中药联合氩激光治疗糖尿病视网膜病变的临床研究
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摘要
目的:比较氩激光光凝结合益气养阴,化瘀止血中药(自拟方—达明饮1号)与单纯氩激光光凝治疗糖尿病性视网膜病变的疗效。
方法:临床采集Ⅱ型糖尿病并发糖尿病性视网膜病变Ⅲ、Ⅳ期眼底改变的糖尿病性视网膜病变患者46例73只眼,按随机原则采用分组治疗方法,其中23例37眼为治疗组(中药联合氩激光组),23例36眼为对照组(单纯氩激光组)。治疗前和治疗3个月后分别对46例患者进行视力,视网膜振荡电位,眼底照相及眼底荧光造影检查,记录视网膜出血及渗出的范围、微血管瘤的数量、荧光素渗漏等情况。每周检眼镜检查眼底,观察记录水肿、出血、渗出吸收时间,观察疗效。
结果:(1)治疗组总有效率为89.19%,对照组的总有效率为75%,两组相比有统计学意义(P<0.05);(2)治疗组视力提高与对照组比较有统计学意义(P<0.05);(3)眼底照相检查中,两组治疗后出血量与渗出量的疗效比较有统计学意义(P<0.05);(4)眼底荧光血管造影检查中,两组微动脉瘤数、渗漏面积的疗效比较,P<0.05,差异有统计学意义,无灌注面积的疗效比较无统计学意义(P>0.05);同组治疗前后视网膜微血管瘤数、渗漏面积比较有统计学意义(P<0.05),而无灌注面积比较无统计学意义(P>0.05);治疗后两组间视网膜微血管瘤数、渗漏面积比较有统计学意义(P<0.05),而无灌注面积比较无统计学意义(P>0.05);(5)治疗组治疗前后OPs总振幅比较有统计学意义(P<0.05),治疗后两组间OPs总振幅比较有统计学意义(P<0.05)。(6)光凝结合中药治疗组较光凝组眼底水肿、出血、渗出吸收时间缩短,两组间比较有统计学意义(P<0.05)。
结论:氩激光光凝结合益气养阴,化瘀止血中药(自拟方—达明饮1号)治疗糖尿病性视网膜病变的疗效优于单纯氩激光光凝。
Objective: To observe the clinical curative effect of the two methods to treat the diabetic retinopathy between the therapy effect of the Chinese native medicine (decoction—DaMingYin) combined with argon laser photocoagulation and the effect of the argon laser photocoagulation only. The decoction has the effect of removing extravasted blood and stoping bleeding ,and can pass winds the clear vision.Method: Clinically gathered the diabetic retinopathy patients 46 examples 73 eyes which Ⅱ diabetes concurrent with diabetic retinopathy Ⅲ,Ⅳ issue of eyeground changes .The 73 eyes were divided into treatment group and control group at random.The treatment group had 23 examples 37eyes(the traditional Chinese medicine uniting with argon laser photocoagulation group),the control group had 23 examples 36 eyes(the pure argon laser photocoagulation group),and we observed the effectiveness of the two groups.The therapy course is three months. Before and after three months of treating, the vision , oscillatory potentials , eyeground photography and eyeground fluorescence radiography of the 46 examples were checked and recorded the scope of retina hemorrhage and infiltration, the quantity of capillaries lump and the situation of fluorescein leakage and appraised the curative effect finally. Result:(1)The total effectiveness of the treatment group was 89.19%,the total effectiveness of the control group was 75%,there were significant diffience between the two groups(P<0.05);(2)The corrective eyesight improvement of the treatment group had remarkable difference compared with the control group(P<0.05);(3)
The eyeground photograph inspection indicated that there was remarkable difference on the effectiveness comparison of the quantity of hemorrhage and infiltration after treating between the two groups(P<0.05);(4) The eye ground fluorescence angiography inspection indicated that before and after treating,there was significant difference on the therapy effectiveness of the capillaries lump quantity and the leakage area(P<0.05) between the two groups,but there was no statistics significance in the effectiveness comparison in the area that was not poured (P>0.05). After treating there were remarkable difference between the two groups in the comparison of the capillaries lump quantity and leakage aera (P<0.05),but it had no significant difference in the comparison of the area that was not poured (P>0.05);(5)Before and after treating ,there was significant difference in the comparison of altitude sum of OPs in the treatment group (P<0.05) ,and there was remarkable difference between the two groups in the OPs comparison after treating (P<0.05);(6)The laser photocoagulation uniting with the traditional Chinese medicine treatment group surpass the laser photocoagulation on shortening the absorption time of the eyeground hemorrhage > dropsy and infiltration,there was a prominent difference between thetwo groups (P<0.05).Conclusion: Argon laser photocoagulation uniting with traditional Chinese medicine (decoction—DaMingYin)which has the effect of removing extravasted blood> stoping bleeding and can pass winds the clear vision has more superior curative effect than the argon laser photocoagulation only on treating the diabetic retinopathy.
