中西药结合治疗中心性渗出性脉络膜视网膜炎25例

Combined Western and traditional Chinese compounds for 25 cases of central exudative chorioretinopathy

目的探讨中西医结合药物治疗中心性渗出性脉络膜视网膜炎(CEC)的方法及疗效。方法依据病史、年龄、症状、眼底表现及眼底血管荧光造影(FFA)检查确诊为CEC的患者25例(26眼),采用中医辨证与辨病相结合及西医常规药物治疗,参照《临床疾病诊断依据、治愈好转标准》进行疗效判定。结果25例患者26眼中,治愈8眼(31％),好转14眼(54％),无效4眼(15％),总有效率85％。治疗后3月内18眼行FFA复查,8眼荧光素渗漏消失,6眼仍有渗漏,无效的4眼,2眼有瘢痕形成。结论中西医结合药物治疗该病临床效果确定,中药能很好的促进眼底出血、渗出及视网膜水肿的消退,提高视力,但对于治疗后仍有荧光素渗漏的患者如果能行经瞳孔温热疗法(TTT)及光动力疗法(PDT)治疗,使新生血管萎缩、闭合、则治疗效果会更好。

Aim To investigate the method of and effect of combined Western and traditional Chinese treatment for central exudative chorioretinopathy (CEC). Methods Twenty five cases (26 eyes) diagnosed of CEC according to disease history, age, symptoms, fundal condition and fundal fluorescence angjography (FFA) findings were given combined Western and traditional Chinese treatment. The effectiveness was determined by 'The standard of diagnosis, recovery and improvement of clinical diseases (1998)'. Results Eight eyes (31%) was cured, 14 (54%) turned better and 4 (15%) failed to respond. Thus, the total effective rate was 85%. Within 3 months after treatment, FFA recheck indicated that fluorescence exudatives completely disappeared in 8 eyes and remained in 6 eyes while 2 of the 4 eyes for which the treatment was ineffective had scarred. Conclusion Combined Western and traditional Chinese treatment has reliable effect. Chinese drugs can promote the absorption of fundal bleeding, fundal exudation and retinal edema, and improve vision. As for patients in which the fluorescence exudative persists after the combined treatment, TTT and PDT can help in that they produce atrophy and closure of the new vessels.