视网膜光凝联合糖网康治疗糖尿病视网膜病变  

A clinical research on the effect of retinal photocoagulation combined with Tangwangkang for the treatment of nonproliferative diabetic retinopathy

作　　者：孙燕[1] 郑吉琦[1] 周小明[1] 罗向霞[2] 

机构地区：[1]甘肃省康复中心医院眼科,兰州730000 [2]甘肃省中医院眼科,兰州730050

出　　处：《中华眼外伤职业眼病杂志》2016年第3期214-219,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：甘肃省高等学校科研资助项目,2011年度甘肃省教育厅第二批科研项目计划（1106B-15）

摘　　要：目的评价非增生型糖尿病性视网膜病变（NPDR）进行氩绿激光视网膜光凝术联合中药糖网康胶囊治疗的临床效果。方法用平行随机对照方法，选取非增生型糖尿病性视网膜病变84例，随机分为两组，每组42例（56眼）：治疗组予视网膜光凝联合中药糖网康胶囊口服；对照组予视网膜光凝联合递法明口服。均连续服药3个月，根据治疗后视力、视觉电生理、荧光素眼底血管造影、OCT及血液流变学等检查结果，以评价疗效。结果治疗组的疗效优于对照组，表现为：术后视力，治疗组优于对照组，两组差异有统计学意义（X^2=5．6，P=0．036）。视觉电生理，治疗组视网膜震荡电位（OPs）波振幅，OPs波峰潜时优于对照组，两组差异有统计学意义（F=6．80，P=0．042）。治疗组及对照组用药后血流变均改善，全血黏度、血沉、全血还原黏度较用药前显著下降（F=15．2，P=0．008；F=12．1，P=0．0088；F=12．1，P=0．009），红细胞变形指数较用药前显著升高（F=15．2，P=0．0076），治疗组与对照组用药前后血流变学各项指标差异有统计学意义（P=0．04）。治疗组与对照组相比OCT检查黄斑厚度差异无统计学意义，（F=2．35，P=0．324）。结论视网膜光凝联合中药糖网康胶囊治疗NPDR有较好效果。Objective To evaluate the effect of retinal laser photocoagulation combined with traditional Chinese medicine ＂ Tangwangkang＂ capsule for the treatment of uouproliferative diabetic retinopathy （NPDR）. Methods In a parallel randomized trial, 84 patients of NPDR were randomly divided into the treatment group and the control group with 56 eyes of 42 cases in each group. In the treatment group, the patients were treated with retinal photocoagulation combined with oral traditional Chinese medicine ＂ TangWangKang＂ capsule. In the control group, the patients were treated with retinal photocoagulation combined with oral Difrarel. After 3 months of medicine treatment, the vision, electro- physiological test, fluorescence fundus angiography, OCT and hemorheological changes were observed to evaluate the treatment effect. Results The curative effect of the treatment group was better than that of the control group. The postoperative visual acuity of treatment group was better than that of control group and the difference between the two groups was statistically significant （X2 = 5.6, P = 0. 036）. The peak value and latency period of electro-physiological oscillatory potentials （OPs） in treatment group were better than those of control group and the differences were statistically significant between the two groups. （ F = 6. 80, P =0.042）. Hemorheological changes were improved in both two groups. Blood viscosity, eruthrocutes sedimentation rate and whole blood viscosity significantly declined after the treatment in both groups （ HSV F =15.2, P=0.008; ESR F=12. 1, P =0.0088; HRV F=12. 1, P =0.009）, and the red blood cell deformed exponent increased significantly （F = 15.2, P = 0. 0076）. The differences in all parameters of hemorheological changes between before and after the treatment in both two groups were statistically significant （P = 0.04 ）. There was no statistically significant difference in macula thickness by OCT examination between the two groups （ F = 2. 35, P = 0. 324）. Conclus

关 键 词：视网膜病变 糖尿病性 非增生型 视网膜光凝术 氩绿激光 糖网康 中药 

分 类 号：R587.2[医药卫生—内分泌] R779.6[医药卫生—内科学]