患者,女,36岁.初诊日期:2020年12月17日.主诉:左眼视物模糊10 d.现病史:10 d前用眼过度后突发左眼视物模糊,眼前暗影,伴畏光、流泪,于浙江省眼科医院就诊,查双眼视力:左眼0.6,右眼1.2.光学相干断层扫描(OCT)示:左眼黄斑区视网膜神经上皮脱离,其下液体呈无反射信号的液性暗区,水肿高度为592 μm.诊断为左眼中心性浆液性脉络膜视网膜病变,嘱休息,未予特殊治疗,症状未见明显好转.刻下症:神清,精神可,左眼视物模糊,伴眼部干涩,前额部胀痛,偶有心烦,纳可,夜寐欠佳、梦多易醒,口苦,二便可,舌暗、苔薄白,脉弦.

OBJECTIVE To observe the clinical effect of modified Wuling Powder in the treatment of central serous chorioretinopathy(CSC) according to syndrome differentiation.METHODS Sixty patients with CSC were randomly divided into the treatment group and the control group, 30 cases in each group.The treatment group was intervened by orally taking modified Wuling Powder, and the control group was treated with orally taking vitamin B1 tablets and vitamin C tablets, with one course lasting for one month.Clinical effects were observed after 3 courses of treatment.RESULTS The total effective rate in the treatment group was 96.7%, and 73.3% in the control group.The curative effect was better in the treatment group than that of the control group(P<0.05).Vision, FFA fluorescence leakage area and edema degree were compared before and after treatment to be significantly different in two groups(P<0.01).The treatment group was better than the control group(P<0.05).CONCLUSION Modified Wuling Powder has good curative effects in the treatment of CSC.

糖尿病性视网膜病变(DR)是最常见的视网膜血管病,为50岁以上人群主要致盲眼病之一.本病早期无自觉症状,病变发展到黄斑后出现不同程度的视力减退.近几年来,笔者采用自拟滋阴活血方治疗糖尿病性视网膜病变31例,疗效显著.现总报道下.

目的 探讨头孢丙烯与玉屏风散联合治疗急性细菌感染性鼻窦炎的临床作用,研究其改善症状和体征的程度及时间,并得出其有效性.方法 研究选择2010年1月-2013年1月就诊符合诊断标准的患者作为研究对象,共调查200例,将其随机分为治疗组和对照组,每组各100例,观察组给予玉屏风散与头孢丙烯口服治疗,对照组仅用头孢丙烯治疗,两组药物均在应用7d后停服,并记录临床症状、典型体征的改善程度及开始改善时间,统计其痊愈率及有效率,采用SPSS软件16.0,计量资料分析采用t检验,计数资料分析采用x2检验.结果 治疗组在鼻塞(x2 =3.18,P=0.01)、流涕(x2=3.23,P=0.01)、鼻道有黏性分泌物(x2=3.23,P=0.01)、鼻黏膜肿胀肥厚(x2=3.05,P=0.02)等症状的改善程度均优于对照组;治疗组在鼻塞(t=1.78,P=0.03)、流涕(t=1.26,P=0.04)、头痛(t=1.68,P=0.03)、咳嗽(t=1.84,P=0.02)等症状的改善时间均比对照组早;患者痊愈率及总有效率治疗组分别为75.0％及98.0％,对照组分别为53.0％及83.0％,治疗组均高于对照组(x2=8.67,P＜0.01及x2=7.34,P＜0.01).结论 玉屏风散与头孢丙烯联合治疗在改善症状体征的程度、时间上均优于单一使用头孢丙烯组;急性细菌感染性鼻窦炎采用玉屏风散联合头孢丙烯治疗,临床疗效更佳,可予推广应用.