目的:探讨活血化淤汤对超声乳化白内障吸除术后黄斑区的保护作用。方法:单纯年龄相关性白内障患者130例140眼分为A,B两组,A组80眼常规超声乳化吸除术;B组60眼行超声乳化吸除术后给予活血化瘀汤口服两个疗程,A,B两组分别于术前、术后1d;1,2,4,6,8wk及3mo观察最佳矫正视力、角膜及房水情况、黄斑中心凹视网膜厚度及黄斑区组织变化情况。结果:术后3mo,B组视力≥1.0的比例明显高于A组,差别有统计学意义。术后1wk,B组房水轻度闪辉比例明显低于A组,差别有统计学意义。术后1,2,4,6,8wk;3mo白内障超声乳化术后出现中心注视点厚度增加,A,B两组术后2～8wk与术前比较差异均有统计学意义;其中A组11眼(13.7%)出现术后黄斑水肿,均发生于术后2～6wk,包括9眼中心凹增厚及2眼黄斑囊样水肿,其中7眼3mo内水肿消失;B组2眼(3.3%)出现术后黄斑水肿,包括1眼中心凹增厚及1眼黄斑囊样水肿,发生于术后4～6wk,到术后3mo水肿消失。术后2～8wk,B组中心凹厚度低于A组,差异有统计学意义。结论:白内障超声乳化术后黄斑部呈现厚度增加的趋势,造成一定程度的视力下降,少数人会出现黄斑囊样水肿,术后口服中药活血化瘀汤后视力≥1.0的比例明显提高,黄斑中心凹的厚度及黄斑水肿的发生率大大降低,提示了活血化瘀汤对超声乳化白内障吸除术后黄斑区的保护作用。

·AIM:To investigate the protective effect of huoxuehuayu decoction on macula after phacoemulsification.METHODS:Simple age-related cataract patients(130 cases 140 eyes)were divided into A,B groups.The 80 eyes of A group were treated by conventional phacoemulsification;the patients(60 eyes)of B group were given huoxuehuayu decoction orally for two courses after phacoemulsification.Best-corrected visual acuity(BCVA),corneal and aqueous conditions,thickness of macular central fovea and changes of macular retinal tissue in A,B groups were observed before surgery,1 day;1 week,2,4,6,8 weeks and 3 months after surgery.RESULTS:Three months after surgery,the ratio of visual acuity ≥1.0 in group B was significantly higher than that of group A.One week after surgery the ratio of mild aqueous flare in group B was significantly lower than that of group A.The thickness of central fixation was significantly increased in both groups 1 week,2,4,6,8 weeks and 3 months after phacoemulsification;the difference between 2 to 8 weeks after surgery and pre-operation showed statistical significance in both groups.11 eyes in A group had macular edema during 2 to 6 weeks after surgery,including 9 eyes with fovea thickened and 2 eyes with cystoid macular edema,and seven eyes’ edema disappeared in 3 months.2 eyes in B group had macular edema,including 1 eye fovea thickened and 1 eye cystoid macular edema,during 4 to 6 weeks after surgery,and the two eyes’ edema disappeared 3 months after surgery.The fovea thickness in group B during 2 to 8 weeks after surgery was statistically lower than group A.CONCLUSION:Huoxuehuayu decoction orally has protective effect on macula after phacoemulsification.

R276.7

中国山东省中医药科技发展计划项目资助（No.2009177）