活血利水方联合532激光对糖尿病黄斑水肿视功能与形态学变化的影响

目的观察活血利水方联合532激光对糖尿病黄斑水肿视功能与形态学变化的影响。方法将90例（147眼）糖尿病黄斑水肿患者随机分为中药组30例（47眼）、光凝组30例（48眼）和联合组30例（52眼）,分别采用活血利水方、532激光以及中药联合激光治疗;治疗后及疗程结束后6个月观察各组最佳矫正视力、FFA及OCT变化情况。结果中药组治疗前后视力差异有统计学意义（P〈0.05）,但随访时（疗程结束后6个月）较治疗前无提高（P〉0.05）;光凝组、联合组治疗后和随访时视力较治疗前均有提高（P〈0.05）。中药组治疗后和随访时视网膜厚度较治疗前无明显变化（P〉0.05）,光凝组、联合组治疗后和随访时视网膜厚度较治疗前差异均有统计学意义（P〈0.05）。中药组治疗后和随访时黄斑水肿渗漏有效率分别为40.42%和36.17%,光凝组分别为66.67%和60.41%,联合组分别为88.46%和80.77%。联合组、光凝组与中药组视力、视网膜厚度、黄斑水肿渗漏情况治疗后及随访时比较差异有统计学意义（P〈0.05）,联合组与光凝组治疗后及随访时比较差异有统计学意义（P〈0.05）。结论活血利水方联合532激光治疗糖尿病黄斑水肿疗效好,可明显提高患者的视力,改善视网膜病变和黄斑水肿渗漏。

Effects of "Huoxue Lishui Decoction" and 532-laser irradiation on visual function and morphological changes in treating diabetic macular edema

Objective To observe the effects of ＂Huoxue Lishui Decoction＂ and 532-laser irradiation on visual function and morphologic changes in treating diabetic macular edema.Methods Ninety subjects（147 eyes） were randomly divided into Chinese medicine group（30 cases with 47 eyes）,laser group（30 cases with 48 eyes） and combination group（30 cases with 52 eyes）,and treated respectively with ＂Huoxue Lishui Decoction＂,532-laser irradiation and combined ＂Huoxue Lishui Decoction＂ and 532-laser irradiation.The best corrected visual acuity,FFA and OCT changes were observed after treatment and following 6-month survey.Results The vision was improved in Chinese medicine group after treatment（P0.05）,while improved little in 6-months survey（P0.05）.The vision was improved in laser group and combination group（P0.05）.The retinal thickness in Chinese medicine group was of no significant difference（P0.05）,but of striking differences in laser group and combination group（P0.05）.The total effective rate for macular edema and effusion was 40.42% after 3 months and 36.17% after 6 months in Chinese medicine group;they were 66.67% and 60.41% in laser group,and 88.46% and 80.77% in combination group.There were significant differences in the vision,retinal thickness and macular edema and effusion between combination group,laser group and Chinese medicine group（P0.05）,and between combination group and laser group（P0.05）.Conclusion ＂Huoxue Lishui Decoction＂ and 532-laser irradiation is quite effective to treat diabetic macular edema by improving eyesight,relieving diabetic retinopathy and macular edema and effusion.