目的：分析湿性年龄相关性黄斑变性(wARMD)在雷珠单抗(IVR)注射基础上联合驻景方加减治疗的疗效。

方法：前瞻性研究。选取榆林市中医医院眼科2022年9月至2024年10月wARMD患者，将研究对象根据随机数字表法分为试验组、对照组，对照组应用IVR治疗，试验组在IVR注射的基础上应用驻景方加减治疗。对比两组临床疗效、中医症状评分、视网膜中央厚度(CRT)、最佳矫正视力(BCVA)、黄斑区出血面积、脉络膜新生血管面积(CNV)、眼血流动力学参数\〖阻力指数(RI)、舒张期血液最大流速(EDV)、收缩期血液最大流速(PSV)\〗、1 a复发率。

结果：本研究纳入wARMD患者60例60眼，其中对照组30例30眼，试验组30例30眼。对照组年龄67.52±3.12岁，男17例，女13例。试验组年龄67.62±3.04岁，男18例，女12例。试验组总有效率(97%)高于对照组(73%)(P<0.05)。试验组治疗1 mo后视物模糊、腰膝酸软、虚烦不寐、头晕耳鸣评分均比对照组低(均P<0.01)。试验组治疗后EDV、PSV均比对照组高(均P<0.05)。试验组治疗后不同时间BCVA、CRT、黄斑区出血面积、CNV、RI均比对照组低(均P<0.05)。试验组1 a复发率(3%)比对照组(27%)低(P<0.05)。

结论：驻景方加减联合IVR可有效缓解wARMD患者视物模糊、眼底出血等症状，改善视力与眼部血流动力学，降低复发率，提示可能具有协同增效作用。

METHODS: A prospective study was conducted on wARMD patients at the Ophthalmology Department of Yulin Hospital of Traditional Chinese Medicine from September 2022 to October 2024. The study subjects were divided into the experimental group and the control group according to the random number table method. The control group received IVR treatment, while the experimental group was treated with modified Zhujing formula in addition to IVR injection. The clinical efficacy, TCM symptom scores, central retinal thickness(CRT), best corrected visual acuity(BCVA), macular hemorrhage area, choroidal neovascularization area(CNV), ocular hemodynamic parameters \〖resistance index(RI), maximum diastolic blood flow(EDV), maximum systolic blood flow(PSV)\〗, and 1-year recurrence rate were compared between the two groups.

RESULTS: This study included 60 eyes from 60 wARMD patients. Among them, the control group consisted of 30 patients and 30 eyes, while the experimental group consisted of 30 patients and 30 eyes. The age of the control group was 67.52±3.12 y, with 17 males and 13 females. The age of the experimental group was 67.62±3.04 y, with 18 males and 12 females.The clinical efficacy of the experimental group(97%)was higher than that of the control group(73%)(P<0.05). After treatment, the scores of blurred vision, soreness and weakness of the waist and knees, restlessness and insomnia, dizziness and tinnitus in the experimental group were all lower than those in the control group(all P<0.05); the EDV and PSV in the experimental group were both higher than those in the control group(both P<0.05); the BCVA, CRT, macular hemorrhage area, CNV and RI of the experimental group were all lower than those of the control group(all P<0.05), and the 1-year recurrence rate in the experimental group(3%)was lower than that in the control group(27%)(P<0.05).

CONCLUSION:The combined use of modified Zhujing formula and IVR can effectively alleviate symptoms such as blurred vision and retinal hemorrhage in wARMD patients, improve vision and ocular hemodynamic conditions, and reduce the recurrence rate. This suggests that there may be a synergistic enhancing effect.