五苓散加味治疗糖尿病黄斑水肿的临床观察
|
摘要
目的：探讨五苓散加味治疗糖尿病黄斑水肿的临床疗效
方法：将我院眼科门诊2009年7月1日～2009年12月30日收治的糖尿病黄斑水肿的病例共17例32只眼,随机分为单纯中药组(A组10例19只眼),球周注射TA组(B组7例13只眼)。两组患者中若有激光治疗适应症者,激光光凝术后一周随机纳入A、B组。A、B两组均观察一个月。疗效评价指标：采用视力(BCVA)和经第4代OCT测量的四项指标：黄斑中心区直径lmm范围的厚度(Central Subfield Thickness, CST)、黄斑中心区直径6mm的平均厚度(Average Thickness)、黄斑水肿区的最高厚度和黄斑中心区直径6mm的总体积(Volume)四项指标,并观察治疗后可能出现的并发症。
结果：两组的BCVA、CST、平均厚度、黄斑水肿区的最高厚度和黄斑区总体积均较治疗前有显著统计学差异(P<0.05)。而两组疗效差别无显著统计学差异(P>0.05)。两组无一例出现不良反应。
结论：五苓散加味治疗DME短期内有一定疗效,但长期疗效尚待观察。中药治疗与球周注射TA治疗DME,短期观察二者疗效无统计学上的差别
Objective:To investigate the clinical efficacy of Wuling Powder Modified on the treatment of diabetic macular edema.
Methods:Between July 1,2009～December 30,2009,32 eyes of 17 patients were admitted to cases of diabetic macular edema in our eye clinic of Dongfang Hospital. They were randomly divided into Chinese Medicine Croup (A group of 10 cases of 19 eyes) and peribulbar injection of Triamcinolone acetonide (TA) group (B group of seven cases of 13 eyes). If any patient in two groups needs laser treatment on DR, after one week after laser photocoagulation, he may be admitted into the observation group. Both groups were observed for one month. Efficancy evaluation:best corrected visual acuity (BCVA) and the following four indicators measured by the Cirrus HD-OCT:Central Subfield Thickness (CST),Average thickness, the maximum thickness of macular edema and the volume of macular area,which diameter range of 6mm. Besides, the complications were evaluated after treatment.
Results:Both oftwo groups'BCVA, CST, average thickness, maximum thickness of macular edema and volume show a significant statistical difference than those before treatment (P<0.05). Efficacy difference between two groups shows no significant statistical difference (P> 0.05). None of the two groups'elevation of intraocular pressure and other complications occurred.
Conclusion:The treatment of Wuling Powder Modified on the DME is valid after short-term observation. Still the long-term efficancy remains to be seen. Efficacy shows no statistical difference after the short-term observation, compared with the treatment of TA on DME through peribulbar injection.
方法：将我院眼科门诊2009年7月1日～2009年12月30日收治的糖尿病黄斑水肿的病例共17例32只眼,随机分为单纯中药组(A组10例19只眼),球周注射TA组(B组7例13只眼)。两组患者中若有激光治疗适应症者,激光光凝术后一周随机纳入A、B组。A、B两组均观察一个月。疗效评价指标：采用视力(BCVA)和经第4代OCT测量的四项指标：黄斑中心区直径lmm范围的厚度(Central Subfield Thickness, CST)、黄斑中心区直径6mm的平均厚度(Average Thickness)、黄斑水肿区的最高厚度和黄斑中心区直径6mm的总体积(Volume)四项指标,并观察治疗后可能出现的并发症。
结果：两组的BCVA、CST、平均厚度、黄斑水肿区的最高厚度和黄斑区总体积均较治疗前有显著统计学差异(P<0.05)。而两组疗效差别无显著统计学差异(P>0.05)。两组无一例出现不良反应。
结论：五苓散加味治疗DME短期内有一定疗效,但长期疗效尚待观察。中药治疗与球周注射TA治疗DME,短期观察二者疗效无统计学上的差别
Objective:To investigate the clinical efficacy of Wuling Powder Modified on the treatment of diabetic macular edema.
Methods:Between July 1,2009～December 30,2009,32 eyes of 17 patients were admitted to cases of diabetic macular edema in our eye clinic of Dongfang Hospital. They were randomly divided into Chinese Medicine Croup (A group of 10 cases of 19 eyes) and peribulbar injection of Triamcinolone acetonide (TA) group (B group of seven cases of 13 eyes). If any patient in two groups needs laser treatment on DR, after one week after laser photocoagulation, he may be admitted into the observation group. Both groups were observed for one month. Efficancy evaluation:best corrected visual acuity (BCVA) and the following four indicators measured by the Cirrus HD-OCT:Central Subfield Thickness (CST),Average thickness, the maximum thickness of macular edema and the volume of macular area,which diameter range of 6mm. Besides, the complications were evaluated after treatment.
Results:Both oftwo groups'BCVA, CST, average thickness, maximum thickness of macular edema and volume show a significant statistical difference than those before treatment (P<0.05). Efficacy difference between two groups shows no significant statistical difference (P> 0.05). None of the two groups'elevation of intraocular pressure and other complications occurred.
Conclusion:The treatment of Wuling Powder Modified on the DME is valid after short-term observation. Still the long-term efficancy remains to be seen. Efficacy shows no statistical difference after the short-term observation, compared with the treatment of TA on DME through peribulbar injection.
