五苓散联合玻璃体内注射康柏西普治疗肝郁脾虚型糖尿病性黄斑水肿的效果OA
Effect of Wuling Powder Combined with Intravitreal Injection of Conbercept in Diabetic Macular Edema of Liver-stagnation Spleen Deficiency Type
目的:探究五苓散联合玻璃体内注射康柏西普治疗肝郁脾虚型糖尿病性黄斑水肿的效果.方法:将 2021 年 4 月—2025 年 4 月北京市第一中西医结合医院收治的 120 例肝郁脾虚型糖尿病性黄斑水肿患者纳入研究,使用信封法将患者随机分为研究组和对照组,每组 60 例.对照组接受玻璃体内注射康柏西普治疗,研究组在对照组基础上联合五苓散治疗.对比两组疗效、中医证候积分、黄斑中心凹下视网膜厚度、最佳矫正视力、眼动脉血流动力学[眼动脉阻力指数(RI)、舒张末期峰值流速(EDV)、收缩期峰值流速(PSV)]、血清相关因子[血管内皮生长因子(VEGF)、IL-6、一氧化氮合酶(NOS)]水平及治疗期间不良反应发生情况.结果:开始治疗 3 个月后,研究组总有效率高于对照组(P<0.05);开始治疗 3 个月后,研究组中医证候积分低于对照组(P<0.05);开始治疗 3 个月后,研究组黄斑中心凹下视网膜厚度低于对照组,最佳矫正视力优于对照组(P<0.05).开始治疗 3 个月后,研究组 EDV、PSV 水平高于对照组(P<0.05);开始治疗 3 个月后,两组 RI 比较,差异无统计学意义(P>0.05);开始治疗 3 个月后,研究组 VEGF、IL-6 低于对照组,NOS 高于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05).结论:五苓散联合玻璃体内注射康柏西普治疗肝郁脾虚型糖尿病性黄斑水肿的效果显著,能有效缓解患者症状,提高视力水平,恢复眼部血流供给.
Objective:To explore the effect of Wuling Powder combined with intravitreal injection of Conbercept in diabetic macular edema of liver-stagnation spleen deficiency type.Method:A total of 120 patients with diabetic macular edema of liver-stagnation spleen deficiency type in Beijing First Hospital of Integrated Traditional Chinese and Western Medicine were enrolled from April 2021 to April 2025.According to envelope method,they were randomly divided into study group and control group,60 cases in each group.The control group was given intravitreal injection of Conbercept,while study group was treated with Wuling Powder on basis of control group.The curative effect,scores of traditional Chinese medicine syndromes,central foveal thickness,best corrected visual acuity,hemodynamics of ophthalmic artery[ophthalmic artery resistance index(RI),end-diastolic velocity(EDV),peak systolic velocity(PSV)]and serum-related factors[vascular endothelial growth factor(VEGF),IL-6,nitric oxide synthase(NOS)],and the occurrence of adverse reactions during treatment in the two groups were compared.Result:Three months after the start of treatment,the total effective rate in the study group was higher than that in the control group(P<0.05).Three months after the start of treatment,the scores of traditional Chinese medicine syndromes in study group were lower than those in control group(P<0.05).Three months after the start of treatment,central foveal thickness in the study group was lower than that in the control group,and the best corrected visual acuity was better than that in the control group(P<0.05).Three months after the start of treatment,the levels of EDV and PSV in study group were higher than those in control group(P<0.05).Three months after the start of treatment,there was no significant difference in RI between the two groups(P>0.05).Three months after the start of treatment,the levels of VEGF and IL-6 in study group were lower than those in control group,while NOS level was higher than that in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Curative effect of Wuling Powder combined with intravitreal injection of Conbercept is significant in diabetic macular edema of liver-stagnation spleen deficiency type,which can effectively alleviate symptoms response,improve visual acuity and recover ocular blood supply.
马红霞
北京市第一中西医结合医院眼科 北京 100020
医药卫生
糖尿病性黄斑水肿五苓散玻璃体内注射康柏西普眼动脉血流动力学
Diabetic macular edemaWuling PowderIntravitreal injectionConberceptHemodynamics of ophthalmic artery
《中国医学创新》 2026 (14)
46-50,5
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