益气活血化瘀汤联合曲安奈德及532nm氩激光治疗BRVO继发黄斑水肿

Treatment of macular edema secondary to branch retinal vein occlusion with Yiqihuoxuehuayu decoction combined with triamcinolone acetonide and 532nm argon laser

摘要:

目的：观察益气活血化瘀汤联合曲安奈德及532nm氩激光治疗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2014-01/2016-08我院收治的BRVO继发ME患者80例80眼，根据治疗方式不同分为对照组与观察组每组40例40眼，对照组采用玻璃体腔注射曲安奈德联合532nm氩激光光凝治疗，观察组在对照组基础上加用益气活血化瘀汤治疗，均测定治疗前，治疗1wk，1、3mo患者最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)、眼压，比较两组患者视力、ME及症状(视物变形、出血、渗出等)改善情况，并发症发生率及治疗3mo后复发率。

结果：观察组治疗后不同时间BCVA优于对照组，CMT低于对照组(P<0.05)； 两组治疗不同时间眼压比较无差异(P>0.05)； 观察组ME改善效果优于对照组，视物变形、出血渗出吸收情况均优于对照组(P<0.05)，两组并发症发生情况比较无差异(P>0.05)，治疗后3mo观察组无复发，对照组复发3眼，复发病例均予激光光凝治疗后改善。

结论：益气活血化瘀汤联合曲安奈德及532nm氩激光治疗BRVO继发ME疗效肯定，可改善视力，减轻黄斑水肿，促进眼底出血渗出吸收，且安全性高。

Abstract:

AIM: To observe the clinical value of Yiqihuoxuehuayu decoction combined with triamcinolone acetonide and 532nm argon laser in the treatment of macular edema(ME)secondary to branch retinal vein occlusion(BRVO).

METHODS: Totally 80 patients(80 eyes)with ME secondary to BRVO admitted to the hospital from January 2014 to August 2016 were randomly divided into control group and observation group, with 40 cases(40 eyes)in each group. Control group was given intravitreal injection of triamcinolone acetonide combined with 532nm argon laser photocoagulation, and observation group was additionally given Yiqihuoxuehuayu decoction. The best corrected visual acuity(BCVA), central foveal thickness(CMT)and intraocular pressure were measured before treatment and at 1wk, 1mo and 3mo of treatment. The visual acuity, improvement effects of ME and improvements of symptoms(metamorphopsia, hemorrhage, exudation, etc.)were compared between the two groups, and the incidence rate of complications and the recurrence rate at 3mo after treatment were statistically analyzed.

RESULTS: There were significant differences in the BCVA and CMT between the two groups at different time points of treatment(P<0.05), and the BCVA in observation group at different time points after treatment was higher than that in control group while the CMT was lower than that in control group(P<0.05). There was no significant difference in intraocular pressure between the two groups at different time points of treatment(P>0.05). The visual acuity and ME improvement effects in observation group were better than those in control group, and the metamorphopsia and hemorrhage exudation absorption were better than those in control group(P<0.05). There were no significant difference in the incidence rate of complications and the recurrence rate at 3mo after treatment between the two groups(P>0.05).

CONCLUSION: Yiqihuoxuehuayu decoction combined with triamcinolone acetonide and 532nm argon laser has definite efficacy in the treatment of ME secondary to BRVO, and it can improve visual acuity, reduce macular edema and promote fundus hemorrhage exudation absorption, and it has high safety.