目的 探討杞菊地黃片聯(lián)合卵磷脂絡(luò)合碘治療中心性漿液性脈絡(luò)膜視網(wǎng)膜病變的療效。方法 選取2019年1月—2021年12月天津市寶坻區(qū)人民醫(yī)院收治的82例中心性漿液性脈絡(luò)膜視網(wǎng)膜病變患者，按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各41例。對(duì)照組口服卵磷脂絡(luò)合碘膠囊，2粒/次，3次/d。治療組在對(duì)照組基礎(chǔ)上口服杞菊地黃片，3片/次，3次/d。兩組療程均為8周。觀察兩組的臨床療效，比較治療前后兩組患眼最佳矯正視力（BCVA）、25項(xiàng)國(guó)立眼科研究所視功能問(wèn)卷（NEI VFQ-25）總分及患眼Amsler表檢查異常率、視網(wǎng)膜黃斑區(qū)微結(jié)構(gòu)參數(shù)[黃斑中心凹厚度（CMT）、總黃斑容積（CV）、視網(wǎng)膜色素上皮（RPE）脫離高度]及患眼熒光滲漏面積和脈絡(luò)膜擴(kuò)張血管面積。結(jié)果 治療后，治療組總有效率為95.1%，顯著高于對(duì)照組的80.5%（P＜0.05）。治療后，兩組BCVA和NEI VFQ-25總分均較治療前顯著提高，Amsler表檢查異常率均顯著降低（P＜0.05）；治療后，治療組BCVA和NEI VFQ-25總分均顯著高于對(duì)照組，Amsler表檢查異常率顯著低于對(duì)照組（P＜0.05）。治療后，兩組患眼黃斑區(qū)微結(jié)構(gòu)參數(shù)CMT、CV和RPE脫離高度均較治療前顯著減?。?i>P＜0.05）；且以治療組改善更顯著（P＜0.05）。治療后，兩組患眼熒光滲漏面積和脈絡(luò)膜擴(kuò)張血管面積較治療前均顯著縮?。?i>P＜0.05）；且以治療組改善更顯著（P＜0.05）。結(jié)論 杞菊地黃片聯(lián)合卵磷脂絡(luò)合碘對(duì)中心性漿液性脈絡(luò)膜視網(wǎng)膜病變患者具有確切的臨床療效，可安全有效地改善患者視力，減輕視直如曲，并可進(jìn)一步減輕眼底病變。

Objective To investigate the clinical efficacy of Qiju Dihuang Tablets combined with iodized lecithin in the treatment of central serous chorioretinopathy. Methods A total of 82 patients with plasma disease admitted to Tianjin Baodi District People’s Hospital from January 2019 to December 2021 were selected and divided into control group and treatment group according to random number table method, with 41 cases in each group. Patients in the control group were po administered with Iodized Lecithin Capsules, 2 capsules/time, three times daily. Patients in the treatment group were po administered with Qijudihuang Tablets on the basis of the control group, 3 tablets/time, three times daily. The treatment course of both groups was 8 weeks. The clinical efficacy of the two groups was observed, the best corrected visual acuity (BCVA), the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) total score, the abnormal rate of Amsler table examination, and the retinal macular microstructural parameters [concave thickness (CMT), total macular volume (CV), retinal pigment epithelium (RPE) detachment height], the area of fluorescein leakage and choroidal dilated vessels in the affected eye were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 95.1%, which was significantly higher than that of the control group (80.5%, P< 0.05). After treatment, the total scores of BCVA and NEI VFQ-25 were significantly increased in both groups compared with before treatment, and the abnormal rates of Amsler were significantly decreased (P < 0.05). After treatment, the total score of BCVA and NEI VFQ-25 in the treatment group was significantly higher than that in the control group, and the abnormal rate of Amsler was significantly lower than that in the control group (P < 0.05). After treatment, the detachment height of microstructural parameters CMT, CV, and RPE in macular area of affected eye in both groups was significantly decreased compared with that before treatment (P < 0.05). The improvement was more significant in the treatment group (P< 0.05). After treatment, the area of fluorescent leakage and the area of choroidal dilatation vessels were significantly reduced in both groups compared with before treatment (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). Conclusion Qiju Dihuang Tablets combined with iodized lecithin has definite clinical effect in the treatment of central serous chorioretinopathy, and can safely and effectively improve the visual acuity of patients, reduce straight and curved vision,which further reduce fundus lesions.

R988.1

天津市眼科醫(yī)院科技基金資助項(xiàng)目（YKQN1907）