通络复明方对糖尿病视网膜病变激光术后视功能恢复的影响

王露露; 廖良; 张陶陶; 李丽; 肖艳萍

通络复明方对糖尿病视网膜病变激光术后视功能恢复的影响

1.
北京中医药大学东方医院，北京 100078
2.
北京中医药大学第二临床医学院，北京 100078

计量
- 文章访问数: 331
- HTML全文浏览量: 6
- PDF下载量: 445
- 被引次数: 0
出版历程
- 刊出日期: 2020-09-10

Effect of Tongluo Fuming Decoction on Visual Function of Patients with Diabetic Retinopathy after Panretinal Photocoagulation

1.
Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, China
2.
The Second School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, 100078, China

摘要

摘要: 目的研究通络复明方对糖尿病视网膜病变（DR）患者光凝术后视功能恢复的影响。方法选择2017年11月-2019年5月在北京中医药大学东方医院眼科门诊就诊且符合纳入标准的阴虚夹瘀证糖尿病视网膜病变患者46例，随机分为试验组和对照组，试验组采用通络复明方口服，对照组采用羟苯磺酸钙+迈之灵片治疗，连续治疗2周，停药后随访2周。比较2组患者治疗前后视力、视野、中医证候积分的变化。结果实际纳入42例69眼完成研究，其中试验组21例（34只眼），对照组21例（35只眼）。试验组治疗后2周、4周视力均较治疗前提高（P＜0.05），对照组没有统计学差异，治疗后4周试验组视力明显高于对照组（P＜0.05）。2组治疗后2周和4周的视野平均缺损（MD）值均较治疗前降低(P＜0.05)；试验组MD明显低于对照组(P＜0.05)。阴虚夹瘀证证候积分，试验组显著低于对照组（P＜0.05）。试验组总有效率显著高于对照组（P＜0.05）。结论通络复明方治疗可以缓解阴虚夹瘀证DR患者中医证候，对DR患者光凝术后视功能改善有积极作用，可恢复部分患者视力，并使受损的视野得到一定改善。
- 通络复明方 /
- 阴虚夹瘀证 /
- 全视网膜光凝 /
- 糖尿病视网膜病变 /
- 最佳矫正视力
Abstract: OBJECTIVE To study the effect of Tongluo Fuming decoction on the recovery of visual function after diabetic retinopathy (DR) photocoagulation. METHODS A total of 46 diabetic retinopathy patients with yin deficiency and blood stasis syndrome， who were admitted in the ophthalmology clinic of Dongfang Hospital， affiliated to Beijing University of Chinese Medicine from November 2017 to May 2019 and met the inclusion criteria， were randomly divided into the experimental group and the control group. The experimental group orally adopted Tongluo Fuming decoction while the control group was treated with calcium dobesilate plus Maizhiling tablets for 2 weeks and followed up for 2 weeks after stopping taking drugs. The changes in vision， visual field， and TCM syndrome scores before and after treatment were compared between the two groups. RESULTS 42 cases of 69 eyes completed the study， including 21 cases (34 eyes) in the experimental group and 21 cases (35 eyes) in the control group. The visual acuities of the experimental group at 2 and 4 weeks after treatment were improved compared with that before treatment (P<0.05). However， there was no statistical difference in the control group. The visual acuity of the experimental group was significantly better than that of the control group at 4 weeks after treatment (P<0.05). The mean defect (MD) values of the visual field at 2 and 4 weeks after treatment in the two groups were lower than those before treatment (P<0.05). MD value in the experimental group was significantly lower than that in the control group (P<0.05). TCM syndrome scores were significantly lower in the experimental group than those in the control group (P<0.05). The total effective rate of the experimental group was 66.7%， which was significantly higher than 28.6% of the control group (P<0.05). CONCLUSION Tongluo Fuming decoction can alleviate the TCM syndromes for DR patients with yin deficiency and blood stasis syndrome and has a positive effect on the improvement of visual function after DR photocoagulation. It can restore the visual power of partial patients and improve the damaged visual field to a certain extent.
- Tongluo Fuming decoction /
- yin deficiency and blood stasis syndrome /
- panretinal photocoagulation /
- diabetic retinopathy /
- best-corrected visual acuity

HTML全文

参考文献(20)

[1]	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.
[2]	LECHNER J， O'LEARY OE， STITT AW. The pathology associated with diabetic retinopathy[J]. Vision Research，2017，139:7-14.
[3]	陈素英.药物结合激光光凝治疗糖尿病性视网膜病变分析[J].实用中西医结合临床，2019，19(5):56-58.
[4]	张风.中国糖尿病视网膜病变诊疗指南与眼底激光治疗在DR治疗的地位[J].中国激光医学杂志，2016，25(5):308.
[5]	王露露，孙艳红，韦企平，等.糖尿病视网膜病变激光治疗的并发症及其防治[J].国际眼科杂志，2019，19(3):405-408.
[6]	中华医学会糖尿病分会.中国2型糖尿病防治指南（2010年版）[J].中国糖尿病杂志，2012，20：S1-S37.
[7]	任泽钦.视力资料统计学处理的几个基本问题[J].中华眼科杂志，2007，43(6):484-488.
[8]	彭清华. 中医眼科学[M]. 北京:中国中医药出版社，2016：177.
[9]	国家中医药管理局.中医病证诊断疗效标准[S].北京:中药医药科技出版社，2012:218.
[10]	国家中医药管理局医政司.22个专业95个病种中医诊疗方案[S]．北京:国家中医药管理局，2010：360-365.
[11]	李磊，王刚，马远程.眼底激光联合羟苯磺酸钙治疗糖尿病视网膜病变60例疗效分析[J].安徽医药，2019，23(7):1452-1455.
[12]	孔淑艳.糖尿病视网膜病变致患者视野缺损的临床治疗研究[J].中国卫生标准管理，2018，9(20):23-25.
[13]	刘凌，吕同府.激光治疗糖尿病视网膜病变的并发症观察[J]．实用糖尿病杂志，2008，4（4）：10-11.
[14]	ALASIL T，WAHEED NK．Pan retinal photocoagulation for proliferative diabetic retinopathy：Pattern scan laser versus argon laser[J]．Curr Opin Ophthalmol，2014，25(3):164-170.
[15]	CHHABLANI J， MATHAI A，RANI P，et al．Comparison of conventional pattern and novel navigated pan retinal photocoagulation in proliferative diabetic retinopathy [J]．Invest Ophthalmol Vis Sci， 2014， 55(6): 3432-3438．
[16]	黄慧君，晏世刚，陈建明.羟苯磺酸钙联合视网膜激光治疗对糖尿病黄斑水肿的影响[J].国际眼科杂志，2011，11(4):681-682.
[17]	柴芳，王越，黄强.复方血栓通胶囊联合羟苯磺酸钙治疗早期糖尿病性视网膜病变对IGF-1、VEGF及血液动力学指标的影响[J].实用中医药杂志，2018，34(11):1360-1362.
[18]	赵帅，尹妮.激光光凝治疗糖尿病视网膜病变后的药物干预[J].实用医院临床杂志，2016，13(2):117-118.
[19]	段惠静，付玉芳，孙桂芳，等.芪明颗粒加迈之灵治疗非增殖期糖尿病视网膜病变患者的临床效果[J].航空航天医学杂志，2014，25(4):531-532.
[20]	赵晓玲，徐灿坤，杨清峰.糖尿病视网膜病变流行病学及中医药研究进展[J].世界最新医学信息文摘，2019，19(59):98-99.