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目的观察活血利水方联合532激光对糖尿病黄斑水肿视功能与形态学变化的影响。方法将90例(147眼)糖尿病黄斑水肿患者随机分为中药组30例(47眼)、光凝组30例(48眼)和联合组30例(52眼),分别采用活血利水方、532激光以及中药联合激光治疗;治疗后及疗程结束后6个月观察各组最佳矫正视力、FFA及OCT变化情况。结果中药组治疗前后视力差异有统计学意义(P<0.05),但随访时(疗程结束后6个月)较治疗前无提高(P>0.05);光凝组、联合组治疗后和随访时视力较治疗前均有提高(P<0.05)。中药组治疗后和随访时视网膜厚度较治疗前无明显变化(P>0.05),光凝组、联合组治疗后和随访时视网膜厚度较治疗前差异均有统计学意义(P<0.05)。中药组治疗后和随访时黄斑水肿渗漏有效率分别为40.42%和36.17%,光凝组分别为66.67%和60.41%,联合组分别为88.46%和80.77%。联合组、光凝组与中药组视力、视网膜厚度、黄斑水肿渗漏情况治疗后及随访时比较差异有统计学意义(P<0.05),联合组与光凝组治疗后及随访时比较差异有统计学意义(P<0.05)。结论活血利水方联合532激光治疗糖尿病黄斑水肿疗效好,可明显提高患者的视力,改善视网膜病变和黄斑水肿渗漏。
Objective To observe the effects of Huoxue Recipe combined with 532 laser on visual function and morphological changes of diabetic macular edema. Methods Ninety patients (147 eyes) with diabetic macular edema were randomly divided into 30 cases (47 eyes) in the traditional Chinese medicine group, 30 eyes (48 eyes) in the photocoagulation group and 30 eyes (52 eyes) in the combined group. Laser and traditional Chinese medicine combined with laser treatment; After treatment and 6 months after the end of treatment observed the best corrected visual acuity, FFA and OCT changes. Results There were significant differences in visual acuity between the two groups before and after treatment (P <0.05), but there was no significant difference between the two groups before and after treatment (P> 0.05) Visual acuity than before treatment were improved (P <0.05). There was no significant difference in retinal thickness between the two groups (P> 0.05) after treatment and at follow-up. There was significant difference in retinal thickness between the two groups (P <0.05). The effective rates of leakage of macular edema in Chinese medicine group after treatment and follow-up were 40.42% and 36.17% respectively, 66.67% and 60.41% in the photocoagulation group and 88.46% and 80.77% in the combined group respectively. The differences of visual acuity, retinal thickness and leakage of macular edema between the combination group, the photocoagulation group and the traditional Chinese medicine group after treatment and at follow-up were statistically significant (P <0.05). There was significant difference between the combined group and the photocoagulation group after treatment and at follow-up Statistical significance (P <0.05). Conclusion The combination of Huoxue Recipe and 532 laser in the treatment of diabetic macular edema has a good curative effect, which can obviously improve the patients’ vision and improve the leakage of retinopathy and macular edema.