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目的:观察口服芪明颗粒联合曲安奈德(TA)玻璃体腔注射及黄斑区格栅样视网膜光凝治疗糖尿病性黄斑水肿(DME)的临床疗效。方法:选取医院临床确诊的糖尿病性黄斑水肿患者68例(98只眼),排除增殖期糖尿病视网膜病变(PDR)需做玻切的患者,随机分为治疗组和对照组,其中治疗组37例(46眼),采用芪明颗粒口服联合曲安奈德玻璃体腔注药及黄斑区格栅样视网膜光凝;对照组31例(52眼),采用曲安奈德玻璃体腔注药联合黄斑区格栅样视网膜光凝;术后随访1个月、3个月、半年、1年、2年。观察最佳矫正视力(BRVA)、OCT示黄斑区厚度变化、黄斑水肿复发时间及频率和并发症(白内障、青光眼)发生情况。结果:治疗组在视力提高方优高于对照组,在糖尿病性黄斑水肿复发方面较对照组明显减少,差异有统计学意义(P<0.05);而并发症发生率对比两组无统计学差异(P>0.05)。结论:芪明颗粒口服联合曲安奈德玻璃体腔注射及黄斑区格栅样视网膜光凝治疗糖尿病性黄斑水肿安全有效,尤其对贫困患者经济适用。
Objective: To observe the clinical efficacy of oral stilberamine granules combined with triamcinolone acetonide (TA) intravitreal injection and macular grid retinal photocoagulation in the treatment of diabetic macular edema (DME). Methods: Sixty-eight patients (98 eyes) with clinically diagnosed diabetic macular edema were enrolled in the study. Patients with proliferative diabetic retinopathy (PDR) were excluded and randomly divided into treatment group and control group, of which 37 (46 eyes). Intravitreal injection of triamcinolone acetonide combined with triamcinolone acetonide vitreum and macular grid retinal photocoagulation were used. In control group, 31 cases (52 eyes) were treated with triamcinolone acetonide vitreous cavity injection combined with macular grid Retinal photocoagulation; follow-up 1 month, 3 months, 6 months, 1 year, 2 years. Observation of best corrected visual acuity (BRVA), OCT showed macular thickness changes, macular edema recurrence time and frequency and complications (cataracts, glaucoma) occurred. Results: In the treatment group, the visual acuity improvement was superior to that of the control group, and the recurrence of diabetic macular edema was significantly lower than that of the control group (P <0.05); while the incidence of complications was no significant difference between the two groups (P> 0.05). Conclusion: The combination of shenming granule and triamcinolone acetonide intravitreal injection and macular grid retinal photocoagulation for the treatment of diabetic macular edema is safe and effective, especially for poor patients.