加味五苓散治疗白内障超声乳化术后黄斑水肿的疗效观察

Efficacy of Jiawei Wuling Powder in the Treatment of Macular Edema After Phacoemulsification for Cataract

目的:探讨加味五苓散治疗白内障超声乳化术后黄斑水肿的临床疗效。方法:选取2018年1月至2019年7月湖南中医药高等专科学校附属第一医院收治的白内障行超声乳化吸除术后并发黄斑水肿的患者93例,按随机数字表法分为研究组47例(47只眼)和对照组46例(46只眼)。对照组患者给予普拉洛芬滴眼液和妥布霉素地塞米松滴眼液点眼治疗,研究组患者在对照组的基础上给予加味五苓散口服治疗。观察两组患者治疗前后的最佳矫正视力(BCVA)、视网膜中央厚度(CRT)和中医证候积分,临床疗效和黄斑水肿消退时间等指标。结果:(1)研究组患者的总有效率为93.62%(44/47),明显高于对照组的78.26%(36/46),差异有统计学意义(χ^(2)=4.559,P=0.033)。(2)治疗后30 d,研究组患者主要中医证候积分总分明显低于本组治疗前及对照组,差异均有统计学意义(组内比较:t=57.569,P=0.000;组间比较:t=-29.747,P=0.000)。(3)两组患者治疗后15、30d的CRT明显降低,BCVA明显改善;研究组患者的CRT明显低于对照组同期(15 d:t=-3.287,P=0.001;30 d:t=-4.650,P=0.000),BCVA改善情况明显优于对照组同期(15 d:t=-2.209,P=0.030;30 d:t=-3.505,P=0.001),上述差异均有统计学意义。(4)研究组患者黄斑水肿消退时间明显短于对照组,差异有统计学意义(t=-4.343,P=0.000)。结论:加味五苓散治疗白内障超声乳化术后黄斑水肿的疗效肯定,能有效减少患者的CRT,缩短黄斑水肿消退时间,提高BCVA。

OBJECTIVE: To probe into the clinical efficacy of Jiawei Wuling powder in the treatment of macular edema after phacoemulsification for cataract. METHODS: Totally 93 patients with cataract complicated with macular edema after phacoemulsification admitted into the First Affiliated Hospital of Hunan College of Traditional Chinese Medicine from Jan. 2018 to Jul. 2019 were extracted to be divided into 47 cases in the study group( 47 eyes) and46 cases in the control group( 46 eyes) via the random number table method. The control group was given pranoprofen eye drops and tobramycin dexamethasone eye drops,while the study group received oral treatment with Jiawei Wuling powder on the basis of the control group. The best corrected visual acuity( BCVA),the central retinal thickness( CRT) and traditional Chinese medicine( TCM) syndrome scores before and after treatment,clinical efficacy and disappearance time of macular edema in two groups were observed. RESULTS:( 1) The total effective rate in the study group was 93. 62%( 44/47),higher than 78. 26%( 36/46) in the control group,the difference was statistically significant( χ^(2)= 4. 559,P = 0. 033).( 2) After treatment of 30 d,the total traditional Chinese medicine syndrome scores of the study group were significantly lower than those before treatment and the control group,the differences were statistically significant( intra group comparison: t = 57. 569,P = 0. 000;comparison between groups: t =-29. 747,P = 0. 000).( 3) The CRT of two groups decreased significantly reduced after treatment of 15 d and 30 d,and the BCVA was significantly improved. CRT in the study group was significantly lower than that in the control group( 15 d:t =-3. 287,P = 0. 001;30 d: t =-4. 650,P = 0. 000),the improvement of BCVA was significantly better than that of the control group( 15 d: t =-2. 209,P = 0. 030;30 d: t =-3. 505,P = 0. 001),the differences were statistically significant.( 4) The disappearance time of macular edema in the study group was significantly shorter than that in the control group,with statistically significant differences( t =-4. 343,P = 0. 000). CONCLUSIONS: The efficacy of Jiawei Wuling powder in the treatment of macular edema after phacoemulsification for cataract is significant,which can effectively reduce CRT,shorten the disappearance time of macular edema and improve BCVA.