目的：探讨四物五子汤联合玻璃体腔注射康柏西普治疗湿性年龄相关性黄斑变性(ARMD)的效果及对血清血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)和炎症因子的影响。

方法：选取2019-05/2020-11我院眼科收治的湿性ARMD患者60例60眼进行回顾性研究，对照组30例30眼给予玻璃体腔注射康柏西普治疗，观察组30例30眼在对照组基础上加用四物五子汤治疗。比较两组患者治疗3mo后最佳矫正视力(BCVA)、眼底情况、黄斑部视网膜脉络膜血管复合体(CBRC)及视网膜神经上皮层(RNL)厚度、未消退新生血管数目、血清VEGF、TGF-β1、白介素-6(IL-6)和白介素-13(IL-13)水平及总体疗效。

结果：治疗3mo后，两组患者BCVA、眼底出血、渗出情况、CBRC及RNL厚度较治疗前均得到改善(P<0.05)，且观察组优于对照组(P<0.05)。与治疗前相比，两组患者治疗3mo后血清VEGF、TGF-β1、IL-6、IL-13均降低(P<0.001)，且观察组患者血清VEGF、TGF-β1、IL-6和IL-13水平显著低于对照组(P<0.05)。观察组总有效率明显优于对照组(P=0.037)。

结论：四物五子汤联合玻璃体腔注射康柏西普治疗能消退湿性ARMD患者眼底新生血管，降低血清VEGF、TGF-β1和炎症因子水平，改善眼部微循环，促进湿性ARMD患者视力恢复。

AIM: To explore the effect of SiWuWuZi decoction combined with intravitreal injection of conbercept on patients with wet age-related macular degeneration(ARMD)and its effects on serum vascular endothelial growth factors(VEGF), transforming growth factor-β1(TGF-β1)and inflammatory factors.

METHODS: A retrospective study. A total of 60 cases(60 eyes)wet ARMD patients admitted to the ophthalmology department of our hospital from May 2019 to November 2020 were divided into 30 cases(30 eyes)of the control group were treated with intravitreal injection of conbercept, while observation group 30 cases(30 eyes)was added with SiWuWuZi decoction on the basis of treatment for control group. The best corrected visual acuity(BCVA), the neovascular area were not be vanished fundus hemorrhage, exudation, choriocapillario-Bruch's membrane-retinal pigment epithelium complex(CBRC), and retinal neuroepithelial layer(RNL), serum VEGF, TGF-β1, interleukin-6(IL-6)and interleukin-13(IL-13)levels and overall efficacy after 3mo were compared.

RESULTS: After 3mo treatment, BCVA, fundus hemorrhage, exudation, CBRC and RNL thickness in 2 groups were improved compared with before treatment(P<0.05), and the observation group was better than the control group(P<0.05). Compared with before treatment, serum VEGF, TGF-β1, IL-6 and IL-13 in 2 groups after 3mo treatment were decreased(P<0.001), and serum VEGF, TGF-β1, IL-6 and IL-13 levels in observation group were significantly lower than those in control group(P<0.05). The overall effect of observation group was significantly better than control group(P=0.037).

CONCLUSION: SiWuWuZi decoction combined with intravitreal injection of conbercept can gradually vanish fundus neovascularization in patients with wet ARMD, serum levels of VEGF, TGF-β1 and inflammatory factors, improve ocular microcirculation and promote vision recovery in patients with wet ARMD.

2020年度山东省医药卫生科技发展计划项目(No.202007020149); 青岛市2019年度医药科研指导计划(No.2019-WJZD058)