四物汤加减联合沃丽汀治疗高度近视黄斑出血临床疗效观察

发布时间：2018-05-26 04:25

  本文选题：高度近视 + 黄斑出血　； 参考：《湖北中医药大学》2011年硕士论文

【摘要】：目的：通过回顾分析中西医结合治疗高度近视黄斑出血病例,评价其治疗效果,总结证型规律及诊疗经验。 方法：所有受试对象均来源于湖北省中医院2009年6月至2011年3月间门诊及住院病人。选取其中随访良好的36岁至72岁42例(48眼)作为观察对象,观察其疗效。据患者的临床表现分为三期,早期(即出血期)、中期(即出血静止期)、晚期(即机化期),予以四物汤加减联合沃丽汀治疗。分别在一周、两周、三周、四周由专人检查最佳矫正视力及荧光血管照影(FFA)。 疗效评定标准：根据《国家中医行业标准·中医病证诊断疗效标准》为疗效判定标准：治愈：黄斑部出血吸收完全,视力恢复至出血前矫正视力；显效：黄斑出血墓本吸收,视力提高2行及以上；有效：黄斑出血部分吸收,视力提高0—1行；无效：黄斑部出血没有吸收或吸收缓慢,或发生新的出血,视力不提高或反而下降。 结果： 1视力变化： 治疗前,矫正视力最低为20/HM,最高为0.2；治疗后,矫正视力最低为50/CF,最高为0.7。经配对t检验,P0.01,统计学上具有极显著意义。比较单纯型黄斑出血患眼(共5眼)及新生血管型黄斑出血患眼(共43眼),单纯型黄斑出血患眼,治疗后视力均有不同程度的改善,提高2行及以上的4眼(即80%),视力提高1行的1眼(即20%)。而伴新生血管型黄斑出血患眼,治疗后3个月视力提高小于2行的14眼(占13.9%),视力提高2行及以上共25眼(占58.1%),无变化的4眼(占7.1%),下降的1眼(占2.3%)。X2检验, p0.01,有极显著意义。单纯型患眼治疗后视力均改善,治疗间较短；新生血管型患眼的治疗时间较长,且中医药治疗高度近视黄斑出血的临床研究治疗3个月的总体视力较治疗1个月的好。 2黄斑出血变化。 单纯型黄斑出血的5眼出血全部吸收。新生血管型黄斑出血的43眼,在3个月时,25眼出血全部吸收,14眼出血部分吸收,1眼出血增加,4眼出血无变化。治疗前后,经配对t检验,P0.01,统计学上具有极显著意义。单纯型黄斑出血较新生血管型的黄斑出血更容易全部吸收,统计学上有显著差异。 2种类型的黄斑出血吸收情况,卡方检验, p=0.017,统计学结合中医证型,发现在新生血管型病例里,气血亏虚证所占比例较大,相比其他证型,有随治疗时间延长,黄斑出血吸收情况进行性改善的特点。肝肾不足证在治疗1个月后,出血变化较缓慢。 结论： 本临床试验研究结果表明：四物汤加减联合沃丽汀治疗各期高度近视黄斑出血具有较好的疗效,能有效促进高度近视眼底黄斑出血的吸收,是一种安全而有效的治疗高度近视黄斑出血的方法。
[Abstract]:Objective: To review and analyze the treatment of macular hemorrhage with high myopia by combining traditional Chinese and Western medicine, evaluate its therapeutic effect, and summarize the syndrome pattern and experience of diagnosis and treatment.
Methods: all subjects were from the outpatient and hospitalized patients between June 2009 and March 2011 in Hubei Provincial Traditional Chinese Medical Hospital, and 42 cases of 36 to 72 years of age (48 eyes) were selected as the subjects. The clinical manifestations were divided into three stages, early (that is, bleeding period), mid-term (that is, bleeding static period), and late stage (i. e. machine period). Siwu Decoction Combined with Valentine's treatment. The best corrected visual acuity and fluorescein angiography (FFA) were examined by a special person in one week, two weeks and three weeks.
The standard of evaluation of curative effect: according to the national standard of Chinese medicine industry and the standard of TCM syndrome diagnosis, it is the standard of curative effect: Cure: macular hemorrhage is absorbed completely, visual acuity is restored to pre bleeding correction visual acuity; the visual effect: macular hemorrhage tomb absorption, eyesight increase 2 lines and above; effective: macular hemorrhage partial absorption, eyesight raising 0 - 1 Ineffective: macular hemorrhage is not absorbed or absorbed slowly, or new bleeding occurs. The vision does not increase or decrease.
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本文编号：1935928