引文
1. Akduman L, Olk RJ, Laser Photocoagulation of diabetic macular edema[J]. Ophthalmic Surg Lasers,1997. May:28 (5):387-408
2.黄叔任,张晓峰,眼底病诊断与治疗[M].北京：人民卫生出版社,2008：287
3. Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy. Early Treatment Diabetic Retinopathy Study number 1 [J].Arch Ophthalmol.1985. Dec:103(12):1796-806
4.翟明,苏冠方,刘早霞等.糖尿病性视网膜病变黄斑水肿的临床分析[J].吉林医学,2006,27(8)：864-865
5.刘丽英,董方田,李蕙.糖尿病黄斑水肿类型与相关因素[J].中国医学科学院学报,2007,29(6)：797-802
6. Goebel W, Kretzchmar-Gross T. Retinal thickness in diabetic retinopathy:a study using optical coherence tomography (OCT) [J]. Retina,2002; 22(6):759
7.Massin P, Vicaut E, Haouchine B, et al. Reproducibility of retinal mapping using optical coherence tomography [J]. Arch Ophthalmol,2001; 119:1135
8. Klein R, Klein BE, Moss SE, et al. The Wisconsin epidemiologic study of diabetic retinopathy. The long-term incidence of macular edema [J]. Ophthalmology,1995,10 (1):7-16
9. Hee MR, CA Puliafito, C wong, et al, Quantitative assessment of macular edema with optical coherence tomography[J]. Arch Ophthalmol, 1995.113(8):1019-1029
10. Browning DJ, MD McOwen, RM Bowen, Jr, et al, Comparison of the diabetic macular edema with diagnosis by Optical coherence tomogarphy[J]. Ophthalmology,2004.111(4):712-715
11. Goebel W, and T Krelzchmar-Gross, Retinal thickness in diabetic retinopathy:a study using optical coherence tomography (OCT)[J]. Retina,2002.22(6):759-767
12. Sehuadig UF, Scholz RC, lerche, et al. [Optical coherence tomography for macular edema. Classification, quantitative assessment, and rational usage in the clinical practice] [J]. Ophthalmology,2004.101 (8):785-793
13. Klein R, SE Moss, BE Klein, et al. The Wisconsin epidemiologic study of diabetic retinopathy. XI. The incidence of macular edema[J]. Ophthalmology,1989.96(10):1501-1510
14.Song E, Yang W, Cui ZH,et al., Effects of high-concentration insulin on expression of vascular endothelial growth factor in cultured Muller cells vitro[J]. Intern J Ophthalmol,2004,4:202-205
15.Knudsen ST, T Bek, PL Poulscn, et al., Macular edema reflects generalized vascular hyperpermeabiltiy in type 2 diabetic Patients with retinopathy[J]. Diabetes care,2002.25(12):2328-2334
16.Akduman L,01k RJ. Laser photocoagulation of diabetic macular edema[J]. Ophthalm ol Surg Lasers 1997; 28:387-408
17.The effect of intensive diabetes treatment on the Progression of diabetic retinopathy in insulin—dependent diabetes mellitus. The diabetes control and complications trial[J]. Arch Ophthalmology, 1995.113(1):36-51
18.Wada H, Mori Y, Shimura M. et al., Poor outcome in disseminated intravascular coagulation or thrombotic thrombocytopenic purpura patients with severe vascular endothelial cell injuries[J]. Am JHematol,1998,58:189-194
19.Nasrallah FP, AE Jalkh, F Van Coppenolle, et al.,The role of the vitreous in diabetic macular edema[J]. Ophtholmology,1988.95(10):1335-1339
20.戴虹,李永,龙力等.糖尿病性黄斑水肿眼玻璃体状况的观察[J].中华眼底病杂志,2003,19(6).341-343
21.李双龙.糖尿病黄斑水肿相关因素分析[J].国外医学眼科学分册,2003,27(2)：114-117
22. Gass JDM. Current concepts concerning cystoid macular edema.In Franklin RM. Retina and vitreous[M]. Amsterdam:Kugler,1993.295-297
23. Sander B, Larsen M,Moldow B, et al. Diabetic macular edema:passive and active transport of fluorescein through the blood-retina barrier[J]. Invest Ophthalmol Vis Sci,2001,42 (2):433-438
24. Gass JDM. Pathophysiologic and histopathologic bases for interpretation of fluorescein angiography. In:JDM. Stereoscopic atlas of macular diseases:diagnosis andtreatment[M].4th ed. Stlouis.Mo:Mo shy-year Book Inc,1997.40-41
25. CharalamPous FC. Metabolic functions of myo-inositol. IX. Role of Intracellular K+and Na Plus-and K Plus-activated adenosine triphosphatase in the transport of alpha-aminoisobutyric acid. J Biol Chem.1971 Jan 25:246 (2):461-465
26. Yanoff M. Diabetic retinopathy. N Engl J Med.1966 Jun 16; 274(24):1344-1349
27.Cunha-Vaz JG. Pathophysiology of diabetic retinopathy. Br J OPhthalmol.1978 Jun,62(6):351-355
28. Antonetti DA, Barber AJ, Khin S, et al. Diabetes,1998,47:1953-1959 29. Barber AJ, Antonetti DA, Gardner TW. Invest Ophthalmol VisSci,2000, 41:3561-3568
30. Vinores SA, Derevjanik NL, Mahlow J, et al. Pathol Res Pract,1998,194: 497-505
