本文選題：高度近視 + 黃斑出血�。� 參考：《湖北中醫(yī)藥大學》2011年碩士論文

【摘要】：目的：通過回顧分析中西醫(yī)結(jié)合治療高度近視黃斑出血病例,評價其治療效果,總結(jié)證型規(guī)律及診療經(jīng)驗。 方法：所有受試對象均來源于湖北省中醫(yī)院2009年6月至2011年3月間門診及住院病人。選取其中隨訪良好的36歲至72歲42例(48眼)作為觀察對象,觀察其療效。據(jù)患者的臨床表現(xiàn)分為三期,早期(即出血期)、中期(即出血靜止期)、晚期(即機化期),予以四物湯加減聯(lián)合沃麗汀治療。分別在一周、兩周、三周、四周由專人檢查最佳矯正視力及熒光血管照影(FFA)。 療效評定標準：根據(jù)《國家中醫(yī)行業(yè)標準·中醫(yī)病證診斷療效標準》為療效判定標準：治愈：黃斑部出血吸收完全,視力恢復至出血前矯正視力；顯效：黃斑出血墓本吸收,視力提高2行及以上；有效：黃斑出血部分吸收,視力提高0—1行；無效：黃斑部出血沒有吸收或吸收緩慢,或發(fā)生新的出血,視力不提高或反而下降。 結(jié)果： 1視力變化： 治療前,矯正視力最低為20/HM,最高為0.2；治療后,矯正視力最低為50/CF,最高為0.7。經(jīng)配對t檢驗,P0.01,統(tǒng)計學上具有極顯著意義。比較單純型黃斑出血患眼(共5眼)及新生血管型黃斑出血患眼(共43眼),單純型黃斑出血患眼,治療后視力均有不同程度的改善,提高2行及以上的4眼(即80%),視力提高1行的1眼(即20%)。而伴新生血管型黃斑出血患眼,治療后3個月視力提高小于2行的14眼(占13.9%),視力提高2行及以上共25眼(占58.1%),無變化的4眼(占7.1%),下降的1眼(占2.3%)。X2檢驗, p0.01,有極顯著意義。單純型患眼治療后視力均改善,治療間較短；新生血管型患眼的治療時間較長,且中醫(yī)藥治療高度近視黃斑出血的臨床研究治療3個月的總體視力較治療1個月的好。 2黃斑出血變化。 單純型黃斑出血的5眼出血全部吸收。新生血管型黃斑出血的43眼,在3個月時,25眼出血全部吸收,14眼出血部分吸收,1眼出血增加,4眼出血無變化。治療前后,經(jīng)配對t檢驗,P0.01,統(tǒng)計學上具有極顯著意義。單純型黃斑出血較新生血管型的黃斑出血更容易全部吸收,統(tǒng)計學上有顯著差異。 2種類型的黃斑出血吸收情況,卡方檢驗, p=0.017,統(tǒng)計學結(jié)合中醫(yī)證型,發(fā)現(xiàn)在新生血管型病例里,氣血虧虛證所占比例較大,相比其他證型,有隨治療時間延長,黃斑出血吸收情況進行性改善的特點。肝腎不足證在治療1個月后,出血變化較緩慢。 結(jié)論： 本臨床試驗研究結(jié)果表明：四物湯加減聯(lián)合沃麗汀治療各期高度近視黃斑出血具有較好的療效,能有效促進高度近視眼底黃斑出血的吸收,是一種安全而有效的治療高度近視黃斑出血的方法。
[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.
Result錛，

本文編號：1935928