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要約 目的:糖尿病黄斑浮腫の症例に漢方薬(黄連解毒湯)を投与したので報告する。症例:21年の糖尿病歴を有し,7年前から経口血糖降下薬,1年前からインスリン治療中の66歳女性。1か月前から左眼視力障害を自覚し受診した。所見:矯正視力は右1.2,左0.2で,左眼に黄斑浮腫とその耳側に硬性白斑を認めた。黄連解毒湯製剤を内服し,1か月後に左眼視力は0.5,3か月後に0.9,2年後に1.0に改善した。光干渉断層計(OCT)により囊胞様黄斑浮腫の改善が確認された。初診から1年後に血糖コントロールが不良になったが,眼底病変の悪化は認めない。結論:片眼に糖尿病黄斑浮腫のある症例に黄連解毒湯を経口投与した結果,1か月後から黄斑浮腫が軽減し,視力が改善した。
Abstract. Purpose:To report a case of diabetic macular edema treated by Orengedoku-to, a traditional Chinese medicine. Case:A 66-year-old female with a history of 21 years of diabetes mellitus was referred to our clinic because of deterioration of vision in the left eye. She had been treated with oral hypoglycemic agent(OHA)7 years, and insulin 1 year before the initial visit. Findings:Corrected visual acuities were 0.2 OD and 0.2 OS. The left eye showed cystoid macular edema(CME)with hard exudates temporal to the fovea. She started receiving treatment by oral medication(Orengedoku-to)three times a day. The left visual acuity improved to 0.5 one month later, 0.9 three months later, and 1.0 two years later. Optical coherence tomography showed improvement of CME. Fundus findings have remained stable in spite of poor control of blood sugar level one year after start of treatment. Conclusion:Treatment by oral medication(Orengedoku-to)was followed by improvement in CME and visual acuity in a case of diabetic macular edema.
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