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中西医结合治疗糖尿病性黄斑水肿的效果

Efficacy of integrated traditional Chinese and Western medicine in diabetic macular edema

  • 摘要:
    目的 评估益气养阴经验方与抗血管内皮生长因子(vascular endothelial growth factor, VEGF)联合治疗糖尿病性黄斑水肿(diabetic macular edema, DME)的效果。
    方法 回顾性分析2019年6月至2022年12月在同济大学附属同济医院或上海市嘉定区南翔医院确诊为DME的59例患者的临床资料。其中,29例接受单纯玻璃体腔注射雷珠单抗治疗(抗VEGF组),30例接受玻璃体腔注射雷珠单抗联合口服益气养阴经验方治疗(联合治疗组)。比较两组患者在治疗前和治疗后4、8、12、16、20、24周的最佳矫正视力(best corrected visual acuity, BCVA)、黄斑中心凹视网膜厚度(central macular thickness, CMT)、中医证候评分等。
    结果 与治疗前相比,两组DME患者治疗后不同时间点的BCVA明显提升(P<0.05)、CMT显著减小(P<0.05)。治疗后第16、20、24周,联合治疗组的BCVA优于抗VEGF组(P<0.01);治疗后第12、16、20、24周,联合治疗组的CMT小于抗VEGF组(P<0.01);治疗后第8周起,联合治疗组的中医证候评分低于抗VEGF组(P<0.01)。
    结论 益气养阴经验方能提高抗VEGF治疗DME的效果,表明中西医结合治疗DME具有一定的临床应用价值。

     

    Abstract:
    Objective To evaluate the efficacy of combining the replenishing qi and nourishing yin empirical formula with anti-vascular endothelial growth factor (VEGF) in diabetic macular edema (DME).
    Methods A retrospective analysis was conducted on 59 patients diagnosed with DME at Tongji Hospital of Tongji University or Shanghai Nanxiang Hospital, Jiading District from June 2019 to December 2022. Among them, 29 cases received intravitreal injection of ranibizumab (anti-VEGF group), while 30 cases received both intravitreal injection of ranibizumab and oral administration of the replenishing qi and nourishing yin empirical formula (combined treatment group). The best corrected visual acuity (BCVA), central macular thickness (CMT), and the traditional Chinese medicine (TCM) syndrome score were compared between the two groups before treatment and at 4, 8, 12, 16, 20, and 24 weeks after treatment.
    Results Compared with before treatment, BCVA significantly improved (P<0.05) and CMT significantly decreased (P<0.05) at different time points after treatment in both groups. At 16, 20, and 24 weeks after treatment, BCVA in the combined treatment group was superior to that in the anti-VEGF group (P<0.01). At 12, 16, 20, and 24 weeks after treatment, CMT in the combined treatment group was lower than that in the anti-VEGF group (P<0.01). Starting from week 8 after treatment, the TCM syndrome scores in the combined treatment group were lower than those in the anti-VEGF group (P<0.01).
    Conclusions The replenishing qi and nourishing yin empirical formula could improve the efficacy of anti-VEGF therapy in DME patients, indicating that integrating traditional Chinese and Western medicine has certain clinical application value in treating DME.

     

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