曲安奈德联合中药治疗黄斑水肿的效果及安全性评价

目的优化黄斑水肿（ME）干预治疗方案。方法将146例（160眼）ME患者随机分为曲安奈德组73例（79眼）和曲安奈德联合中药组（联合组）73例（81眼）。曲安奈德组玻璃体腔注射曲安奈德（IVTA），联合组同时加服中药汤剂，两组疗程均为2个月。结果①12周时联合组视力提高率、稳定率和降低率分别为58．03％、38．27％和3．70％，曲安奈德组分别为43．04％、48．10％和8．86％，联合组疗效明显优于曲安奈德组（P〈0．05）；②治疗后两组黄斑区视网膜厚度（CMT）均显著降低（P〈0．05），联合组CMT下降程度大于曲安奈德组（P〈0．05）；③治疗后两组眼压均升高（P〈0．05），但联合组眼压升高幅度小于曲安奈德组（P〈O．05）；④曲安奈德组和联合组12个月复发率分别为27．89／6和18．3％，差异无统计学意义（P〉0．05）。结论中西医结合治疗ME可以显著提高近期疗效，并降低激素性眼压升高的不良反应。

Evaluation of Efficacy and Safety of Triamcinolone Acetonide Combined with Traditional Chinese Medicine for the Treatment of Macular Edema

Objective To optimize intervention measures for macular edema. Methods 146 patients（160 eyes） with macular edema were randomly divided into triamcinolone acetonide group（73 cases, 79 eyes）and combination group（73 cases,81 eyes）. Triamcinolone acetonide group was treated by intravitreal injection of triamcinolone acetonide,and the combination group was treated by triamcinolone acetonide combined with traditional Chinese medicine decoction. The courses of treatment in two groups were 2 months. Results ①At 12 weeks after treatment,the rate of improvement,stable and descended were 58.03%, 38. 27% and 3.70% in combination group respectively, and 43.04% ,48.10% and 8.86% in triamcinolone acetonide group. The clinical efficacy of combination group was better than triamcinolone acetonide group（P〈0.05）. ②The central macular thickness（CMT）in both groups reducd significantly after treatment（P〈0.05）, but the decreasing degree of CMT in combination group was more remarkable（P〈0.05）. QThe intraocular pressure in both groups increased after the treatment（P〈0.05）,but the combination group had less increasing amplitude compared with triamcinolone acetonide group（P〈0.05）. ③The recurrence rate of triamcinolone acetonide group and combination group was 27.8% vs 18.3% ,there was no statistical significance（P〈0.05）. Conclusion Treatment by integrated Chinese and western medicine could improve the short-term efficacy in patients with macular edema,and reduce the side effects of glucocorticoid ocular hypertension.