31. Antcilff RJ, Marshall J, The pathogenesis of edema in diabetic maculopathy[J]. Semin Ophthalmol,1999,14:223-232
32.Antonetti DA, Barber AJ, Hollinger LA, et al. J Biol Chem,1999,274: 2346-2347
33. Hofman P, Blaauwgeers HG, Tolentino MJ, et al. Curr Eye Res,2000,21: 637-645
34. Feng Y, Venema VJ, Venema RC, et al. Invest Ophthalmol VisSci,1999, 40:157-167
35. Aiello LP, Bursell SE, Clermont A, et al. Diabetes,1997,46:1473-1480
36. Funatsu H, Yamashita H,Sakata K, et al.Vitreous levels of vascular endothelial growth factor and intercellular adhesion molecule 1 are related to diabetic macular edema [J]. Ophthalmol,2005,112(5),806-816
37. Shimizu E, Funatsu H, Yamashita H. Jpn J Ophthalmol,2002,46:78-83
38. Barouch FC, Miyamoto K, Allport JR, et al. Invest Ophthalmol Vis Sci, 2000,41:1153-1158
39. Shestakova MV, Kochemasova TV, Gorelysheva VA. Ter Arkh,2002,74: 24-27
40. Joussen AM, Murata T, Tsujikawa A, et al. Am J Pathol,2001,158:147-152
41. Miyamoto K, Khosrof S, Bursell SE, et al. Proc Natl Acad Sci U SA, 1999,96:10836-0841
42. Joussen AM, Poulaki V, Mitsiades N. FASEB J,2002,16:438-440
43. Cosentino F, Eto M, De Paolis P, et al. Circulation,2003, 107:1017-1023
44. Liu XH, Kirschenbaum A, Yao S, et al. Clin Exp Metastasis,1999,17: 687-694
45. Sakurai S, Alam S, Pagan-Mercado, et al. Invest Ophthalmol Vis Sci, 2002,43:2774-2781
46.张福燕,李志敏,李建阳等.OCT定性定量糖尿病黄斑水肿[J].第三军医大学学报,2007,29(8),690-694
47.王海欣,张卯年.糖尿病黄斑水肿的早期诊断和治疗[J].国外医学眼科学分册.2005,Dec.29(6).416-422
48. Stefansson E. The therapeutic effects of retinal laser treatment and vitrectomy A theroy based on oxygen and vascular phisiology[J]. Acta Olphthamol Scand,2001:79,435-440
49. Richardson PRS, Boulton ME, Young JD,et al. Immunocytochemical study of retinal diode laser photocoagulation in the rat [J]. Br J Ophthalmol, 1996,80:1092-1098
50. Khairallah M, Brahim R, Allagui M, et al. Comparative effects of argon green and kryton red laser photocoagulation for patientswith diabetic exudative maculopathy [J]. Br J Ophthalmol,1996,80:319-322 51. Ulbig MW, McHugh DA, Hamilton AMP. Diode laser photocoagulation diabetic macular edema[J].Br J Ophthalmol,1995,79:318-321
52.黎晓新,廖菊生.眼底病激光治疗指南[M].北京：人民卫生出版社,2009：17-19
53. Blankenship GW. Diabetic macular edema argon laser photocoagulation: A prospective random study. Ophthalmol,1979,86:69
54.Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy [J]. Ophthalmology,1991,98:766-785
55.01k RJ. Argon green (514nm) versus krypton red (647nm) modified grid laser photocoagulation for diffuse diabetic macular edema. Ophthalmology,1990,97:1101-1113
56.郭彤,张惠蓉.氩激光和氪激光治疗糖尿病性黄斑水肿疗效的比较[J].中国实用眼科杂志,2006,Feb.24(2).142-144
57. Kishi S, Kamei Y, Shimizu K. Tractional elevation of Henle's fiber layer in idiopathic macular holes. Am J Ophthalmol,1995,120:486-496
58. Lewis H, Abrams GW, Blumenkranz MS,et al. Vitrectomy for diabetic macular traction and edema associated with posterior hyaloidal traction. Ophthalmology,1992,99:753-759
59.Harbour JW, Smiddy WE, Flynn HW Jr, et al. Vitrectomy for diabetic macular edema associated with a thickened and taut posterior hyaloid membrane. Am J Ophthalmol,1996,121:405-413
60. Yamamoto T, Akabane N, Takeuchi S. Am J Ophthalmol,2001,132:369-377
61.Otani T, Kishi S. Am J Ophthalmol,2002,134:214-219
62.Tachi N,Ogino N. Vitrectomy for diffuse macular edema in cases of diabetic retinopathy. Am J Ophthalmol,1996,122:258-260
63. Gandorfer A,Messmer EM, Ulbig MW, et al. Resolution of diabetic macular edema after surgical removal of the posterior hyaloid and the inner limiting membrane. Retina,2000,20:126-133
64.Yang CM.Surgical treatment for severe diabetic macular edema with massive hard exudates. Retina,2000,20:121-125
65.Capone A Jr, Panozzo G. Semin Ophthalmol,2000,15:78-80
66.Sato Y, Lee Z, Shimade H. Jpn J Ophthalmol,2002,46:315-322
67.Hikichi T, Fujio N, Akiba J, et al. Ophthalmology,1997,104:473-478
68.La Heij EC, Hendrikse F, KesselsAG. GraefesArch Clin Exp Ophthalmol, 2001,239:264-270
69. Kadonosono K, Itoh N, Ohno S. Am J Ophthalmol,2000,130:740-744
70.Micelli Ferrari T, Cardascia N, Durante G, et al. Pars plana vitrectomy in diabetic macular edema. Doc Ophthalmol,1999,97:471-474.
