摘要
目的观察中医药联合经瞳孔温热疗法(transpupillary thermotherapy,TTT)治疗渗出期老年性黄斑变性(exudative senile macular degeneration,ESMD)的疗效。方法对观察组患者35例(39只眼)辨证用归芍地黄汤或六君子汤加减,配合静脉滴注血塞通或复方丹参注射液,当出血和渗出减轻时予以TTT治疗。对对照组患者32例(35只眼)经辨证仅用上述中医药治疗。所有患者治疗前均通过荧光素眼底血管造影(FFA)检查确诊及明确黄斑部脉络膜新生血管膜(choroidal neovascularization,CNV)部位。治疗1月后复查FFA判断新生血管消退情况,随访时间半年。结果统计学显示观察组疗效较对照组好。疗效与病程的关系比较,两组均显示病程小于3个月的患者疗效好于病程大于3个月者。两组患者治疗2月时视力改善情况接近,差异无显著性。半年内复发率对照组明显高于观察组,差异有显著性。结论中医药对ESMD出血、水肿和渗出的吸收有促进作用,TTT对CNV消退有效,这是减少ESMD复发的治疗关键。
OBJECTIVE To evaluate the curative effect of transpupillary thennotherapy（TIT）combined with traditional Chinese herbal medicine on the treatment of exudative senile macular degeneration（ ESMD）. METHODS Thirty -five cases containing 39 diseased eyes of the observational group were treated first with decoction of Gui Shao Di - huang（归芍地黄）or modified decoction of Lujunzi（六君子）, combined with venous infusion of Xuesaitong（血塞通, to clear blood stasis or obstruction）or composite Danshen（丹参）infusion fluid, based on an overall analysis and differentiation of signs and symptoms by traditional Chinese medicinal doctors. And TIT was then given when alleviation of hemorrhage and exudation had taken place. Thirty- two cases containing 35 diseased eyes of the control group were treated only with the above mentioned traditional Chinese medicine, based on overall analysis of patient＇s clinical condition. All the patients had fluorescence fundus angiography（FFA）before treatment started, to make clear the diagnosis and the site of choroidal neovascularization（CNV） ; and FFA re - check one month after treatment to evaluate alleviation of neovascularization. Time of follow-up of the patients was half a year. RESULTS The observational group showed better curative effect than the control group. In both groups, and those with duration of the disease less than 3 month usually had better outcome than those with longer duration. Two months after treatment, percentage of improvement of visual acuity was almost the same in both groups, with no significant difference. The control group had higher rate of recurrence of the disease within the follow -up time, and the difference is significant. CONCLUSIONS It seems traditional Chinese medicine could accelerate the resolution of hemorrhage, exudation and edema of ESMD, and TIT is effective in CNV extinction, the latter is the key of less recurrence of the disease after treatment.
出处
《中国中医眼科杂志》
2007年第3期135-138,共4页
China Journal of Chinese Ophthalmology
基金
国家中医药管理局资助课题(02-03LP30)
关键词
老年性黄斑变性
中医药
经瞳孔温热疗法
senile maeular degeneration, SMD
Chinese traditional medicine
transpupillary thermotherapy, TTT
