中西医结合治疗Behcet综合征葡萄膜炎的临床观察

摘要

OBJECTIVE To investigate the changes of the central vision and macular thickness of patients with Behcet's uveitis treated by combination of Chinese and western medicine.METHODS Forty patients (66 eyes) with Behcet's uveitis were randomly divided into combined treatment group of 20 cases (34 eyes) and western medicine group (control group) of 20 cases (34 eyes).Patients in combined treatment group were treated by western medicine in addition to Chinese decoction by syndrome differentiation while subjects in the control group received routine western medicine alone.Observed variations of best corrected visual acuity (BCVA),anterior segment and fundus,central macular thickness(CMT) by OCT as well as adverse effects before treatment,one week,one month,3 months and 6 months after treatment.RESULTS The BCVA between two groups one week and one month after therapy showed no statistical difference (P＞0.05),but there were significant differences at three and six months after treatment (P＜0.05).Specifically,BCVA increased at the two time-points.The central macular thickness (CMT) values at one week and one month after treatment were of no significant difference (P＞0.05).There were significant differences at three months and six months after treatment between two groups (P＜0.05),and the CMT values in combined treatment group were lower than the western medicine group.Side effects as hypokalemia,gastrointestinal tract reactions and liver impairment in Chinese and western medicine treatment group were obviously less than those in western medicine group.CONCLUSIONS The combined treatment of Chinese and western medicine was more effective than western medicine alone.Moreover,it reduced the side effect of drugs.%目的 观察中西医方法治疗白塞综合征葡萄膜炎患者的中心视力及黄斑厚度变化.方法 选择2014年1月至2015年12月在我院治疗的Behcet综合征葡萄膜炎40例(66眼),随机分为中西医治疗组20例(34眼),西医治疗组20例(32眼).中西医治疗组,在常规西医治疗方案基础上,辨证分型论治加服中药汤剂;西医治疗组,常规西医治疗.观察治疗前,治疗后1周、1个月、3个月、6个月的最佳矫正视力(BCVA)、眼前节及眼底、光学相干断层扫瞄(OCT)测定黄斑中心视网膜厚度(central macular thickness,CMT)等结果变化;并进行药物副作用观察.结果 治疗后1周及1个月比较,两组最佳矫正视力(BCVA)的差异无统计学意义(P＞0.05),治疗后3个月及6个月的差异有统计学意义(P＜0.05),治疗后3个月及6个月有所提高;两组CMT值比较,在治疗1周、1个月时差异无统计学意义(P＞0.05),治疗后3个月及6个月差异有统计学意义(P＜0.05),治疗后3个月及6个月两组CMT值有所下降,中西医治疗组CMT低于西医组.中西医组治疗中出现低钾、胃肠道反应、肝功能损害等副作用少于西医组.结论 应用中西医结合治疗Behcet综合征葡萄膜炎比单纯西医治疗效果好,并能减轻全身药物应用的副作用.