升清降浊通络明目方治疗糖尿病视网膜病变临床观察
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摘要
目的观察升清降浊通络明目方治疗糖尿病视网膜病变(DR)的临床疗效。方法将200例DR患者按照随机数字表法分为2组。对照组100例予常规西药治疗;治疗组100例在对照组治疗基础上加服升清降浊通络明目方治疗。2组疗程均为8周,检测并比较2组治疗前后血糖[空腹血糖(FPG)、餐后2 h血糖(2 hPG)]、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]及血液流变学[全血黏度(高切、中切、低切)、血浆黏度、红细胞比容、纤维蛋白原]变化,比较2组治疗后眼底病变及视力改善情况。结果治疗组治疗后TC、TG、LDL-C、FPG、2 hPG均降低(P<0.05),HDL-C较治疗前升高(P<0.05);对照组治疗后FPG、2 hPG均降低(P<0.05)。治疗组治疗后TC、TG、LDL-C、FPG、2 hPG均低于对照组(P<0.05),HDL-C高于对照组(P<0.05)。治疗组治疗后全血黏度(高切、中切、低切)、血浆黏度及纤维蛋白原均降低(P<0.05),且均低于对照组(P<0.05)。对照组治疗后全血黏度(低切)明显降低(P<0.05)。治疗组眼底病变改善总有效率90%,明显高于对照组(62%,P<0.05);治疗组视力改善总有效率82%,明显高于对照组(57%,P<0.05)。结论升清降浊通络明目方治疗DR能改善患者血脂、血糖、血液流变学指标,改善眼底病变和视力,具有较好的疗效。
Objective To observe the clinical efficacy of Shenqing Jiangzhuo Tongluo Mingmu prescription in the treatment of diabetic retinopathy(DR). Methods 200 DR patients were divided into two groups according to random number table method. 100 cases in control group were treated by conventional western medicine. 100 cases in treatment group were treated with by Shenqing Jiangzhuo Tongluo Mingmu prescription on the basis of the control group. Both groups were treated for 8 weeks. The changes of blood sugar [ fasting blood glucose(FPG) and postprandial 2-hour blood glucose(2 hPG) ], blood lipid [ total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C) ] and hemorheology [whole blood viscosity(high, medium and low shear), plasma viscosity, erythrocyte specific volume, fibrinogen ] before and after treatment were detected and compared. The changes of fundus diseases and visual acuity after treatment were compared between the two groups. Results After treatment, TC, TG, LDL-C, FPG and 2 hPG were decreased in the treatment group(P<0.05), HDL-C was increased(P<0.05). After treatment, FPG and 2 hPG were decreased in the control group(P<0.05). After treatment, TC, TG, LDL-C, FPG and 2 hPG in the treatment group were lower than those in the control group(P<0.05), and HDL-C was higher than that in the control group(P<0.05). After treatment, the whole blood viscosity(high, medium and low shear), plasma viscosity and fibrinogen in the treatment group were all decreased(P<0.05), and were lower than those in the control group(P<0.05). The whole blood viscosity(low cut) was significantly decreased after treatment in the control group(P<0.05). The total effective rate of fundus lesions in the treatment group was 90%, which was significantly higher than that in the control group(62%, P<0.05). The total effective rate of visual acuity improvement in the treatment group was 82%, which was significantly higher than that in the control group(57%, P<0.05). Conclusion Shenqing Jiangzhuo Tongluo Mingmu prescription can improve the indexes of blood lipid, blood sugar and hemorheology of DR patients, improve fundus lesions and vision, and has better curative effect.