方法:临床采集Ⅱ型糖尿病并发糖尿病性视网膜病变Ⅲ、Ⅳ期眼底改变的糖尿病性视网膜病变患者46例73只眼,按随机原则采用分组治疗方法,其中23例37眼为治疗组(中药联合氩激光组),23例36眼为对照组(单纯氩激光组)。治疗前和治疗3个月后分别对46例患者进行视力,视网膜振荡电位,眼底照相及眼底荧光造影检查,记录视网膜出血及渗出的范围、微血管瘤的数量、荧光素渗漏等情况。每周检眼镜检查眼底,观察记录水肿、出血、渗出吸收时间,观察疗效。
结果:(1)治疗组总有效率为89.19%,对照组的总有效率为75%,两组相比有统计学意义(P<0.05);(2)治疗组视力提高与对照组比较有统计学意义(P<0.05);(3)眼底照相检查中,两组治疗后出血量与渗出量的疗效比较有统计学意义(P<0.05);(4)眼底荧光血管造影检查中,两组微动脉瘤数、渗漏面积的疗效比较,P<0.05,差异有统计学意义,无灌注面积的疗效比较无统计学意义(P>0.05);同组治疗前后视网膜微血管瘤数、渗漏面积比较有统计学意义(P<0.05),而无灌注面积比较无统计学意义(P>0.05);治疗后两组间视网膜微血管瘤数、渗漏面积比较有统计学意义(P<0.05),而无灌注面积比较无统计学意义(P>0.05);(5)治疗组治疗前后OPs总振幅比较有统计学意义(P<0.05),治疗后两组间OPs总振幅比较有统计学意义(P<0.05)。(6)光凝结合中药治疗组较光凝组眼底水肿、出血、渗出吸收时间缩短,两组间比较有统计学意义(P<0.05)。
结论:氩激光光凝结合益气养阴,化瘀止血中药(自拟方—达明饮1号)治疗糖尿病性视网膜病变的疗效优于单纯氩激光光凝。
Objective: To observe the clinical curative effect of the two methods to treat the diabetic retinopathy between the therapy effect of the Chinese native medicine (decoction—DaMingYin) combined with argon laser photocoagulation and the effect of the argon laser photocoagulation only. The decoction has the effect of removing extravasted blood and stoping bleeding ,and can pass winds the clear vision.Method: Clinically gathered the diabetic retinopathy patients 46 examples 73 eyes which Ⅱ diabetes concurrent with diabetic retinopathy Ⅲ,Ⅳ issue of eyeground changes .The 73 eyes were divided into treatment group and control group at random.The treatment group had 23 examples 37eyes(the traditional Chinese medicine uniting with argon laser photocoagulation group),the control group had 23 examples 36 eyes(the pure argon laser photocoagulation group),and we observed the effectiveness of the two groups.The therapy course is three months. Before and after three months of treating, the vision , oscillatory potentials , eyeground photography and eyeground fluorescence radiography of the 46 examples were checked and recorded the scope of retina hemorrhage and infiltration, the quantity of capillaries lump and the situation of fluorescein leakage and appraised the curative effect finally. Result:(1)The total effectiveness of the treatment group was 89.19%,the total effectiveness of the control group was 75%,there were significant diffience between the two groups(P<0.05);(2)The corrective eyesight improvement of the treatment group had remarkable difference compared with the control group(P<0.05);(3)