71.姚毅,姜荔,陈伟民.糖尿病黄斑水肿的治疗进展[J].中华眼底病杂志,2003,19(3),198-200
72.齐慧君,黎晓新,钱彤等.曲安奈德玻璃体腔注射治疗视网膜静脉阻塞和糖尿病视网膜病变继发黄斑水肿分析[J].中国实用眼科杂志,2009,27(9),927-930
73.Parfitt K.Martin dale the complete drug reference 32nded[M]. London:The Pharmaceutical Press,1999,1050-1051
74. Jonas JB, Kreissig I, Sefker A. Intravitreal injection of triamcinolone for diffuse diabetic macular edema[J]. Arch Ophthalmol,2003,121:57-61
75.Massin P,Audren F, Haouchine B,etal. Intravitreal triamcinolone actonide for diabetic diffuse macular edema:preliminary results of a prospective controlled trial[J]. Ophthalmology,2004,111 (2):218-224
76. Kato A, Kimura H, Okabe K, et al. Feasibility of drug delivery to the posterior pole of the rabbit eye with an episcleral implant [J]. Invest Ophthalmol Vis Sci,2004,45 (1):238-244
77. McNeela BJ, Kumar CM. Sub-Tenon's block with an ultrashort cannula [J]. J Cataract Refract Surg,2004,30(4):858-86
78. Yoshinaga T. Posterior Sub-Tenon's Triamcinolone Acetonide for Refractory Diabetic Macular Edema[J]. Br J Ophthalmol,2004,88 (9):1131-1136
79. Bakri SJ,Kaiser PK. Posterior subtenon triamcinolone acetonide for refactory diabetic macular edema. Ophthalmol,2005,139 (2),290-294
80. KogaT, MawatariY, Inumaru J, et al. Trans-Tenon's retrobulbar triamcinolone acetonide infusion for refractory diabeticmacular edema after vitrectomy. Graefe s Arch Clin Exp Ophthalmol2005; 243(12):1247-1252
81.ChotYJ, Oh IK, Oh JR, et al. Intravitreal versus posterior subtenon injection of triamcinolone acetonide fordiabeticmacularedema. Korean J Ophthalmol2006; 20(4):205-209
82. Jaissle GB, Szurman P, Bartz-Schmidt KU. Ocular side effects and complication sofintravitreal triamcinolone acetonide injection. Ophthalmology,2004,101:121-128
83.Mordenti J, Thomsen K, Licko V, et a.1 Intraocular pharmacokinetics intravitreal administration of a solution or a PLGA microsphere formulation[J]. ToxicolSc, i 1999,52:101-106
84. Shahar JS, Avry RL, Heilweil G, et a.l Electrophysiologic and retinal penetration studies following intravitreal injection of bevacizumab[J]. Retina,2006,26:262-269
85. Avery RL, Pieramici DJ, Rabena MD, et a.l Intravitreal bevacizumab(Avastin) for neovascular age-related macular degenerat ion [J]. Ophthalmology,2006,113:363-372
86. Rosenfeld PJ, Fung AE, Puliafito CA. Optical coherence tomography findings after an intravitreal injection of bevacizumab (Avastin) for macular edema from central retinal vein occlusion[J]. Ophthalmic SurgLasers Imag,2005,36:336-339
87. SakaguchiH, Gomi F, KameiM, et a.l Complications in patients after intravitreal injection ofbevacizumab[J]. Acta Ophthalmol Scand, 2007,85:784-788
88. Brunet J,Farine JC, GarayRP, et a.l Angioprotective action of calcium dobesilate against reactive oxygen species-induced capillary permeability in the rat[J]. Eur J Pharmacol,1998,358(3):213-220
89. Brunet J, Farine JC, Garay RP, et a.l In vitro antioxidant properties of calcium dobesilate [J]. Fundam Clin Pharmacol,1998,12(2):205-212
90.郭向阳,黄洲基,朱志刚.羟苯磺酸钙治疗糖尿病视网膜黄斑水肿观察[J].Journal of Medical Forum,2007,Aug,28 (16):67-69
91. Campochiaro PA, The C99-PKC412-003 Study Group. Reduction of diabetic macular edema by oral administration of the kinase inhibitor PKC412. Invest Ophthalmol Vis Sci,2004,45:922-931
1.刘路宏,吴学今,李敏等.激光联合中药治疗糖尿病黄斑水肿的临床观察[J].广西医学,2008,30(3),313-315
2.周绿绿,李晟,汪辉等.中药联合光凝治疗黄斑水肿的疗效观察[J].中国实用眼科杂志,2006,24(12),1295-1297
3.金兰,朱江.中药联合多波长激光治疗糖尿病性黄斑水肿的临床观察[J].国际眼科杂志,2008,8(6),1262-1263
4.魏春惠.黄斑水肿的中西医治疗[J].江苏中医药,2007,39(4),5-6
5.王燕,余杨桂,李志英等.中药联合激光光凝治疗糖尿病视网膜病变黄斑水肿[J].中国中医眼科杂志,1998,8(2),80-83
6.梁俊芳,孙景莹,纪丽君.活血利水法联合倍频固体激光治疗糖尿病弥漫性黄斑水肿的临床观察[J].中国中医眼科杂志,2008,18(2),70-72
7.高波.中西医结合治疗糖尿病视网膜病变黄斑水肿32例[J].现代中西医结合杂志,2004,13(10),1344
8.贾万程,侯俭,崔凡明等.糖尿病性黄斑水肿的分型及中药治疗[J].中国中医眼科杂志,1999,9(4),212-214
9.张莉,汪雪梅.光光凝联合中药治疗糖尿病黄斑水肿26例[J].河北中医,2009,31(2),267-268
10.李国建,尹瑞生,任崇禧等.贞莲明目胶囊治疗糖尿病视网膜黄斑水肿55例临床观察[J].光明中医,2007,22(7),39-42
11.喻青,李志敏,陈玲玲.糖明汤配合氪黄激光治疗糖尿病性黄斑水肿30例[J]. 陕西中医,2008 29(10),1346-1347
12.詹育和,王学锋.中药对糖尿病性黄斑水肿治疗作用的观察[J].中医药临床杂志,2008,20(1),45-46
13.刘玲.糖尿病性黄斑病变辨治体会[J].山东中医药大学学报,1999,23(1)：52-53
14.陈宝军,卢仙月.糖尿病黄斑水肿130例中医治疗体会[J].中国中医急症,2006,15(6),664-665
15.刘立杰,刘立伟,王勇.激光光凝联合卵磷脂络合碘及中药治疗糖尿病性黄斑肿的疗效观察[J].国际眼科杂志,2008,8(4),820-821
16.徐新荣,魏伟,章淑华等.光凝结合中药治疗糖尿病性黄斑水肿的临床研究[J].南京中医药大学学报,2003,19(6),336-338
1.周绿绿,李晟,汪辉等.中药联合光凝治疗黄斑水肿的疗效观察[J].中国实用眼科杂志,2006,24(12),1295-1297
2. Savaga H. Safety and efficacy of intriavitreal triamcinolone[J].Arch Ophthalmol,2004,122:1083-1085
3. Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy. Early Treatment Diabetic Retinopathy Study number 1 [J].Arch Ophthalmol.1985. Dec:103 (12):1796-806
4.黄叔任,张晓峰,眼底病诊断与治疗[M].北京：人民卫生出版社,2008：287
5.金兰,朱江.中药联合多波长激光治疗糖尿病性黄斑水肿的临床观察[J].国际眼科杂志,2008,8(6),1262-1263
6. Jonas JB, Sofker A. Intraocular injection of crystalline cortisone as adjunctive treatment of diabet ic macular edema [J]. Am J Ophthalmol, 2001,132(3):425-427.
