罗格列酮联合安雪颗粒治疗糖尿病视网膜病变的临床研究

Clinical Study on Treating Diabetic Retinopathy by Rosiglitazone Combined with Anxue Granules

  • 摘要: 目的 观察罗格列酮联合安雪颗粒治疗糖尿病视网膜病变(DR)阴虚内热证的疗效及安全性。方法 210例患者随机分为中药组、西药组和联合组各70例。在调控血压、血脂、血糖等常规治疗基础上,分别口服罗格列酮、安雪颗粒、罗格列酮+安雪颗粒,疗程均为60 d。观察治疗前后3组患者眼科常规检查指标(视野灰度值、视网膜厚度、黄斑中心凹厚度、血管瘤体积、视野平均缺损和平均光敏度),视网膜中央动脉血流动力学指标收缩期峰值流速(PSV)、舒张末期流速(EDV)、搏动指数(PI)、血流阻力指数(RI),血清细胞因子血管细胞间粘附因子-1(ICAM-1)、内皮素-1(ET-1)、转化生长因子-β(TGF-β)和基质细胞衍生因子-1(SDF-1),氧化应激相关指标三醋酸纤维素(TAC)、丙二醛(MDA)、脂质过氧化氢(LHP)和总抗氧化能力(TAOC)。比较3组患者总有效率和不良反应发生率。结果 研究期间脱落9例。联合组总有效率97.1%,高于中药组的76.1%和西药组的76.9%(P<0.05),中药组总有效率与西药组比较无明显差异(P>0.05);联合组患者眼科常规检查、视网膜中央动脉血流动力学、血清细胞因子和氧化应激相关指标较中药组和西药组明显改善(P<0.05);不良反应发生率:中药组(1.5%)<联合组(5.8%)<西药组(13.8%)(P<0.05)。结论 罗格列酮联合安雪颗粒治疗DR安全有效,值得临床推广应用。

     

    Abstract: OBJECTIVE To observe the efficacy and safety of rosiglitazone combined with anxue granules in the treatment of diabetic retinopathy (DR). METHODS 210 patients were randomly divided into three groups: Chinese medicine group, western medicine group and combination group. On the basis of regulating blood pressure, blood lipid, blood glucose and other routine treatment, rosiglitazone, anxue granules, rosiglitazone + anxue granules were taken orally by patients in three groups respectively for 60 days. The ophthalmic routine examination indexes (gray value of visual field, thickness of retina, thickness of macular fovea, volume of hemangioma, average defect of visual field and average photosensitivity), hemodynamic indexes of central retinal artery peak systolic velocity (PSV), end-diastolic velocity (EDV), pulse index (PI), resistance index (RI), serum cytokines intercellular Adhesion factor-1 (ICAM-1), endothelin-1 (ET-1), transforming growth factor-β (TGF-β) and stromal cell derived factor-1 (SDF-1), oxidative stress related indicators triacetate cellulose (TAC), malondialdehyde (MDA), lipid hydrogen peroxide (LHP) and total antioxidant capacity (TAOC) were observed before and after treatment. Total effective rate and incidence of adverse reactions were compared among the three groups. RESULTS 9 cases dropped off during the study. The total effective rate of combined group was 97.1%, higher than that of Chinese medicine group (76.1%) and western medicine group (76.9%) (P<0.05). There was no significant difference in the total effective rate between the Chinese medicine group and western medicine group (P>0.05). The ophthalmic routine examination, retinal central artery blood flow mechanics, serum cytokines and oxidative stress were significantly improved in the combined group than that of Chinese medicine group and western medicine group (P<0.05). The incidence of adverse reactions: Chinese medicine group was 1.5%), lower than combined group (5.8%) and western medicine group (13.8%) (P<0.05). CONCLUSION Rosiglitazone combined with anxue granules is safe and effective in the treatment of DR, and it is worthy of clinical application.

     

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