The eyeground photograph inspection indicated that there was remarkable difference on the effectiveness comparison of the quantity of hemorrhage and infiltration after treating between the two groups(P<0.05);(4) The eye ground fluorescence angiography inspection indicated that before and after treating,there was significant difference on the therapy effectiveness of the capillaries lump quantity and the leakage area(P<0.05) between the two groups,but there was no statistics significance in the effectiveness comparison in the area that was not poured (P>0.05). After treating there were remarkable difference between the two groups in the comparison of the capillaries lump quantity and leakage aera (P<0.05),but it had no significant difference in the comparison of the area that was not poured (P>0.05);(5)Before and after treating ,there was significant difference in the comparison of altitude sum of OPs in the treatment group (P<0.05) ,and there was remarkable difference between the two groups in the OPs comparison after treating (P<0.05);(6)The laser photocoagulation uniting with the traditional Chinese medicine treatment group surpass the laser photocoagulation on shortening the absorption time of the eyeground hemorrhage > dropsy and infiltration,there was a prominent difference between thetwo groups (P<0.05).Conclusion: Argon laser photocoagulation uniting with traditional Chinese medicine (decoction—DaMingYin)which has the effect of removing extravasted blood> stoping bleeding and can pass winds the clear vision has more superior curative effect than the argon laser photocoagulation only on treating the diabetic retinopathy.
引文
[1] 曾庆华.中医眼科学[M]新世纪全国高等中医药院校规划教材(供中医药类专业用).北京:中国中医药出版社,2003:201.
[2] 董立均,邵晓颖.中西医结合治疗糖尿病视网膜病变48例分析[J].吉林中医药,2000,(6):52.
[3] 梁光宇,冯明清教授治疗糖尿病学术思想简介[J].河南中医,2000,(1):15.
[4] 李劲亮.消渴明目方治疗早期糖尿病性视网膜病变35例[J].国医论坛,2000,(6):24.
[5] 李红,夏建生.糖尿病视网膜病变辨证及分型的临床研究[J].河南中医,2000,20(5):33.
[6] 赵泉霖,史秀珍.试论元气亏虚是消渴病发病的根本病机[J].山东中医药大学学报,2000,7(4):255.
[7] 欧阳永斌.论痰阻目络是非胰岛素依赖型糖尿病视网膜病变的基本病机之一[J].浙江中医杂志,2002,(2):47-48.
[8] 刘文华.糖尿病性视网膜病变的病因及分型论治探讨[J].国医论坛.2001,5(3):15.[3].
[9] 刘求红,余杨桂教授治疗糖尿病性视网膜病变的思路与经验[J].黑龙江中医药,2004,(2):26-27.
[10] 李志英,余杨桂,张淳.糖尿病中医证型与糖尿病视网膜病变分期关系的探讨[J].中国中医眼科杂志,2000,10(1):29.
[11] 肖家翔,王利民.糖尿病视网膜病变局部辨证与F-ERG的关系初析[J].中国中医眼科杂志,2000,10(1):33.
[12] 徐放明,刘志诚 中药治疗Ⅱ型糖尿病研究进展[J]南京中医药大学学报,2001,17(1):65-66.
[13] 刘文华,廖品正.糖尿病视网膜病变的病因及分型论治探讨.国医论坛,2001,16(3):15-16.
[14] 李振中,和贵章,尹翠梅.糖尿病视网膜新生血管病因病机和防治探讨[J].江苏中医,2000,(3):12.
[15] 吴丹巍,殷长青,郑军,等.辨证分型为主治疗糖尿病视网膜病变临床观察[J].上海中医药杂志,2000,34(6):425.
[16] 高培质,增生型糖尿病视网膜病变的中西医结合治疗[J].中国中医眼科杂志,2001,(4):196-197.
[17] 黄建良,喻千龙.活血化瘀治疗糖尿病视网膜病变38例[J].河南中医杂志,2000,(1):29.
[18] 刘玲,郭霞.糖目清治疗糖尿病视网膜病变临床总结[J].山东中医杂志,2000,(3):145.
