加味温胆汤治疗对渗出性老年性黄斑变性视力改善、脉络膜厚度及日常生活能力的影响

Effect of Jiawei Wendan Decoction on Visual Acuity Improvement, Choroidal Thickness and Daily Living Ability in Patients with Exudative Age-related Macular Degeneration

目的:观察加味温胆汤治疗对渗出性老年性黄斑变性(Age-related macular degeneration,AMD)患者的临床疗效,主要指标包括视力改善、黄斑中心凹下脉络膜厚度及日常生活能力等方面。方法:将渗出性AMD患者66例(66眼)分为加味温胆汤组34眼和对照组32眼。对照组:给予基本药物治疗(维生素E片、甲钴胺胶囊等)。加味温胆汤组:在对照组基础上,加服加味温胆汤1个月。分别于治疗前、治疗1个月、3个月后对所有患者最佳矫正视力、脉络膜厚度及眼底荧光血管造影(FFA)血管渗漏情况进行临床检测和疗效评价。结果:两组患者在治疗前后1个月内,最佳矫正视力、脉络膜厚度等方面比较差异无统计学意义(P>0.05);治疗3个月后,加味温胆汤组最佳矫正视力改善情况优于对照组(P<0.05),且黄斑中心凹下脉络膜厚度小于对照组(P<0.05)。而两组患者在血管渗漏情况差异方面均无统计学意义(P>0.05)。结论:加味温胆汤治疗渗出性AMD安全、有效,可以减轻黄斑水肿、提高视力及减少黄斑中心凹下脉络膜厚度,一定程度抑制新生血管形成,但不能明显降低渗出性AMD患者新生血管渗漏发生率。

Objective:To observe the clinical effect of modified Wendan Decoction in patients with exudative age-related macular degeneration(AMD).Methods:Sixty-six patients(66 eyes)of exudative AMD were involved in this study,detached into two groups.Thirty-four eyes were in the modified Wendan Decoction group and 32 eyes were in the control group.The control group was given basic medicine treatment(i.e.vitamin E tablets,mecobalamin capsules,etc.).The modified Wendan Decoction group was treated with basic medicine andadditional traditional Chinese medicine decoction(the modified Wendan Decoction)for 1 month.The best corrected visual acuity and choroidal thickness were detected before and after the treatment.The leakage of FFA was detected as well as a kind of indicator.Results:There was no significant difference on the best corrected visual acuity and choroidal thicknessbetween two groups before and after the treatment within 1 month(P>0.05).The best corrected visual acuity in the modified Wendan Decoction group was better than that of the control group(P<0.05),with less choroidal thickness than the control group as well(P<0.05)3 months after the treatment.There was no significant difference of vascular leakage between the two groups 1 month and 3 months after the treatment(P>0.05).Conclusion:Modified Wendan Decoction is effective and safe to treat the exudative AMD.It can relieves macular edema,improve visual acuity and reduce the choroidal thickness,suppress neovascularization to a certain extent but the leakage of neovascularization cannot be reduced.However,the incidence of neovascular leakage in patients with exudative AMD cannot be significantly reduced.