【摘要】：目的：通過對(duì)益氣活血化瘀法聯(lián)合激光治療視網(wǎng)膜靜脈阻塞(retinal vein occlusion, RVO)療效的觀察,來探討益氣活血中藥在治療視網(wǎng)膜靜脈阻塞中所取得的良好療效及機(jī)制,為視網(wǎng)膜靜脈阻塞的預(yù)防和治療提供新思路和新途徑。 方法：將RVO患者60例60只眼,采用隨機(jī)原則分組治療,分為治療組和對(duì)照組。其中治療組31例31只眼,根據(jù)中醫(yī)辨證應(yīng)用補(bǔ)陽還五湯加減配合激光光凝治療；對(duì)照組(單純激光組)29例29只眼,采用單純激光治療,治療一個(gè)月后觀察兩組的臨床療效。 結(jié)果： 1.兩組治療視力比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05),補(bǔ)陽還五湯加減配合激光光凝治 療療效優(yōu)于單純激光組,治療組有效率93.55%,對(duì)照組89.66%。 2.兩組治療眼底出血滲出吸收比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),治療組療效優(yōu)于對(duì)照組。 3.兩組治療后視力起效時(shí)間比較,P0.01,有非常顯著性差異。 4.兩組治療后OCT檢查黃斑水腫改善情況比較,具有非常顯著性差異(P0.01)。 5.兩組患者治療一個(gè)月后視網(wǎng)膜循環(huán)時(shí)問(RCT)明顯縮短,與治療前比較有顯著性差異(P0.05)。治療組與對(duì)照組治療后比較,P=0.0320.05,有顯著性差異。 (6)兩組總體療效比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),治療組與對(duì)照組總體療效的有效率分別是96.77%、89.66%,治療組療效優(yōu)于對(duì)照組。 結(jié)論： 1.兩種治療方法對(duì)本病均有一定療效,激光光凝能減少毛細(xì)血管滲漏,形成屏障,阻止液體滲入黃斑；封閉無灌注區(qū),預(yù)防新生血管形成；封閉新生血管及減少和防止玻璃體出血。中藥能促進(jìn)眼底出血和滲出灶的吸收,并改善黃斑水腫,從而有效的防止視網(wǎng)膜靜脈阻塞遠(yuǎn)期并發(fā)癥產(chǎn)生和有利于近期并發(fā)癥的治療。中藥聯(lián)合激光則能發(fā)揮兩者的優(yōu)勢(shì),加速眼底出血的吸收,從而縮短病程提高療效,故治療組療效更優(yōu)于對(duì)照組。 2.中藥在激光圍手術(shù)期具有促進(jìn)視網(wǎng)膜出血、滲出的吸收,彌補(bǔ)激光治療引起的視網(wǎng)膜灼傷的不良反應(yīng),以增強(qiáng)激光療效。而這協(xié)同可明顯提高患者視力,縮短病程,減少視細(xì)胞的損害,明顯改善視功能。
[Abstract]:Objective: to observe the curative effect of tonifying qi, activating blood circulation and removing blood stasis combined with laser in the treatment of retinal vein occlusion (retinal vein occlusion, RVO), and to explore the good curative effect and mechanism of traditional Chinese medicine for invigorating qi and activating blood circulation in the treatment of retinal vein occlusion. To provide new ideas and approaches for the prevention and treatment of retinal vein occlusion. Methods: 60 cases (60 eyes) of RVO were divided into treatment group and control group. 31 eyes of 31 cases in the treatment group were treated with Buyang Huanwu decoction combined with laser photocoagulation according to TCM syndrome differentiation, and 29 eyes of 29 cases in the control group (simple laser group) were treated with laser alone, and the clinical effects of the two groups were observed after one month of treatment. Results: 1. The difference of visual acuity between the two groups was statistically significant (P0.05). The curative effect of Buyang Huanwu decoction combined with laser photocoagulation therapy was better than that of the simple laser group. The effective rate of the treatment group was 93.55, and that of the control group was 89.66.2. The difference between the two groups was statistically significant (P0.01). The curative effect of the treatment group was better than that of the control group. The visual acuity of the two groups was significantly different from that of the control group (P 0.01). There was a significant difference between the two groups in the improvement of macular edema by OCT (P0.01). After one month of treatment, the (RCT) of the two groups was significantly shorter than that before treatment (P0.05). There was significant difference between the treatment group and the control group after treatment. (6) the overall curative effect of the two groups was statistically significant (P0.05). The effective rate of the treatment group and the control group was 96.777.89. 666.The curative effect of the treatment group was better than that of the control group. Conclusion: 1. Laser photocoagulation can reduce capillary leakage, form barrier, prevent fluid from infiltrating into macula, seal no perfusion area and prevent neovascularization. Block neovascularization and reduce and prevent vitreous hemorrhage. Traditional Chinese medicine can promote the absorption of fundus hemorrhage and exudation, and improve macular edema, which can effectively prevent the long-term complications of retinal vein occlusion and the treatment of short-term complications. Chinese medicine combined with laser can play the advantage of both, accelerate the absorption of fundus haemorrhage, thus shorten the course of disease and improve the curative effect, so the curative effect of the treatment group is better than that of the control group. 2. Chinese medicine can promote the absorption of retinal hemorrhage and exudation and compensate for the adverse reaction of retinal burn caused by laser therapy in the perioperative period of laser, so as to enhance the curative effect of laser. This synergism can significantly improve the visual acuity, shorten the course of disease, reduce the damage of visual cells and improve visual function.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R774.1

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