目的 探讨杞菊地黄片联合卵磷脂络合碘治疗中心性浆液性脉络膜视网膜病变的疗效。方法 选取2019年1月—2021年12月天津市宝坻区人民医院收治的82例中心性浆液性脉络膜视网膜病变患者，按照随机数字表法分为对照组和治疗组，每组各41例。对照组口服卵磷脂络合碘胶囊，2粒/次，3次/d。治疗组在对照组基础上口服杞菊地黄片，3片/次，3次/d。两组疗程均为8周。观察两组的临床疗效，比较治疗前后两组患眼最佳矫正视力（BCVA）、25项国立眼科研究所视功能问卷（NEI VFQ-25）总分及患眼Amsler表检查异常率、视网膜黄斑区微结构参数[黄斑中心凹厚度（CMT）、总黄斑容积（CV）、视网膜色素上皮（RPE）脱离高度]及患眼荧光渗漏面积和脉络膜扩张血管面积。结果 治疗后，治疗组总有效率为95.1%，显著高于对照组的80.5%（P＜0.05）。治疗后，两组BCVA和NEI VFQ-25总分均较治疗前显著提高，Amsler表检查异常率均显著降低（P＜0.05）；治疗后，治疗组BCVA和NEI VFQ-25总分均显著高于对照组，Amsler表检查异常率显著低于对照组（P＜0.05）。治疗后，两组患眼黄斑区微结构参数CMT、CV和RPE脱离高度均较治疗前显著减小（P＜0.05）；且以治疗组改善更显著（P＜0.05）。治疗后，两组患眼荧光渗漏面积和脉络膜扩张血管面积较治疗前均显著缩小（P＜0.05）；且以治疗组改善更显著（P＜0.05）。结论 杞菊地黄片联合卵磷脂络合碘对中心性浆液性脉络膜视网膜病变患者具有确切的临床疗效，可安全有效地改善患者视力，减轻视直如曲，并可进一步减轻眼底病变。

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

天津市眼科医院科技基金资助项目（YKQN1907）