7. Macky TA, Helmy D, El Shazly N. Retinal toxicity of triamcinoloe' s vehicle(benzyl alcohol) an electrophysiologic and electron microscopic study. Graefes Arch Clin Exp Ophthalmol,2007,245:817-824
8.毕颖文,徐格致.球周注药对视网膜毒性的实验研究.眼科研究.2006,24：65-68
9. Mizuno S, Nishiwaki A, Morita FL, et al. Effects of periocular administration of triamcinolone acetonide on leukocyte-endothelium interactions in the ischemic retina [J]. Invest Ophthalmol Vis Sci, 2007,48(6):2831-2836
10.陈乔,杨红,陈建斌.球周注射大剂量曲安奈德后眼内药物浓度与安全性实验[J].医药导报,2007,26(7)：713-716
11.Ken HM D, Hideyukuih. Intravitreal versus retrobulbar injections of triamcinolone formacular edema associatedwith branch retinal vein occlusion[J]. Am J Ophthalmol,2005,139(6):972-982.
12. MICHAEL R, SUSAN S L, HYUNCHEOL K, et al.A rabbit model for assessing the ocular barriers to the transscleral delivery of triamcinolone acetonide [J]. Exp Eye Res,2006,82(3):479-487.
13.刘豫,许雪亮,唐仁泓等.曲安奈德球周注射联合激光光凝治疗糖尿病视网膜病变黄斑水肿[J].中华眼底病杂志,1009,25(4),306-307
2.黄叔任,张晓峰,眼底病诊断与治疗[M].北京：人民卫生出版社,2008：287
3. Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy. Early Treatment Diabetic Retinopathy Study number 1 [J].Arch Ophthalmol.1985. Dec:103(12):1796-806
4.翟明,苏冠方,刘早霞等.糖尿病性视网膜病变黄斑水肿的临床分析[J].吉林医学,2006,27(8)：864-865
5.刘丽英,董方田,李蕙.糖尿病黄斑水肿类型与相关因素[J].中国医学科学院学报,2007,29(6)：797-802
6. Goebel W, Kretzchmar-Gross T. Retinal thickness in diabetic retinopathy:a study using optical coherence tomography (OCT) [J]. Retina,2002; 22(6):759
7.Massin P, Vicaut E, Haouchine B, et al. Reproducibility of retinal mapping using optical coherence tomography [J]. Arch Ophthalmol,2001; 119:1135
8. Klein R, Klein BE, Moss SE, et al. The Wisconsin epidemiologic study of diabetic retinopathy. The long-term incidence of macular edema [J]. Ophthalmology,1995,10 (1):7-16
9. Hee MR, CA Puliafito, C wong, et al, Quantitative assessment of macular edema with optical coherence tomography[J]. Arch Ophthalmol, 1995.113(8):1019-1029
10. Browning DJ, MD McOwen, RM Bowen, Jr, et al, Comparison of the diabetic macular edema with diagnosis by Optical coherence tomogarphy[J]. Ophthalmology,2004.111(4):712-715
11. Goebel W, and T Krelzchmar-Gross, Retinal thickness in diabetic retinopathy:a study using optical coherence tomography (OCT)[J]. Retina,2002.22(6):759-767
12. Sehuadig UF, Scholz RC, lerche, et al. [Optical coherence tomography for macular edema. Classification, quantitative assessment, and rational usage in the clinical practice] [J]. Ophthalmology,2004.101 (8):785-793
13. Klein R, SE Moss, BE Klein, et al. The Wisconsin epidemiologic study of diabetic retinopathy. XI. The incidence of macular edema[J]. Ophthalmology,1989.96(10):1501-1510
14.Song E, Yang W, Cui ZH,et al., Effects of high-concentration insulin on expression of vascular endothelial growth factor in cultured Muller cells vitro[J]. Intern J Ophthalmol,2004,4:202-205
15.Knudsen ST, T Bek, PL Poulscn, et al., Macular edema reflects generalized vascular hyperpermeabiltiy in type 2 diabetic Patients with retinopathy[J]. Diabetes care,2002.25(12):2328-2334
16.Akduman L,01k RJ. Laser photocoagulation of diabetic macular edema[J]. Ophthalm ol Surg Lasers 1997; 28:387-408
17.The effect of intensive diabetes treatment on the Progression of diabetic retinopathy in insulin—dependent diabetes mellitus. The diabetes control and complications trial[J]. Arch Ophthalmology, 1995.113(1):36-51
18.Wada H, Mori Y, Shimura M. et al., Poor outcome in disseminated intravascular coagulation or thrombotic thrombocytopenic purpura patients with severe vascular endothelial cell injuries[J]. Am JHematol,1998,58:189-194
19.Nasrallah FP, AE Jalkh, F Van Coppenolle, et al.,The role of the vitreous in diabetic macular edema[J]. Ophtholmology,1988.95(10):1335-1339
20.戴虹,李永,龙力等.糖尿病性黄斑水肿眼玻璃体状况的观察[J].中华眼底病杂志,2003,19(6).341-343
