摘要
目的探讨逐瘀固本方对肾虚血瘀型非增殖期糖尿病性视网膜病变(NPDR)患者视网膜功能及血管管径、血清细胞黏附分子-1(ICAM-1)和血管内皮生长因子(VEGF)水平的影响。方法选取医院2016年9月—2018年8月期间收治的NPDR患者160例,采用随机数字表法分成两组。两组患者均接受健康教育、改善饮食、加强合理运动和控制血糖等常规治疗。对照组采用羟苯磺酸钙胶囊治疗。观察组在对照组的基础上联用逐瘀固本方治疗。两组均以4周为1个疗程,连续治疗3个疗程。检测并比较两组患者治疗前后视网膜电图震荡电位、视野平均敏感度(MS)、视力、视网膜动、静脉血管管径、动静脉管径比值、眼底评分、中医证候评分、血清ICAM-1、VEGF水平,同时评价疗效。结果观察组有效率高于对照组(P<0.05)。治疗后,观察组OP1、OP2潜伏期短于对照组,OP1、OP2、OP4振幅低于对照组(P<0.05);观察组动脉管径和动静脉管径比值大于对照组,静脉管径小于对照组(P<0.05);观察组MS和视力均高于对照组(P<0.05);观察组眼底评分和中医证候评分均低于对照组(P<0.05);观察组血清ICAM-1、VEGF水平均低于对照组(P<0.05)。结论逐瘀固本方治疗肾虚血瘀型NPDR患者,能够有效改善视网膜功能,提高视力,这可能与中药抑制ICAM-1、VEGF表达,调节视网膜血管管径有关,疗效显著,值得推广。
Objective:To explore the effect of Zhuyu Guben Decoction on retinal function,vascular diameter,serum ICAM-1 and vascular endothelial growth factor(VEGF)levels in patients with non-proliferative diabetic retinopathy(NPDR)of kidney deficiency and blood stasis type.Methods:160 NPDR patients admitted to our hospital from September 2016 to August 2018 were divided into two groups by random number table.Both groups received routine treatment such as health education,diet improvement,reasonable exercise and blood sugar control.The control group was treated with calcium dobesilate capsule.The observation group was treated with Zhuyu Guben Decoction on the basis of the gontrol group.Two groups were treated for 4 weeks as a course of treatment,three consecutive courses of treatment.The electroretinogram oscillation potential,mean visual field sensitivity(MS),visual acuity,retinal artery and vein diameter,ratio of arteriovenous diameter,fundus score,tcm syndrome score,serum ICAM-1 and VEGF levels were measured and compared before and after treatment in both groups.Results:The effective rate of observation group was higher(P<0.05);after treatment,the incubation period of OP1 and OP2 in the observation group was shorter,and the amplitudes of OP1,OP2 and OP4 in the observation group were lower(P<0.05);the ratio of artery diameter to vein diameter in the observation group was larger,and the diameter of vein was smaller(P<0.05).MS and visual acuity in observation group were higher(P<0.05).The ocular fundus score and tcm syndrome score in the observation group were lower(P<0.05).The levels of serum ICAM-1 and VEGF in the observation group were lower(P<0.05).Conclusion:Zhuyu Guben Decoction can effectively improve retinal function and visual acuity in the treatment of NPDR patients with kidney deficiency and blood stasis,which may be related to the inhibition of ICAM-1 and vascular endothelial growth factor expression and the regulation of retinal vascular diameter by traditional Chinese medicine.
作者
刘慧颖
胡利梅
史丽
任卫东
闫武超
杜俊宝
闫致旺
LIU Huiying;HU Limei;SHI Li;REN Weidong;YAN Wuchao;DU Junbao;YAN Zhiwang(First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Zhangjiakou Ophthalmological Hospital,Zhangjiakou 075000,Hebei,China;The Second Hospital of Zhangjiakou,Zhangjiakou 075000,Hebei,China)
出处
《辽宁中医药大学学报》
CAS
2020年第1期166-169,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
河北省科学技术研究专项(2018ZY1682).
关键词
非增殖期2型
糖尿病视
网膜病变
逐瘀固本方
视网膜功能
肾虚血瘀
细胞因子
non-proliferative
type 2 diabetic
retinopathy
Zhuyu Guben decoction
retinal function
kidney deficiency and blood stasis
cytokines
作者简介
刘慧颖(1989-),女,山西崞县人,主治医师,硕士,研究方向:糖尿病、甲状腺疾病、骨质疏松等临床内分泌疾病的诊治。
