活血通脉利水明目法治疗非缺血型视网膜静脉阻塞的随机对照试验：对眼底荧光血管造影结果的影响

背景：活血通脉利水明目法能明显改善实验性视网膜静脉阻塞后眼底出血情况，作为一种中医治疗非缺血型视网膜静脉阻塞的治疗方法，显效率高，可有效改善中医症状，其作用机制可能与降低血浆黏度，减少无灌注区，建立有效侧枝循环有关。 目的：观察活血通脉利水明目法（散血明目片）对非缺血型视网膜静脉阻塞患者眼底荧光血管造影结果的影响。 设计、场所、对象和干预措施：纳入2005年4月至2007年4月在湖南中医药大学第一附属医院眼科门诊及病房就诊的34例非缺血型视网膜静脉阻塞患者。所有患者分为气滞血瘀和肝阳上亢两种证型。将该34例患者随机分为治疗组与对照组，治疗组给予散血明目片联合中西医常规治疗方法，对照组给予血栓通片联合中西医常规治疗方法。2个月为1个疗程。 主要结局指标：治疗1个疗程后，行眼底照相与眼底荧光血管造影，并进行评价。 结果：治疗组总有效率较对照组高，但差异无统计学意义，而治疗组总显效率与治疗组比较，差异有统计学意义（P〈0.01）；治疗组视网膜循环时间优于对照组，另外治疗组无灌注区、眼底新生血管和侧枝循环建立的改善程度均优于对照组。 结论：活血通脉利水明目法（散血明目片）是治疗非缺血型视网膜静脉阻塞的有效方法，能改善患者视功能，可反映在眼底荧光血管造影的多项指标上。

Effects of Huoxue Tongmai Lishui method on fundus fluorescein angiography of non-ischemic retinal vein occlusion: a randomized controlled trial

Background： Huoxue Tongmai Lishui method, a traditional Chinese medicine treatment for eliminating water, activating and promoting blood circulation, could inhibit fundus hemorrhage on experimental retinal vein occlusion （RVO） with high obvious effective rate, and improve symptoms in traditional Chinese medicine. The action mechanism may be related to reducing plasma viscosity and non-perfusion area, and the formation of collateral circulation.
Objective： To explore the therapeutic effects of Huoxue Tongmai Lishui method （Sanxue Mingmu Tablet） on fundus fluorescent angiograph of non-ischemic retinal vein occlusion （RVO）.
Design, setting, participants and interventions： Thirty-four patients with non-ischemic RVO in Department of Ophthalmology, the First Affiliated Hospital, Hunan University of Traditional Chinese Medicine from April 2005 to April 2009 were included. All the patients were diagnosed as qi stagnation and blood stasis syndrome or hyperactivity of liver yang syndrome, and they were randomly divided into two groups, with 17 eyes of 17 patients in treatment group treated by Sanxue Mingmu Tablet combined with conventional treatment, and 18 eyes of 17 patients in control group treated by Xueshuantong Tablet combined with conventional treatment. The patients were treated for two months.
Main outcome measures： Fundus colour photography, and fundus fluorescent angiograph were detected in two groups before and after the treatment.
Results： The curative effect of Sanxue Mingmu Tablet was better than that of Xueshuantong Tablet. Huoxue Tongmai Lishui method could significantly shorten the retinal circulation time, reduce the non-perfusion area, decrease the formation of angiogenesis and promote the formation of collateral circulation.
Conclusion： Huoxue Tongmai Lishui method is an effective traditional Chinese medicine treatment with high obvious effective rate in reducing non-perfusion area and avoiding venous occlusion and formation of collateral circulation.