Objective To observe the clinical efficacy of Shenqing Jiangzhuo Tongluo Mingmu prescription in the treatment of diabetic retinopathy(DR). Methods 200 DR patients were divided into two groups according to random number table method. 100 cases in control group were treated by conventional western medicine. 100 cases in treatment group were treated with by Shenqing Jiangzhuo Tongluo Mingmu prescription on the basis of the control group. Both groups were treated for 8 weeks. The changes of blood sugar [ fasting blood glucose(FPG) and postprandial 2-hour blood glucose(2 hPG) ], blood lipid [ total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C) ] and hemorheology [whole blood viscosity(high, medium and low shear), plasma viscosity, erythrocyte specific volume, fibrinogen ] before and after treatment were detected and compared. The changes of fundus diseases and visual acuity after treatment were compared between the two groups. Results After treatment, TC, TG, LDL-C, FPG and 2 hPG were decreased in the treatment group(P<0.05), HDL-C was increased(P<0.05). After treatment, FPG and 2 hPG were decreased in the control group(P<0.05). After treatment, TC, TG, LDL-C, FPG and 2 hPG in the treatment group were lower than those in the control group(P<0.05), and HDL-C was higher than that in the control group(P<0.05). After treatment, the whole blood viscosity(high, medium and low shear), plasma viscosity and fibrinogen in the treatment group were all decreased(P<0.05), and were lower than those in the control group(P<0.05). The whole blood viscosity(low cut) was significantly decreased after treatment in the control group(P<0.05). The total effective rate of fundus lesions in the treatment group was 90%, which was significantly higher than that in the control group(62%, P<0.05). The total effective rate of visual acuity improvement in the treatment group was 82%, which was significantly higher than that in the control group(57%, P<0.05). Conclusion Shenqing Jiangzhuo Tongluo Mingmu prescription can improve the indexes of blood lipid, blood sugar and hemorheology of DR patients, improve fundus lesions and vision, and has better curative effect.
引文
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[19] 王民,范丽辉,王怀安,等.中西医结合治疗单纯型糖尿病视网膜病变106例临床观察[J].河北中医,2015,37(4):527-530.
[20] 陈辉雄,张丽萍,陈玉华,等.探讨同型半胱氨酸血脂及血液体流变学在糖尿病视网膜病变中的意义[J].检验医学与临床,2014,11(9):1179-1181.
[2] 全国防盲技术指导组.糖尿病视网膜病变分级诊疗技术方案[J].中华全科医师杂志,2017,16(8):589-593.
[3] 姚毅,赵军平.糖尿病眼底病防治指南[J].中国实用眼科杂志,2001,19(2):83-95.
[4] 中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志,2014,50(11):851-865.
[5] 中华中医药学会糖尿病分会.糖尿病视网膜病变中医诊疗标准[J].世界中西医结合杂志,2011,6(7):632-637.
[6] 张思琴,余叶蓉.糖尿病视网膜病变的发病机理及治疗进展[J].现代临床医学,2016,42(6):471-475.
[7] 张亚娟.糖尿病视网膜病变治疗进展[J].黑龙江医学,2010,34(9):671-673.
[8] 李丽,任骞,叶存喜.糖尿病视网膜病变治疗的临床研究新进展[J].河北医科大学学报,2013,34(12):1606-1609.
[9] 张凤俊,易敬林,李晶明,等.糖尿病视网膜病变发病机制研究进展[J].眼科新进展,2016,36(6):584-587.
[10] 王宇宏.糖尿病视网膜病变光凝术并发症的处理[J].中国实用医药,2015,10(4):69-70.
[11] 朱琦鸿,彭辉灿.抗血管内皮生长因子药物在糖尿病性视网膜病变中的应用[J].现代医药卫生,2017,33(2):235-238.
[12] 吕安定.自拟藿佩汤治疗湿热中阻型糖尿病30例临床观察[J].北京中医药,2012,31(10):767-769.
[13] 韦企平.黄斑水肿从痰瘀论治浅谈[J].中国中医眼科杂志,2014,24(3):214-216.
[14] 陈炎明,陈静,侴桂新.苍术化学成分和药理活性研究进展[J].上海中医药大学学报,2006,20(4):95-98.
[15] 尤良震,林逸轩,方朝晖.黄芪甲苷治疗糖尿病及其并发症药理作用研究进展[J].中国中药杂志2017,42(24):4700-4706.
[16] 傅兴圣,陈菲,刘训红,等.大黄化学成分与药理作用研究新进展[J].中国新药杂志,2011,20(16):1534-1538.
[17] 朱家颖,岑晓凤,陈星,等.黄连生物碱降糖活性协同作用研究[J].时珍国医国药,2010,21(9):2282-2284.
[18] 王建平,傅旭春.泽泻的化学成分和药理作用研究[J].浙江医学,2012,34(14):1235-1237.
[19] 王民,范丽辉,王怀安,等.中西医结合治疗单纯型糖尿病视网膜病变106例临床观察[J].河北中医,2015,37(4):527-530.
[20] 陈辉雄,张丽萍,陈玉华,等.探讨同型半胱氨酸血脂及血液体流变学在糖尿病视网膜病变中的意义[J].检验医学与临床,2014,11(9):1179-1181.