滋肝益肾汤联合西药治疗糖尿病视网膜病变玻璃体切除术后临床研究  

Clinical Study on Zigan Yishen Decoction Combined with Western Medicine for Patients After Vitrectomy for Diabetic Retinopathy

作　　者：孙耀成 张珍 SUN Yaocheng;ZHANG Zhen

机构地区：[1]桐柏第三医院,河南南阳474750

出　　处：《新中医》2023年第2期85-89,共5页New Chinese Medicine

基　　金：河南省医学科技攻关计划项目(LHGJ2019083)。

摘　　要：目的:观察滋肝益肾汤联合西药治疗糖尿病视网膜病变玻璃体切除术后患者的疗效。方法:选取96例肝肾亏虚型糖尿病视网膜病变患者作为研究对象,按照随机数字表法分为对照组和联合组各48例。2组均行玻璃体切除术,术前1周均在玻璃体腔内注射雷珠单抗注射液,术后使用妥布霉素地塞米松眼膏、氯替泼诺混悬滴眼液治疗,联合组加予滋肝益肾汤治疗。治疗前及治疗2个月后检测2组患者的血清血管内皮生长因子(VEGF)、骨形成蛋白-2(BMP-2)、血糖[餐后2 h血糖(P2hBG)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)],比较2组的视力改善情况、中医证候疗效及不良反应发生率。结果:治疗后,联合组中医证候疗效总有效率(87.50%)高于对照组(64.58%),差异有统计学意义(P<0.01)。联合组视力改善率(85.42%)高于对照组(62.50%),差异有统计学意义(P<0.05)。2组血清VEGF、BMP-2及P2hBG、FBG、HbA1c水平均较治疗前下降(P<0.05),联合组5项指标值均低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:滋肝益肾汤联合西药治疗糖尿病视网膜病变玻璃体切除术后患者可有效改善血管内皮功能及控制血糖水平,改善视力,安全有效。Objective:To observe the curative effect of Zigan Yishen Decoction combined with western medicine for patients after vitrectomy for diabetic retinopathy.Methods:A total of 96 cases of patients with diabetic retinopathy of liver-kidney depletion type were selected as the study subjects and divided into the control group and the combination group according to the random number table method,with 48 cases in each group.Both groups were treated with vitrectomy.One week before the operation,Ranibizumab Injection was injected into the vitreous.After the operation,both groups were treated with Tobramycin Dexamethasone Eye Ointment and Loteprednol Etabonate Ophthalmic Suspension,and the combination group was additionally treated with Zigan Yishen Decoction.Before treatment and after twomonth treatment,the vascular endothelial growth factor(VEGF)and bone morphogenetic protein-2(BMP-2)in serum,and blood glucose including postprandial 2-hour blood glucose(P2hBG),fasting blood glucose(FBG)and hemoglobin A1c(HbA1c)in the two groups were detected.The improvement of vision,curative effect of traditional Chinese medicine(TCM)syndromes and incidence of adverse reactions were compared between the two groups.Results:After treatment,the total curative effect rate of TCM syndromes was 87.50%in the combination group,higher than that of 64.58%in the control group,the difference being significant(P<0.01).The improvement rate of vision was 85.42%in the combination group,higher than that of 62.50%in the control group,the difference being significant(P<0.01).The levels of VEGF and BMP-2 in serum,and P2hBG,FBG and HbA1c in the two groups were decreased when compared with those before treatment(P<0.05),and the five values in the combination group were lower than those in the control group(P<0.05).There was no significant difference being found in the comparison of incidence of adverse reactions between the two groups(P>0.05).Conclusion:Zigan Yishen Decoction combined with western medicine for patients after vitrectomy for diabetic retinopathy

关 键 词：糖尿病视网膜病变 肝肾亏虚证 滋肝益肾汤 血管内皮生长因子 骨形成蛋白-2 血糖 

分 类 号：R781.64[医药卫生—口腔医学]