21.李双龙.糖尿病黄斑水肿相关因素分析[J].国外医学眼科学分册,2003,27(2)：114-117
22. Gass JDM. Current concepts concerning cystoid macular edema.In Franklin RM. Retina and vitreous[M]. Amsterdam:Kugler,1993.295-297
23. Sander B, Larsen M,Moldow B, et al. Diabetic macular edema:passive and active transport of fluorescein through the blood-retina barrier[J]. Invest Ophthalmol Vis Sci,2001,42 (2):433-438
24. Gass JDM. Pathophysiologic and histopathologic bases for interpretation of fluorescein angiography. In:JDM. Stereoscopic atlas of macular diseases:diagnosis andtreatment[M].4th ed. Stlouis.Mo:Mo shy-year Book Inc,1997.40-41
25. CharalamPous FC. Metabolic functions of myo-inositol. IX. Role of Intracellular K+and Na Plus-and K Plus-activated adenosine triphosphatase in the transport of alpha-aminoisobutyric acid. J Biol Chem.1971 Jan 25:246 (2):461-465
26. Yanoff M. Diabetic retinopathy. N Engl J Med.1966 Jun 16; 274(24):1344-1349
27.Cunha-Vaz JG. Pathophysiology of diabetic retinopathy. Br J OPhthalmol.1978 Jun,62(6):351-355
28. Antonetti DA, Barber AJ, Khin S, et al. Diabetes,1998,47:1953-1959 29. Barber AJ, Antonetti DA, Gardner TW. Invest Ophthalmol VisSci,2000, 41:3561-3568
30. Vinores SA, Derevjanik NL, Mahlow J, et al. Pathol Res Pract,1998,194: 497-505
31. Antcilff RJ, Marshall J, The pathogenesis of edema in diabetic maculopathy[J]. Semin Ophthalmol,1999,14:223-232
32.Antonetti DA, Barber AJ, Hollinger LA, et al. J Biol Chem,1999,274: 2346-2347
33. Hofman P, Blaauwgeers HG, Tolentino MJ, et al. Curr Eye Res,2000,21: 637-645
34. Feng Y, Venema VJ, Venema RC, et al. Invest Ophthalmol VisSci,1999, 40:157-167
35. Aiello LP, Bursell SE, Clermont A, et al. Diabetes,1997,46:1473-1480
36. Funatsu H, Yamashita H,Sakata K, et al.Vitreous levels of vascular endothelial growth factor and intercellular adhesion molecule 1 are related to diabetic macular edema [J]. Ophthalmol,2005,112(5),806-816
37. Shimizu E, Funatsu H, Yamashita H. Jpn J Ophthalmol,2002,46:78-83
38. Barouch FC, Miyamoto K, Allport JR, et al. Invest Ophthalmol Vis Sci, 2000,41:1153-1158
39. Shestakova MV, Kochemasova TV, Gorelysheva VA. Ter Arkh,2002,74: 24-27
40. Joussen AM, Murata T, Tsujikawa A, et al. Am J Pathol,2001,158:147-152
41. Miyamoto K, Khosrof S, Bursell SE, et al. Proc Natl Acad Sci U SA, 1999,96:10836-0841
42. Joussen AM, Poulaki V, Mitsiades N. FASEB J,2002,16:438-440
43. Cosentino F, Eto M, De Paolis P, et al. Circulation,2003, 107:1017-1023
44. Liu XH, Kirschenbaum A, Yao S, et al. Clin Exp Metastasis,1999,17: 687-694
45. Sakurai S, Alam S, Pagan-Mercado, et al. Invest Ophthalmol Vis Sci, 2002,43:2774-2781
46.张福燕,李志敏,李建阳等.OCT定性定量糖尿病黄斑水肿[J].第三军医大学学报,2007,29(8),690-694
47.王海欣,张卯年.糖尿病黄斑水肿的早期诊断和治疗[J].国外医学眼科学分册.2005,Dec.29(6).416-422
48. Stefansson E. The therapeutic effects of retinal laser treatment and vitrectomy A theroy based on oxygen and vascular phisiology[J]. Acta Olphthamol Scand,2001:79,435-440
49. Richardson PRS, Boulton ME, Young JD,et al. Immunocytochemical study of retinal diode laser photocoagulation in the rat [J]. Br J Ophthalmol, 1996,80:1092-1098
50. Khairallah M, Brahim R, Allagui M, et al. Comparative effects of argon green and kryton red laser photocoagulation for patientswith diabetic exudative maculopathy [J]. Br J Ophthalmol,1996,80:319-322 51. Ulbig MW, McHugh DA, Hamilton AMP. Diode laser photocoagulation diabetic macular edema[J].Br J Ophthalmol,1995,79:318-321
52.黎晓新,廖菊生.眼底病激光治疗指南[M].北京：人民卫生出版社,2009：17-19
53. Blankenship GW. Diabetic macular edema argon laser photocoagulation: A prospective random study. Ophthalmol,1979,86:69
54.Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy [J]. Ophthalmology,1991,98:766-785
