant(t_(1mon)=16.666,t_(6mons)=16.600,all P=0.000).The results of the combined group improved,and the difference was statistically significant(t_(1mon)=13.057,t_(6mons)=13.644,all P=0.000).The results of the combined group were better than those of the control group,the difference between the two groups was statistically significant(t_(1mon)=2.732,P=0.008;t_(6mons)=4.827,P=0.000).(3)Shots of injection:The average shots of intravitreal injections was 2.40±1.08 in the control group and 1.53±0.51 in the combined group.The difference between the two groups was statistically significant(t=4.636,P=0.000).(4)The total clinical efficacy:The total effective rate was 80.00%in the control group,97.50%in the combined group.The difference between the two groups was statistically significant(x^(2)=6.602,P=0.037).CONCLUSIONS The clinical efficacy of ginkgo biloba dripping pills combined with Conbercept in treating ME due to non-ischemic BRVO with blood stasis syndrome is better than single Conbercept.Moreover,it reduces the shot of intravitreal injection.