散血明目片治疗视网膜静脉阻塞气滞血瘀证的临床研究

目的观察活血通脉利水散结之散血明目片治疗视网膜静脉阻塞气滞血瘀证的临床疗效,并探讨散血明目片的作用机理。方法选用60例(61只眼)临床上确诊为视网膜静脉阻塞气滞血瘀证患者,按入院先后次序随机分为散血明目片治疗组和血塞通对照组,每组30人。治疗30天为1个疗程,共2个疗程。每2周复诊1次,2个疗程后复查荧光素眼底血管造影和血液流变学指标。分析远视力、眼底表现、视网膜循环时间、荧光素眼底血管造影、血液流变学各项指标及中医证候积分。结果散血明目片治疗组总有效率为80.65%,血塞通对照组总有效率为66.67%;治疗组总显效率为41.94%,对照组为20.00%,差异具有统计学意义(P0.05);在视网膜循环时间、血液流变学指标,促进眼底出血吸收以及中医证候的改善方面,散血明目片治疗组与血塞通对照组差异有统计学意义(P0.05)。结论活血通脉利水明目之散血明目片对视网膜静脉阻塞(尤其是对视网膜分支静脉阻塞)气滞血瘀证有较好治疗作用,其机理可能是:通过扩张血管,改善视网膜微循环,加速眼底出血、渗出的吸收,从而促进视功能的恢复。

Clinical observation on the effect of Sanxue Mingmu Tablet for retinal vein occlusion(RVO)patients with syndrome of qi stagnation and blood stasis

OBJECTIVE To observe the clinical effect of method of activating blood and unblocking the meridians,eliminating dampness and dissipating stagnation of Sanxue Mingmu Tablet for retinal vein occlusion（RVO） patients with syndrome of qi stagnation and blood stasis,and discuss the mechanism of Sanxue Mingmu Tablet.METHODS According to the order,sixty RVO patients were randomly divided into two groups：Sanxue Mingmu Tablet treating group and Xuesaitong Pill control group,each group 30 cases,30 days as a course,2 courses for all patients.Check up was made every 2 weeks and FFA was done after the treatment.The indexes of distant vision,fundus function,retinal circulation time,FFA,hemorheology and the multiple scores of manifestation of TCM were analyzed.RESULTS The total curative rate of the Sanxue Mingmu Tablet was 80.65%,the total curative rate of the Xuesaitong Pill was 66.67%.The difference of the two groups was statistically significant（P0.05）.The vision difference of the treating group and the control group was significant（P0.05）;the difference of FFA was significant（P0.05）;the differences of indexes of hemorheology,accelerating the absorption of stagnant blood of eyeground and effects of the multiple manifestation of TCM were significant statistically（P0.05）.CONCLUSIONS Method of activating blood and unblocking the meridians,eliminating dampness and dissipating stagnation of Sanxue Mingmu Tablet had a better effect for the syndrome of qi stagnation and blood stasis of Retinal Vein Occlusion.To expand the blood vessel,improve the circulation of retina,accelerate the clearing of the stagnant blood and promote the recovering of the function of vision might be the mechanism.