[19] 王大千.丹七地黄汤治疗糖尿病视网膜出血161例临床观察[J].北京中医,1999,(5):25-26.
[20] 李炳茂,李耀峰,刘慧玲,等.复方大黄制剂治疗糖尿病视网膜病变200例[J].中医杂志,2000,(2):119.
[21] 李劲亮.消渴明目方治疗早期糖尿病性视网膜病变35例[J].国医论坛,2000,(6):24.
[22] 曹素兰,孙元荣,张兆岳,等.增视胶囊治疗糖尿病性视网膜病变疗效观察[J].山东中医杂志,2000,19(5):281-282
[23] 董立均,邵晓颖.中西医结合治疗糖尿病视网膜病变48例分析[J].吉林中医药,2000,(6):52.
[24] 孙河,郝晓楠.达明饮治疗糖尿病视网膜病变的临床观察[J].论文汇编.中华医学会第十界全国眼科学术大会.2005,9.8-12
[25] 李晓星,程晓霞,高玉新等.血塞通注射液治疗糖尿病性视网膜病变[J].河南中医,2001,21(3):54.
[26] 柯晓云,吴艺.丹参对糖尿病视网膜病变患者脂质过氧化物及超氧化物歧化酶的影响[J].中国中医眼科杂志,1997,7(4):205.
[27] 于健.银杏叶制剂与阿司匹林联合治疗单纯性糖尿病视网膜病变[J].中国新药与临床杂志,2004,23(3):163-165.
[28] 唐爱华,史伟,唐农,郝小波,刘春红.黄芪注射液治疗单纯性糖尿病视网膜病变临床研究[J].浙江中医杂志,2003(4):176-177.
[29] 刘俊瑛,郝洪钟,李焱.红花静点注射对糖尿病性视网膜病变的影响[J].山西医药杂志,1995,24(4):234.
[30] 窦敬芳,翁孝刚.川芎嗪治疗糖尿病性视网膜病变临床研究[J].眼科新进展,1998,18(3):138.
[31] 何剑峰,周伟平,仇宜解,等.枸杞对糖尿病视网膜病变患者抗氧化反应作用的临床研究[J].中国中医眼科杂志,1998,8(2):74.
[32] 任平,胡惠君,张瑞.葛根素治疗糖尿病视网膜病变的疗效观察[J].中国中西医结合杂志,2000,20(8):574.
[33] 相莉,吴谊青,刘新玲.络泰治疗糖尿病视网膜病变[J].中草药,2000,31(4):50.
[34] 王坚,陈敏,李晓冬等.葛根素大黄素对糖基化产物引起牛视网膜微血管周细胞损伤的影响[J].中药药理与临床,2000,16(6):9-10.
[35] 鹿庆,孙褒忱,王津津 人参皂甙Rg1Rb1和维生素E对氧化损伤的牛细胞凋亡的影响[J]眼科新进展.1999,19(3):152-154.
[36] 王为,靡亚兵,陈宝安.汉防己甲素在眼科的基础研究进展[J].中国中医眼科杂志,2001,(1):59-61.
[37] 郑燕林,王毅,袁晓辉等.水蛭素对增生性玻璃体视网膜病变影响的组织病理学观察[J].中国中医眼科杂志,2000,10(1):1-3.
[38] 刘家琦,李凤鸣.实用眼科学[M].第2版.北京:人民卫生出版社,1999.481.
[39] 张承芬,张惠蓉.糖尿病的眼部并发症及治疗[M].人民卫生出版社2003:18-19
[40] 姚毅,赵军平,马志中等.糖尿病防治指南[J].中国实用眼科杂志,2001,19(2):83～93.
[41] Wiedemann P Growth factors in retinoal disease: proliferative viteoretinopathy, proliferafive diabetic retinophathy, and retinal degeneration[J]. Surv Ophthalmol, 1992,36(5) :373.
[42] Pfeiffer A, Schatz H. Diabetic m icrovascular com placations and grow th factors [J]. Exp Clin Endocri. 1995:103(1) :7-14.