55.01k RJ. Argon green (514nm) versus krypton red (647nm) modified grid laser photocoagulation for diffuse diabetic macular edema. Ophthalmology,1990,97:1101-1113
56.郭彤,张惠蓉.氩激光和氪激光治疗糖尿病性黄斑水肿疗效的比较[J].中国实用眼科杂志,2006,Feb.24(2).142-144
57. Kishi S, Kamei Y, Shimizu K. Tractional elevation of Henle's fiber layer in idiopathic macular holes. Am J Ophthalmol,1995,120:486-496
58. Lewis H, Abrams GW, Blumenkranz MS,et al. Vitrectomy for diabetic macular traction and edema associated with posterior hyaloidal traction. Ophthalmology,1992,99:753-759
59.Harbour JW, Smiddy WE, Flynn HW Jr, et al. Vitrectomy for diabetic macular edema associated with a thickened and taut posterior hyaloid membrane. Am J Ophthalmol,1996,121:405-413
60. Yamamoto T, Akabane N, Takeuchi S. Am J Ophthalmol,2001,132:369-377
61.Otani T, Kishi S. Am J Ophthalmol,2002,134:214-219
62.Tachi N,Ogino N. Vitrectomy for diffuse macular edema in cases of diabetic retinopathy. Am J Ophthalmol,1996,122:258-260
63. Gandorfer A,Messmer EM, Ulbig MW, et al. Resolution of diabetic macular edema after surgical removal of the posterior hyaloid and the inner limiting membrane. Retina,2000,20:126-133
64.Yang CM.Surgical treatment for severe diabetic macular edema with massive hard exudates. Retina,2000,20:121-125
65.Capone A Jr, Panozzo G. Semin Ophthalmol,2000,15:78-80
66.Sato Y, Lee Z, Shimade H. Jpn J Ophthalmol,2002,46:315-322
67.Hikichi T, Fujio N, Akiba J, et al. Ophthalmology,1997,104:473-478
68.La Heij EC, Hendrikse F, KesselsAG. GraefesArch Clin Exp Ophthalmol, 2001,239:264-270
69. Kadonosono K, Itoh N, Ohno S. Am J Ophthalmol,2000,130:740-744
70.Micelli Ferrari T, Cardascia N, Durante G, et al. Pars plana vitrectomy in diabetic macular edema. Doc Ophthalmol,1999,97:471-474.
71.姚毅,姜荔,陈伟民.糖尿病黄斑水肿的治疗进展[J].中华眼底病杂志,2003,19(3),198-200
72.齐慧君,黎晓新,钱彤等.曲安奈德玻璃体腔注射治疗视网膜静脉阻塞和糖尿病视网膜病变继发黄斑水肿分析[J].中国实用眼科杂志,2009,27(9),927-930
73.Parfitt K.Martin dale the complete drug reference 32nded[M]. London:The Pharmaceutical Press,1999,1050-1051
74. Jonas JB, Kreissig I, Sefker A. Intravitreal injection of triamcinolone for diffuse diabetic macular edema[J]. Arch Ophthalmol,2003,121:57-61
75.Massin P,Audren F, Haouchine B,etal. Intravitreal triamcinolone actonide for diabetic diffuse macular edema:preliminary results of a prospective controlled trial[J]. Ophthalmology,2004,111 (2):218-224
76. Kato A, Kimura H, Okabe K, et al. Feasibility of drug delivery to the posterior pole of the rabbit eye with an episcleral implant [J]. Invest Ophthalmol Vis Sci,2004,45 (1):238-244
77. McNeela BJ, Kumar CM. Sub-Tenon's block with an ultrashort cannula [J]. J Cataract Refract Surg,2004,30(4):858-86
78. Yoshinaga T. Posterior Sub-Tenon's Triamcinolone Acetonide for Refractory Diabetic Macular Edema[J]. Br J Ophthalmol,2004,88 (9):1131-1136
79. Bakri SJ,Kaiser PK. Posterior subtenon triamcinolone acetonide for refactory diabetic macular edema. Ophthalmol,2005,139 (2),290-294
80. KogaT, MawatariY, Inumaru J, et al. Trans-Tenon's retrobulbar triamcinolone acetonide infusion for refractory diabeticmacular edema after vitrectomy. Graefe s Arch Clin Exp Ophthalmol2005; 243(12):1247-1252
81.ChotYJ, Oh IK, Oh JR, et al. Intravitreal versus posterior subtenon injection of triamcinolone acetonide fordiabeticmacularedema. Korean J Ophthalmol2006; 20(4):205-209
82. Jaissle GB, Szurman P, Bartz-Schmidt KU. Ocular side effects and complication sofintravitreal triamcinolone acetonide injection. Ophthalmology,2004,101:121-128
83.Mordenti J, Thomsen K, Licko V, et a.1 Intraocular pharmacokinetics intravitreal administration of a solution or a PLGA microsphere formulation[J]. ToxicolSc, i 1999,52:101-106
84. Shahar JS, Avry RL, Heilweil G, et a.l Electrophysiologic and retinal penetration studies following intravitreal injection of bevacizumab[J]. Retina,2006,26:262-269
