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目的:以六味地黄软胶囊联合七叶洋地黄双苷滴眼液干预早中期及干性进展期年龄相关性黄斑变性(AMD),并运用光学相干断层扫描(OCT)高级RPE这一新技术对干预效果进行评判。方法:将39例早中期及干性进展期AMD患者随机分为治疗组(21例36眼)与对照组(18例34眼),治疗组予六味地黄软胶囊联合七叶洋地黄双苷滴眼液干预6个月,对照组不予任何针对性治疗。治疗前后对2组患者行视力、眼底照相及OCT高级RPE分析检查,通过组内前后对比与组间对比,观察早中期及干性进展期AMD患者病程进展,并评判中西医结合疗法对本病的干预效果。结果:对照组患者6个月后较初诊时黄斑中心凹5mm圆内玻璃膜疣(drusen)面积、体积及萎缩灶面积明显增加(P<0.05,P<0.01);治疗组治疗6个月后视力及drusen面积、体积均较治疗前略有改善,但差异无统计学意义(P>0.05),萎缩灶面积明显增加(P<0.05)。治疗后治疗组患者drusen体积明显小于对照组(P<0.05),其余指标与对照组比较无统计学差异(P>0.05)。2组患者眼底照相和Amsler表检查组内及组间比较未见明显差异。结论:六味地黄软胶囊联合七叶洋地黄双苷滴眼液干预早中期及干性进展期AMD可延缓视力的降低和drusen面积、体积的增加,在减少萎缩灶面积方面无明显作用。早中期及干性进展期AMD患者病程一直在缓慢发展,只是受限于传统客观检查方法的不足,无法精确呈现这种缓慢发展的过程,而OCT高级RPE分析解决了这一问题,在观察早中期及干性晚期AMD病程进展及评判治疗效果方面较传统检查方法有明显优势。
OBJECTIVE: To use Liuweidihuang soft capsule combined with Digoxin dipivoxil to treat early-stage and advanced stage age-related macular degeneration (AMD) and to use the new technique of optical coherence tomography (OCT) advanced RPE The effect of intervention is judged. Methods: Thirty-nine patients with early-stage and advanced-stage progressive AMD were randomly divided into treatment group (21 cases, 36 eyes) and control group (18 cases, 34 eyes). The treatment group received Liuweidihuang soft capsule combined with Digoxin Eyewash intervention for 6 months, the control group without any targeted treatment. Before and after treatment, visual acuity, fundus photography and OCT advanced RPE analysis were performed before and after treatment. The course of progression of early-stage and advanced-stage AMD patients was observed by comparison of before and after contrast and between groups. The TCM- Intervention effect. Results: The area, volume and atrophic area of drusen in the control group were significantly increased (P <0.05, P <0.01) after 6 months compared with those of the first treatment group. After 6 months of treatment, Visual acuity and drusen area and volume were slightly improved than before treatment, but the difference was not statistically significant (P> 0.05), and the area of atrophic focus was significantly increased (P <0.05). After treatment, the volume of drusen in the treatment group was significantly less than that in the control group (P <0.05). There was no significant difference in the other indexes between the treatment group and the control group (P> 0.05). There was no significant difference between the two groups in fundus photography and Amsler table examination group and between groups. Conclusion: The combination of Liuweidihuang soft capsule and hevea dipyridylate eye drops can reduce the vision loss and drusen area and volume in early, middle and early stage of dry AMD, and has no significant effect in reducing the area of atrophy. The course of early-stage and early-stage AMD patients has been slowly developing, but limited by the traditional objective examination methods, can not accurately present this slow development process, and OCT advanced RPE analysis to solve this problem, in the early observation Mid-term and advanced advanced AMD disease progression and evaluation of the treatment effect than the traditional inspection methods have obvious advantages.