[43] 王另芳,段俊国,张富文.导升明治疗糖尿性视网膜病变的概况[J].临床眼科,2002,10(2):188-189.
[44] 张春侠,杨丽霞.递法明治疗糖尿病视网膜病变的临床研究[J].中国实用眼科杂志,2003,21(1):31-32.
[45] 李伟民,熊永革,王政等.小剂量阿司匹林防治Ⅱ型糖尿病病人视网膜病变的临床研究[J].药学实践杂志,1998,16(6):335-337.
[46] Mayer-davis EJ. Bell Redoussin BA. et al. Antioxidant nutridant intake and diadetic retinopathy.Ophthalmology 1998,105/12:2264-2270
[47] 刘楠,顾永昊,张作明.糖尿病视网膜病变的治疗进展[J].山西医科大学学报,2003,34(5)476-479.
[48] M iyamoto K, Ogura Y, Sem in. Effect of a insulin induced decrease on the hum an diabetic retinal circulation [J]. Ophthalm ol,1999,14:233-239.
[49] 陈鸿,王利群.高压氧佐治糖尿病性单纯视网膜病变的疗效观察[J].中华物理医学与康复杂志2003,25(8):512.
[50] 李瑞峰.对DR的评价及光凝指标.眼科激光治疗学概要[M].北京:人民卫生出版社,1998:108.
[51] 张承芬.眼科新编fM].第1版.北京:人民卫生出版社,1991.411.
[52] Ferris FL, Podgor MJ, David MD. Macular edema in diadetic retinopathy study patients. Ophthalmology 1987,94:754-760.
[53] Funatsu H, Hoein S,Yamashita H et al. Effectine mechanisms of laser photocoagulation for neovascularization in diadetic retinopathy. Jpn Ophthalmol 1996,100(5):339-349.
[54] Early treatment diadetic retinopathy study reasetch geoup. Early photocoagulation for diadetic retinopathy. ET-DRS report number 9.Ophthalmology 1991,98:766-785.
[55] 刘豪杰,周明,邵彦.激光光凝治疗增殖期糖尿病视网膜病变[J].中国实用眼科杂志,2006:24(2)167-168.
[56] 张良,黎爱莲,余柏儒,等.光凝治疗增殖型糖尿病性视网膜病变.中国实用眼科杂志,2000,18(6):356-357.
[57] 邹吉新,张繁友,张戈非.全视网膜光凝治疗糖尿病性视网膜病变的疗效观察.中国实用眼科杂志.1998,16(10):593-595.
[58] 张靖东,龚启荣.氪激光治疗增殖期糖尿病性视网膜病变76例[J].南通医学院学报2004:24(4)516-517.
[59] 胡琦,徐锦堂,崔浩.氩激光光凝治疗糖尿病性视网膜病变疗效观察[J].中国实用眼科杂志.2002,20(2):95-96.
[60] 李瑞峰主编.眼科激光治疗学概要[MJ.第1版.北京,人民卫生出版社,1998:117-123.
[61] 黎晓新,王景昭.玻璃体视网膜手术学[M].第1版.北京:人民卫生出版社,2000:125-297.
[62] 严密.眼科学[M].北京:人民卫生版社,1995:203.
[63] 韩萍,王竞.氩激光光凝结合活血化瘀中药治疗糖尿病性视网膜病变.眼科研究,2001,10(5):459-461.
[64] 芦伟,马冰松.中药合激光治疗糖尿病性视网膜病变临床观察[J].辽宁中医杂志,2005:32(3)205-206.
[65] 宋毅,雷霍,刘楚玉.中药联合激光治疗糖尿病视网膜病变的临床观察[J].中国中医眼科杂志,2005:15(4)193-195.
[66] 李晟,刘爱琴,廖品正.激光联合中药治疗糖尿病性视网膜病变的临床观察[J].中国实用眼科杂志,2002,20(4):276-278.
[67] 任建萍,张明德,朱雅琴.激光光凝配合补肝肾中药治疗糖尿病视网膜病变[J].中国中医眼科杂志,2003,13(2):90-92.