85. Avery RL, Pieramici DJ, Rabena MD, et a.l Intravitreal bevacizumab(Avastin) for neovascular age-related macular degenerat ion [J]. Ophthalmology,2006,113:363-372
86. Rosenfeld PJ, Fung AE, Puliafito CA. Optical coherence tomography findings after an intravitreal injection of bevacizumab (Avastin) for macular edema from central retinal vein occlusion[J]. Ophthalmic SurgLasers Imag,2005,36:336-339
87. SakaguchiH, Gomi F, KameiM, et a.l Complications in patients after intravitreal injection ofbevacizumab[J]. Acta Ophthalmol Scand, 2007,85:784-788
88. Brunet J,Farine JC, GarayRP, et a.l Angioprotective action of calcium dobesilate against reactive oxygen species-induced capillary permeability in the rat[J]. Eur J Pharmacol,1998,358(3):213-220
89. Brunet J, Farine JC, Garay RP, et a.l In vitro antioxidant properties of calcium dobesilate [J]. Fundam Clin Pharmacol,1998,12(2):205-212
90.郭向阳,黄洲基,朱志刚.羟苯磺酸钙治疗糖尿病视网膜黄斑水肿观察[J].Journal of Medical Forum,2007,Aug,28 (16):67-69
91. Campochiaro PA, The C99-PKC412-003 Study Group. Reduction of diabetic macular edema by oral administration of the kinase inhibitor PKC412. Invest Ophthalmol Vis Sci,2004,45:922-931
1.刘路宏,吴学今,李敏等.激光联合中药治疗糖尿病黄斑水肿的临床观察[J].广西医学,2008,30(3),313-315
2.周绿绿,李晟,汪辉等.中药联合光凝治疗黄斑水肿的疗效观察[J].中国实用眼科杂志,2006,24(12),1295-1297
3.金兰,朱江.中药联合多波长激光治疗糖尿病性黄斑水肿的临床观察[J].国际眼科杂志,2008,8(6),1262-1263
4.魏春惠.黄斑水肿的中西医治疗[J].江苏中医药,2007,39(4),5-6
5.王燕,余杨桂,李志英等.中药联合激光光凝治疗糖尿病视网膜病变黄斑水肿[J].中国中医眼科杂志,1998,8(2),80-83
6.梁俊芳,孙景莹,纪丽君.活血利水法联合倍频固体激光治疗糖尿病弥漫性黄斑水肿的临床观察[J].中国中医眼科杂志,2008,18(2),70-72
7.高波.中西医结合治疗糖尿病视网膜病变黄斑水肿32例[J].现代中西医结合杂志,2004,13(10),1344
8.贾万程,侯俭,崔凡明等.糖尿病性黄斑水肿的分型及中药治疗[J].中国中医眼科杂志,1999,9(4),212-214
9.张莉,汪雪梅.光光凝联合中药治疗糖尿病黄斑水肿26例[J].河北中医,2009,31(2),267-268
10.李国建,尹瑞生,任崇禧等.贞莲明目胶囊治疗糖尿病视网膜黄斑水肿55例临床观察[J].光明中医,2007,22(7),39-42
11.喻青,李志敏,陈玲玲.糖明汤配合氪黄激光治疗糖尿病性黄斑水肿30例[J]. 陕西中医,2008 29(10),1346-1347
12.詹育和,王学锋.中药对糖尿病性黄斑水肿治疗作用的观察[J].中医药临床杂志,2008,20(1),45-46
13.刘玲.糖尿病性黄斑病变辨治体会[J].山东中医药大学学报,1999,23(1)：52-53
14.陈宝军,卢仙月.糖尿病黄斑水肿130例中医治疗体会[J].中国中医急症,2006,15(6),664-665
15.刘立杰,刘立伟,王勇.激光光凝联合卵磷脂络合碘及中药治疗糖尿病性黄斑肿的疗效观察[J].国际眼科杂志,2008,8(4),820-821
16.徐新荣,魏伟,章淑华等.光凝结合中药治疗糖尿病性黄斑水肿的临床研究[J].南京中医药大学学报,2003,19(6),336-338
1.周绿绿,李晟,汪辉等.中药联合光凝治疗黄斑水肿的疗效观察[J].中国实用眼科杂志,2006,24(12),1295-1297
2. Savaga H. Safety and efficacy of intriavitreal triamcinolone[J].Arch Ophthalmol,2004,122:1083-1085
3. Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy. Early Treatment Diabetic Retinopathy Study number 1 [J].Arch Ophthalmol.1985. Dec:103 (12):1796-806
4.黄叔任,张晓峰,眼底病诊断与治疗[M].北京：人民卫生出版社,2008：287
5.金兰,朱江.中药联合多波长激光治疗糖尿病性黄斑水肿的临床观察[J].国际眼科杂志,2008,8(6),1262-1263
6. Jonas JB, Sofker A. Intraocular injection of crystalline cortisone as adjunctive treatment of diabet ic macular edema [J]. Am J Ophthalmol, 2001,132(3):425-427.
7. Macky TA, Helmy D, El Shazly N. Retinal toxicity of triamcinoloe' s vehicle(benzyl alcohol) an electrophysiologic and electron microscopic study. Graefes Arch Clin Exp Ophthalmol,2007,245:817-824
8.毕颖文,徐格致.球周注药对视网膜毒性的实验研究.眼科研究.2006,24：65-68
9. Mizuno S, Nishiwaki A, Morita FL, et al. Effects of periocular administration of triamcinolone acetonide on leukocyte-endothelium interactions in the ischemic retina [J]. Invest Ophthalmol Vis Sci, 2007,48(6):2831-2836
10.陈乔,杨红,陈建斌.球周注射大剂量曲安奈德后眼内药物浓度与安全性实验[J].医药导报,2007,26(7)：713-716
11.Ken HM D, Hideyukuih. Intravitreal versus retrobulbar injections of triamcinolone formacular edema associatedwith branch retinal vein occlusion[J]. Am J Ophthalmol,2005,139(6):972-982.
12. MICHAEL R, SUSAN S L, HYUNCHEOL K, et al.A rabbit model for assessing the ocular barriers to the transscleral delivery of triamcinolone acetonide [J]. Exp Eye Res,2006,82(3):479-487.
13.刘豫,许雪亮,唐仁泓等.曲安奈德球周注射联合激光光凝治疗糖尿病视网膜病变黄斑水肿[J].中华眼底病杂志,1009,25(4),306-307
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |