交泰归芍方联合玻璃体切割术治疗增殖性糖尿病视网膜病变合并黄斑水肿临床研究  

Clinical Observation of Jiaotai Guishao Formula(交泰归芍方)Combined with Vitrectomy in Treatment of Proliferative Diabetic Retinopathy Complicated with Macular Edema

作　　者：翟军印 陆亚玲 张艺 ZHAI Junyin;LU Yaling;ZHANG Yi(The 926th Hospital of Joint Logistics Support Force of the Chinese People’s Liberation Army,Kaiyuan 661600,China)

机构地区：[1]中国人民解放军联勤保障部队第九二六医院,云南开远661600

出　　处：《山东中医杂志》2023年第1期38-44,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：云南省科技计划项目[编号:2017F118(-026)]。

摘　　要：目的:观察交泰归芍方联合玻璃体切割术治疗增殖性糖尿病视网膜病变(PDR)合并黄斑水肿(ME)的临床疗效及对视网膜功能和角膜内皮细胞变化等指标的影响。方法:选择95例符合标准的PDR合并ME患者,按随机数字表法将患者分为观察组48例与对照组47例,两组均给予玻璃体切割术治疗,观察组在此基础上联合交泰归芍方口服,检测两组治疗前后房水中血管内皮生长因子(VEGF)、基质细胞衍生因子-1(SDF-1)、一氧化氮合成酶(NOS)、单核细胞趋化蛋白-1(MCP-1)、白细胞介素-1(IL-1)、可溶性细胞间黏附分子-1(sICAM-1)水平,检测两组患者中心区a波、b波的潜伏期及振幅密度,检测角膜六角形细胞比例、角膜内皮细胞密度、黄斑中心凹视网膜厚度(CRT)、最佳矫正视力(BCVA)水平,观察两组患者ME消退情况。结果:治疗后,观察组患者SDF-1、VEGF、IL-1、MCP-1、sICAM-1水平低于对照组,NOS水平高于对照组,差异均有统计学意义(P<0.05);观察组中心区a波、b波的潜伏期低于对照组,振幅密度高于对照组,差异均有统计学意义(P<0.05);观察组六角形细胞比例及内皮细胞密度高于对照组,CRT水平均低于对照组,BCVA水平高于对照组,差异均有统计学意义(P<0.05);观察组ME消退效果优于对照组(P<0.05)。结论:交泰归芍方联合玻璃体切割术治疗PDR合并ME,可通过降低炎症反应水平,减少角膜内皮细胞储备功能、视网膜功能的损伤,提升视力,提升ME消退效果。Objective:To observe the clinical efficacy of Jiaotai Guishao Formula(交泰归芍方)combined with vitrectomy in the treatment of proliferative diabetic retinopathy(PDR)complicated with macular edema(ME)and its influence on retinal function and changes in corneal endothelial cells.Methods:Total 95 patients with PDR and ME who meet the criteria were selected.The patients were divided into observation group(48 cases)and control group(47 cases)according to random number table.Control group and were treated with vitrectomy.Observation group were given Jiaotai Guishao Formula combined with vitrectomy.Before and after treatment,the two groups of patients were tested for vascular endothelial growth factor(VEGF),stromal cell-derived factor 1(SDF-1),and nitric oxide synthase(NOS),monocyte chemoattractant protein-1(MCP-1),interleukin-1(IL-1),soluble intercellular adhesion molecule-1(sICAM-1)levels.And the latency and amplitude density of central area a wave and b wave were detected.The proportion of corneal hexagonal cell ratio,corneal endothelial cell density,macular foveal retinal thickness(CRT),best corrected visual acuity(BCVA)level were detected.The ME subside of two groups were observed.Results:The levels of SDF-1 and VEGF,IL-1,MCP-1,sICAM-1 in the observation group were lower than those in the control group.The level of NOS in the observation group was higher than that in the control group.The difference between the two groups were all statistically significant(P<0.05).The latencies of the a wave and b wave in the central area of the observation group were lower than those of the control group,amplitude density was higher than that of the control group.The difference between the two groups were all statistically significant(P<0.05).The proportion of hexagonal cells,the density of endothelial cells in the observation group were higher than those in the control group.The CRT level was lower than that of the control group and the BCVA level of the observation group was higher than that of the control group.The differe

关 键 词：交泰归芍方 玻璃体切割术 增殖性糖尿病视网膜病变 黄斑水肿 角膜内皮细胞 视网膜功能 

分 类 号：R276.7[医药卫生—中医五官科学]