[68] 魏广川,刘名显,温转,周荣芬.银杏达莫注射液联合视网膜激光光凝术治疗糖尿病视网膜病变近期疗效观察[J].中国综合临床,2005:21(9)833-835.
[69] 陈姚若.血栓通联合氩激光治疗糖尿病性视网膜病变[J].临床眼科杂志,2001,09(2):149-150.
[70] 叶任高,陆再英.第6版内科学[M].普通高等教育“十五”国家级规划教材:北京:人民卫生出版社,2004,2:797.
[71] 第三届全国眼科学术会议.糖尿病性视网膜病变分期标准[[J].中华眼科杂志,1985,21(2):113.
[72] 张承宏.眼底病学[M].北京:人民卫生出版社,1998,1:223-255.
[73] 张晓峰.中药预防早期糖尿病性视网膜病变的动物实验研究.眼底病,1991;7(2):83
[2] 董立均,邵晓颖.中西医结合治疗糖尿病视网膜病变48例分析[J].吉林中医药,2000,(6):52.
[3] 梁光宇,冯明清教授治疗糖尿病学术思想简介[J].河南中医,2000,(1):15.
[4] 李劲亮.消渴明目方治疗早期糖尿病性视网膜病变35例[J].国医论坛,2000,(6):24.
[5] 李红,夏建生.糖尿病视网膜病变辨证及分型的临床研究[J].河南中医,2000,20(5):33.
[6] 赵泉霖,史秀珍.试论元气亏虚是消渴病发病的根本病机[J].山东中医药大学学报,2000,7(4):255.
[7] 欧阳永斌.论痰阻目络是非胰岛素依赖型糖尿病视网膜病变的基本病机之一[J].浙江中医杂志,2002,(2):47-48.
[8] 刘文华.糖尿病性视网膜病变的病因及分型论治探讨[J].国医论坛.2001,5(3):15.[3].
[9] 刘求红,余杨桂教授治疗糖尿病性视网膜病变的思路与经验[J].黑龙江中医药,2004,(2):26-27.
[10] 李志英,余杨桂,张淳.糖尿病中医证型与糖尿病视网膜病变分期关系的探讨[J].中国中医眼科杂志,2000,10(1):29.
[11] 肖家翔,王利民.糖尿病视网膜病变局部辨证与F-ERG的关系初析[J].中国中医眼科杂志,2000,10(1):33.
[12] 徐放明,刘志诚 中药治疗Ⅱ型糖尿病研究进展[J]南京中医药大学学报,2001,17(1):65-66.
[13] 刘文华,廖品正.糖尿病视网膜病变的病因及分型论治探讨.国医论坛,2001,16(3):15-16.
[14] 李振中,和贵章,尹翠梅.糖尿病视网膜新生血管病因病机和防治探讨[J].江苏中医,2000,(3):12.
[15] 吴丹巍,殷长青,郑军,等.辨证分型为主治疗糖尿病视网膜病变临床观察[J].上海中医药杂志,2000,34(6):425.
[16] 高培质,增生型糖尿病视网膜病变的中西医结合治疗[J].中国中医眼科杂志,2001,(4):196-197.
[17] 黄建良,喻千龙.活血化瘀治疗糖尿病视网膜病变38例[J].河南中医杂志,2000,(1):29.
[18] 刘玲,郭霞.糖目清治疗糖尿病视网膜病变临床总结[J].山东中医杂志,2000,(3):145.
[19] 王大千.丹七地黄汤治疗糖尿病视网膜出血161例临床观察[J].北京中医,1999,(5):25-26.
[20] 李炳茂,李耀峰,刘慧玲,等.复方大黄制剂治疗糖尿病视网膜病变200例[J].中医杂志,2000,(2):119.
[21] 李劲亮.消渴明目方治疗早期糖尿病性视网膜病变35例[J].国医论坛,2000,(6):24.
[22] 曹素兰,孙元荣,张兆岳,等.增视胶囊治疗糖尿病性视网膜病变疗效观察[J].山东中医杂志,2000,19(5):281-282
[23] 董立均,邵晓颖.中西医结合治疗糖尿病视网膜病变48例分析[J].吉林中医药,2000,(6):52.
[24] 孙河,郝晓楠.达明饮治疗糖尿病视网膜病变的临床观察[J].论文汇编.中华医学会第十界全国眼科学术大会.2005,9.8-12
[25] 李晓星,程晓霞,高玉新等.血塞通注射液治疗糖尿病性视网膜病变[J].河南中医,2001,21(3):54.
[26] 柯晓云,吴艺.丹参对糖尿病视网膜病变患者脂质过氧化物及超氧化物歧化酶的影响[J].中国中医眼科杂志,1997,7(4):205.
[27] 于健.银杏叶制剂与阿司匹林联合治疗单纯性糖尿病视网膜病变[J].中国新药与临床杂志,2004,23(3):163-165.
[28] 唐爱华,史伟,唐农,郝小波,刘春红.黄芪注射液治疗单纯性糖尿病视网膜病变临床研究[J].浙江中医杂志,2003(4):176-177.
[29] 刘俊瑛,郝洪钟,李焱.红花静点注射对糖尿病性视网膜病变的影响[J].山西医药杂志,1995,24(4):234.
[30] 窦敬芳,翁孝刚.川芎嗪治疗糖尿病性视网膜病变临床研究[J].眼科新进展,1998,18(3):138.
[31] 何剑峰,周伟平,仇宜解,等.枸杞对糖尿病视网膜病变患者抗氧化反应作用的临床研究[J].中国中医眼科杂志,1998,8(2):74.
[32] 任平,胡惠君,张瑞.葛根素治疗糖尿病视网膜病变的疗效观察[J].中国中西医结合杂志,2000,20(8):574.
[33] 相莉,吴谊青,刘新玲.络泰治疗糖尿病视网膜病变[J].中草药,2000,31(4):50.
[34] 王坚,陈敏,李晓冬等.葛根素大黄素对糖基化产物引起牛视网膜微血管周细胞损伤的影响[J].中药药理与临床,2000,16(6):9-10.
[35] 鹿庆,孙褒忱,王津津 人参皂甙Rg1Rb1和维生素E对氧化损伤的牛细胞凋亡的影响[J]眼科新进展.1999,19(3):152-154.
[36] 王为,靡亚兵,陈宝安.汉防己甲素在眼科的基础研究进展[J].中国中医眼科杂志,2001,(1):59-61.
[37] 郑燕林,王毅,袁晓辉等.水蛭素对增生性玻璃体视网膜病变影响的组织病理学观察[J].中国中医眼科杂志,2000,10(1):1-3.
[38] 刘家琦,李凤鸣.实用眼科学[M].第2版.北京:人民卫生出版社,1999.481.
[39] 张承芬,张惠蓉.糖尿病的眼部并发症及治疗[M].人民卫生出版社2003:18-19
[40] 姚毅,赵军平,马志中等.糖尿病防治指南[J].中国实用眼科杂志,2001,19(2):83～93.
[41] Wiedemann P Growth factors in retinoal disease: proliferative viteoretinopathy, proliferafive diabetic retinophathy, and retinal degeneration[J]. Surv Ophthalmol, 1992,36(5) :373.
[42] Pfeiffer A, Schatz H. Diabetic m icrovascular com placations and grow th factors [J]. Exp Clin Endocri. 1995:103(1) :7-14.
[43] 王另芳,段俊国,张富文.导升明治疗糖尿性视网膜病变的概况[J].临床眼科,2002,10(2):188-189.
[44] 张春侠,杨丽霞.递法明治疗糖尿病视网膜病变的临床研究[J].中国实用眼科杂志,2003,21(1):31-32.
[45] 李伟民,熊永革,王政等.小剂量阿司匹林防治Ⅱ型糖尿病病人视网膜病变的临床研究[J].药学实践杂志,1998,16(6):335-337.
[46] Mayer-davis EJ. Bell Redoussin BA. et al. Antioxidant nutridant intake and diadetic retinopathy.Ophthalmology 1998,105/12:2264-2270
[47] 刘楠,顾永昊,张作明.糖尿病视网膜病变的治疗进展[J].山西医科大学学报,2003,34(5)476-479.
