【作者】 冯松福；

【导师】 周至安；

【作者基本信息】 广州中医药大学 ， 中医五官科学， 2010， 硕士

【摘要】 研究背景年龄相关性黄斑变性(age-related macular degeneration, AMD)又称老年性黄斑变性,是一种可严重影响中心视力的常见的视网膜变性类疾病,其发病率也与年龄增长有着密切的联系。根据临床表现的不同而分为干性和湿性两型。其确切的发病原因至今尚不清楚,故治疗上亦未有满意有效的疗法。祖国传统医学将其归属为“视瞻昏渺”范畴,认为本病的发生主要与肝、脾、肾的功能失调、气血失和以及痰瘀互结有关,病性为本虚标实,虚实夹杂。因此我们选用凉血散结、填精明目法来治疗脏腑虚弱、气血精亏；营养脏腑,使之气血调和,兼顾活血通络,从而促进黄斑部渗出、出血和新生血管的消退,并取得满意的疗效。研究目的观察凉血散结、填精明目法为主的中药治疗肝肾阴虚型年龄相关性黄斑变性患者的黄斑部渗出、出血及视网膜下新生血管的影响。方法将广东省中医院2008年10月至2009年10月眼科门诊就诊的符合肝肾阴虚型的AMD患者60例(60眼),随机分为2组：治疗组30例(30眼)和对照组30例(30眼)。治疗组采用填精明目汤(茜根20克,草决明15克,太子参15克,黄芪10克,枸杞子10克,法半夏10克,浙贝15克,蒲黄5克,补骨脂5克,熟地10克、桑葚子10克、旱莲草15克、女贞子15克等)治疗,每天1剂,开水冲服；对照组口服杞菊地黄丸,6g,bid。疗程为1个月。观察治疗前后患者视力、荧光造影下黄斑部渗出、出血及新生血管的变化。结果治疗组30例(30眼),显效7例,有效15例,总有效率70.33%；对照组30例(30眼),显效2例,有效9例,总有效率36.67%,两组疗效比较,治疗组疗效优于对照组,差异有统计学意义(P<0.05)。结论以凉血散结、填精明目法为主的中药能促进肝肾阴虚型年龄相关性黄斑变性患者黄斑部渗出的吸收和CNV的缩小甚至消退。更多还原

【Abstract】 BackgroundAge-related macular degeneration (AMD), also known as senile macular degeneration, is a common type of retinal degeneration diseases which can seriously affect central vision. The increase in incidence is closely related to age. According to different clinical manifestations, it is divided into two types of dry and wet. Until now, the precise cause is unclear, so it has not effective therapy. AMD belongs to the category of traditional Chinese medical(TCM) science of "Shizhanhunmiao", consider that the disease is mainly related to the liver, spleen, kidney dysfunction, blood loss and as well as phlegm related illness sex-based vacuity false is mixed. Therefore, we use cooling blood Sanjie, tianjing mingmu method for the treatment of the disease, and promote blood to reconcile、Huoxuetongluo, thus contributing to macular exudation, hemorrhage and regression of choroidal neovascularization. And achieved satisfactory outcomes.ObjectiveTo observe the effection of the cooling blood Sanjie, tianjing mingmu method based traditional Chinese medicine Yin Deficiency of Liver and Kidney patients with age-related macular degeneration macular exudation, hemorrhage, and subretinal neovascularization.MethodsChose 60 patients (60 eyes) patients in TCM Hospital of Guangdong Province from October 2008 to October 2009 ophthalmology clinic of the AMD line with Yin Deficiency of Liver and Kidney, which were randomly divided into 2 groups: treatment group,30 patients (30 eyes) and a control group of 30 patients (30 eyes). Treatment group was filling a tianjing mingmu soup (Qiangen-20 grams, Cassia-15 grams, Heterophylla-15 grams, Astragalus-10 grams, Medlar-10 grams, Pinellia-10 grams, Fritillaria-15 grams, Puhuang-5 grams, Bu guzi 5 grams, Rehmannia-10 grams, Mulberry-10 grams, Eclipta alba-15 grams, Ligustrum lucidum 15 g, etc.) treatment, one agent per day; the control group was treated with Qi Ju Di Huang Wan,6g, bid. Treatment for 1 month. Before and after treatment, observe visual acuity、macular exudation under fluorescence imaging、hemorrhage、and choroidal neovascular changes under OCT.ResultsThe total effective ratio(76.67%)in the treatment group was remarkable higher than the control group(36.67%), the two groups Comparative efficacy of P<0.05, statistically significant differences between the treatment group and control group.ConclusionsLiangxue Sanjie, Tianjing Mingmu method can promote Yin Deficiency of Liver and Kidney patients with age-related macular degeneration macular exudate absorption and CNV the shrink or even disappear.更多还原