目的：观察益肾养肝明目方联合抗VEGF药物治疗湿性年龄相关性黄斑变性(wARMD)的临床疗效。

方法：选取2020-09/2022-11宁波市眼科医院收治的wARMD患者58例58眼，按照随机数字表法分为注射组(玻璃体腔注射康柏西普，29例29眼)和联合用药组(在注射组的基础上口服益肾养肝明目方，29例29眼)。观察两组患者治疗3mo后最佳矫正视力(BCVA)、中心凹厚度(CMT)及中医证候的改善情况，评估临床疗效。

结果：治疗3mo后，联合用药组总有效率(76%)高于注射组(66%)，两组BCVA均较治疗前改善(P<0.05)，CMT均较治疗前降低(P<0.05)，且联合用药组治疗前后CMT改善情况优于注射组(-155.93±143.79μm vs -95.36±56.81μm，P<0.05)。治疗3mo后，联合用药组各项中医证候均较治疗前显著好转(P<0.001)，注射组仅视物昏蒙较治疗前好转(P<0.05)，且联合用药组头晕失眠、腰膝酸软、倦怠乏力、目睛干涩、面白肢冷中医证候积分均显著低于注射组(P<0.001)。

结论：益肾养肝明目方联合玻璃体腔注射抗VEGF药物治疗wARMD疗效确切。

METHODS: A total of 58 patients(58 eyes)with wARMD who were treated in Ningbo Eye Hospital from September 2020 to November 2022 were collected. They were divided into two groups according to randomized digital table: 29 patients(29 eyes)for the combination group and the other 29 patients(29 eyes)for the injection group. The injection group was only given intravitreal injection of conbercept; the combination group was orally administrated with Yishen Yanggan Mingmu formula combined with intravitreal injection of conbercept. The best corrected visual acuity(BCVA), central macular thickness(CMT)and the improvement of traditional Chinese medicine(TCM)syndromes after 3mo of treatment were observed and the clinical efficacy was evaluated.

RESULTS: After 3mo of treatment, the total improved effective rate of the combination group(76%)was higher than the rate of the injection group(66%). After the treatment, the BCVA of the two groups was both higher than that before treatment(P<0.05), the CMT in both groups was lower than that before the treatment(P<0.05), and the improvement of CMT of the combination group was better than the injection group(-155.93±143.79μm vs. -95.36±56.81μm, P<0.05). After 3mo of treatment, each kinds of TCM syndrome in the combination group were significantly improved compared with those syndromes before the treatment(P<0.001). In the injection group, only blurred vision was improved(P<0.05). After the treatment, the scores of dizziness and insomnia, soreness and weakness of waist and knees, paleness and cold limbs, dry eyes and fatigue in the combination group were significantly lower than the injection group(P<0.001).

CONCLUSIONS: The Yishen Yanggan Mingmu formula combined with intravitreal anti-VEGF drug injection is effective in the treatment of wARMD.