[48] M iyamoto K, Ogura Y, Sem in. Effect of a insulin induced decrease on the hum an diabetic retinal circulation [J]. Ophthalm ol,1999,14:233-239.
[49] 陈鸿,王利群.高压氧佐治糖尿病性单纯视网膜病变的疗效观察[J].中华物理医学与康复杂志2003,25(8):512.
[50] 李瑞峰.对DR的评价及光凝指标.眼科激光治疗学概要[M].北京:人民卫生出版社,1998:108.
[51] 张承芬.眼科新编fM].第1版.北京:人民卫生出版社,1991.411.
[52] Ferris FL, Podgor MJ, David MD. Macular edema in diadetic retinopathy study patients. Ophthalmology 1987,94:754-760.
[53] Funatsu H, Hoein S,Yamashita H et al. Effectine mechanisms of laser photocoagulation for neovascularization in diadetic retinopathy. Jpn Ophthalmol 1996,100(5):339-349.
[54] Early treatment diadetic retinopathy study reasetch geoup. Early photocoagulation for diadetic retinopathy. ET-DRS report number 9.Ophthalmology 1991,98:766-785.
[55] 刘豪杰,周明,邵彦.激光光凝治疗增殖期糖尿病视网膜病变[J].中国实用眼科杂志,2006:24(2)167-168.
[56] 张良,黎爱莲,余柏儒,等.光凝治疗增殖型糖尿病性视网膜病变.中国实用眼科杂志,2000,18(6):356-357.
[57] 邹吉新,张繁友,张戈非.全视网膜光凝治疗糖尿病性视网膜病变的疗效观察.中国实用眼科杂志.1998,16(10):593-595.
[58] 张靖东,龚启荣.氪激光治疗增殖期糖尿病性视网膜病变76例[J].南通医学院学报2004:24(4)516-517.
[59] 胡琦,徐锦堂,崔浩.氩激光光凝治疗糖尿病性视网膜病变疗效观察[J].中国实用眼科杂志.2002,20(2):95-96.
[60] 李瑞峰主编.眼科激光治疗学概要[MJ.第1版.北京,人民卫生出版社,1998:117-123.
[61] 黎晓新,王景昭.玻璃体视网膜手术学[M].第1版.北京:人民卫生出版社,2000:125-297.
[62] 严密.眼科学[M].北京:人民卫生版社,1995:203.
[63] 韩萍,王竞.氩激光光凝结合活血化瘀中药治疗糖尿病性视网膜病变.眼科研究,2001,10(5):459-461.
[64] 芦伟,马冰松.中药合激光治疗糖尿病性视网膜病变临床观察[J].辽宁中医杂志,2005:32(3)205-206.
[65] 宋毅,雷霍,刘楚玉.中药联合激光治疗糖尿病视网膜病变的临床观察[J].中国中医眼科杂志,2005:15(4)193-195.
[66] 李晟,刘爱琴,廖品正.激光联合中药治疗糖尿病性视网膜病变的临床观察[J].中国实用眼科杂志,2002,20(4):276-278.
[67] 任建萍,张明德,朱雅琴.激光光凝配合补肝肾中药治疗糖尿病视网膜病变[J].中国中医眼科杂志,2003,13(2):90-92.
[68] 魏广川,刘名显,温转,周荣芬.银杏达莫注射液联合视网膜激光光凝术治疗糖尿病视网膜病变近期疗效观察[J].中国综合临床,2005:21(9)833-835.
[69] 陈姚若.血栓通联合氩激光治疗糖尿病性视网膜病变[J].临床眼科杂志,2001,09(2):149-150.
[70] 叶任高,陆再英.第6版内科学[M].普通高等教育“十五”国家级规划教材:北京:人民卫生出版社,2004,2:797.
[71] 第三届全国眼科学术会议.糖尿病性视网膜病变分期标准[[J].中华眼科杂志,1985,21(2):113.
[72] 张承宏.眼底病学[M].北京:人民卫生出版社,1998,1:223-255.
[73] 张晓峰.中药预防早期糖尿病性视网膜病变的动物实验研究.眼底病,1991;7(2):83