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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
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摘要 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.
作者 张军涛 陆勤康 赖晓明 王惠云 李竞 董飞 ZHANG Juntao;LU Qinkang;LAI Xiaoming;WANG Huiyun;LI Jing;DONG Fei(Department of Ophthalmology,Yinzhou Hospital Affiliated to Ningbo University,Ningbo 315040,Zhejiang,China;Department of Traditional Chinese Medicine,Yinzhou Hospital Affiliated to Ningbo University,Ningbo 315040,Zhejiang,China)
出处 《中华中医药学刊》 CAS 北大核心 2019年第4期978-980,1045共4页 Chinese Archives of Traditional Chinese Medicine
基金 浙江省中医药科技计划项目(2017ZB083,2018ZA114) 宁波市自然科学基金项目(2016A610024).
关键词 加味温胆汤 老年性黄斑变性 黄斑水肿 Modified Wendan Decoction Age-related macular degeneration macular edema
作者简介 张军涛(1983-),男,浙江宁波人,主治医师,硕士,研究方向:中西医结合眼科。
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