通窍活血汤联合补阳还五汤对糖尿病视神经病变患者视神经的保护作用及机制分析  

The protective effect of Tongqiao Huoxue Decoction combined with Buyang Huanwu Decoction on the optic nerve of patients with diabetic optic neuropathy and its mechanism analysis

作　　者：李霭燕 吴小桃[2] 陈丽华[2] 凌梓韵 黎灿文 LI Ai-yan;WU Xiaotao;CHEN Li-hua(Department of Pharmacy,Panyu District Hospital of Traditional Chinese Medicine,Guangzhou 511400,China)

机构地区：[1]广州市番禺区中医院药学部,511400 [2]广州市番禺区中医院眼科,511400 [3]广州市番禺区中医院检验科,511400

出　　处：《中国现代药物应用》2020年第14期17-20,共4页Chinese Journal of Modern Drug Application

基　　金：一般医疗卫生项目-中医医学研究类(项目编号:2019-Z04-72),项目名称:活血化瘀膏对前部缺血性视神经病变的作用及机制研究。

摘　　要：目的探讨糖尿病视神经病变患者行通窍活血汤联合补阳还五汤治疗对视神经的保护作用及机制。方法 80例糖尿病视神经病变患者,随机分为对照组及观察组,各40例。对照组行常规基础治疗,观察组行通窍活血汤联合补阳还五汤治疗。比较两组治疗4周后的疗效,治疗前、治疗4周后的空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、色素上皮衍生因子(PEDF)、血管内皮生长因子(VEGF)、缺氧诱导因子-1α(HIF-1α)、视觉平均偏差、P100波潜伏期、视网膜神经纤维层厚度(RNFL)水平。结果治疗4周后,观察组总有效率为92.50%,高于对照组的72.50%,差异具有统计学意义(P<0.05)。治疗4周后,两组患者的FPG、2 h PG、HbA1c水平均较本组治疗前降低,且观察组FPG、2 h PG、HbA1c水平分别为(5.44±0.46)mmol/L、(6.56±1.04)mmol/L、(5.53±0.18)%,均低于对照组的(5.86±0.61)mmol/L、(7.93±1.12)mmol/L、(6.42±0.20)%,差异均具有统计学意义(P<0.05)。治疗4周后,两组患者的PEDF、VEGF、HIF-1α、视觉平均偏差、P100波潜伏期、RNFL水平均较本组治疗前改善,且观察组改善程度优于对照组,差异均具有统计学意义(P<0.05)。结论针对糖尿病视神经病变患者在常规基础治疗外增加通窍活血汤联合补阳还五汤治疗可进一步控制血糖水平,利于视力恢复,有效抗视神经凋亡,发挥保护作用,治疗价值较高,值得推广。Objective To discuss the protective effect of Tongqiao Huoxue Decoction combined with Buyang Huanwu Decoction on the optic nerve of patients with diabetic optic neuropathy and its mechanism. Methods A total of 80 patients with diabetic optic neuropathy were randomly divided into control group and observation group, with 40 cases in each group. The control group was treated by conventional basic therapy, and the observation group was treated by Tongqiao Huoxue Decoction combined with Buyang Huanwu Decoction. The efficacy 4 weeks after treatment, and the levels of fasting plasma glucose(FPG), 2 h postprandial glucose(2 h PG), glycated hemoglobin(HbA1 c), pigment epithelium-derived factor(PEDF), vascular endothelial growth factor(VEGF), hypoxia-inducible factor-1α(HIF-1α), visual mean deviation, P100 wave latency and retinal nerve fiber layer(RNFL) were compared between the two groups. Results 4 weeks after treatment, the total effective rate of the observation group was 92.50%, which was higher than that of the control group 72.50%, and the difference was statistically significant(P<0.05). 4 weeks after treatment, the levels of FPG, 2 h PG and HbA1 c of the two groups were lower than those before treatment, and the levels of FPG, 2 h PG and HbA1 c of the observation group were(5.44±0.46) mmol/L,(6.56±1.04) mmol/L,(5.53±0.18)%, which was lower than those of the control group(5.86±0.61) mmol/L,(7.93±1.12) mmol/L,(6.42±0.20)%, and the difference was statistically significant(P<0.05). 4 weeks after treatment, PEDF, VEGF, HIF-1α, visual mean deviation, P100 wave latency and RNFL of the two groups were improved compared with those before treatment, and the improvement of the observation group was better than that of the control group, and the difference was statistically significant(P<0.05). Conclusion For diabetic optic neuropathy patients, Tongqiao Huoxue decoction combined with Buyang Huanwu decoction can further control blood sugar level, facilitate vision recovery, effectively resist optic nerve apoptosis,

关 键 词：糖尿病视神经病变 通窍活血汤 补阳还五汤 保护机制 治疗效果 

分 类 号：R259[医药卫生—中西医结合] R276.7[医药卫生—中医内科学]