清肝明视汤治疗轻中度非增生性糖尿病视网膜病变的疗效及对血清25羟维生素D、胱抑素C、血栓调节蛋白的影响  

Efficacy of Qinggan Mingshi Decoction on mild to moderate nonproliferative diabetic retinopathy and the effect of serum 25-hydroxyvitamin D,cystinase inhibitor and thrombomodulin

作　　者：王晓蕴[1] 吴进 张忠勇[1] 牛跃龙 陈伟 王元松[1] WANG Xiaoyun;WU Jing;ZHANG Zhongyong;NIU Yuelong;CHEN Wei;WANG Yuansong(Second Department of Endocrinology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei 061001)

机构地区：[1]河北省沧州中西医结合医院内分泌二科,河北沧州061001

出　　处：《河北中医》2023年第5期765-769,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北中医药管理局科研计划项目(编号:2021349);中国民族医药学会科研项目(编号:2020ZY118-580101)。

摘　　要：目的观察清肝明视汤治疗轻中度非增生性糖尿病视网膜病变(NPDR)的疗效及对血清25羟维生素D[25-(OH)D]、胱抑素C(CysC)、血栓调节蛋白(TM)的影响。方法将96例轻中度NPDR患者(共177眼)按照随机数字表法分为2组,对照组48例(90眼)予羟苯磺酸钙胶囊治疗,试验组48例(87眼)在对照组治疗基础上予清肝明视汤治疗,4周为1个疗程,2组均连续治疗6个疗程。比较2组治疗前后中医证候评分、血清25-(OH)D、CysC、TM、超氧化物歧化酶(SOD)水平及眼底视网膜微血管病变程度,统计2组治疗期间不良反应发生情况,对比2组治疗后最佳矫正视力,比较2组临床疗效。结果试验组总有效率94.25%(82/87),对照组总有效率73.33%(66/90),试验组临床疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分及总分均较本组治疗前降低(P<0.05),且试验组治疗后均低于对照组(P<0.05)。试验组治疗后最佳矫正视力>0.05眼数占比高于对照组,比较差异有统计学意义(P<0.05)。2组治疗后血清25-(OH)D、SOD水平均较本组治疗前升高(P<0.05),且试验组治疗后均高于对照组(P<0.05),2组治疗后血清CysC、TM水平均较本组治疗前降低(P<0.05),且试验组治疗后均低于对照组(P<0.05)。2组治疗后渗出灶面积、微血管瘤数量、出血灶面积均较本组治疗前降低(P<0.05),且试验组治疗后均低于对照组(P<0.05)。结论清肝明视汤联合羟苯磺酸钙胶囊治疗轻中度NPDR效果显著,可改善临床症状,提升视力,提高血清25-(OH)D水平,降低血清CysC、TM水平,改善眼底视网膜微血管病变程度,且安全可靠。Objective To investigate the curative effect of Qinggan Mingshi Decoction on mild to moderate non-proliferative diabetic retinopathy(NPDR)and its serum 25-hydroxyvitamin D[25-(OH)D],cystinase inhibitor(CysC),Effects of thrombomodulin(TM).Methods A total of 96 patients with mild to moderate NPDR(a total of 177 eyes)were selected as the research subjects,and randomly allocated to the control group(n=48,90 eyes)and the experimental group(n=48,87 eyes).The control group received calcium dobesilate capsules,and the experimental group received Qinggan Mingshi Decoction on the basis of the control group.Four weeks was a course of treatment.Before treatment and after 6 courses of treatment,traditional Chinese medicine(TCM)symptom scores,serum 25-(OH)D,CysC,TM,superoxide dismutase(SOD),and retinal microvascular lesions were compared between the two groups.The incidence of adverse reactions within 6 courses of treatment in the two groups was compared.The best corrected visual acuity after 6 courses of treatment in the 2 groups was compared.The clinical efficacy of the two groups was compared.Results After 6 courses of treatment,the total effective rate of the experimental group[was higher than that of the control group(94.25%[82/87]vs 73.33%[66/90],P<0.05).The total scores of TCM syndromes in both groups were lower than those before treatment in this group(P<0.05),and the experimental group was lower than that in the control group(P<0.05).The best corrected visual acuity in both groups was higher than that before treatment(P<0.05),and the experimental group was significantly higher than that in the control group(P<0.05).The levels of serum 25-(OH)D and SOD in both groups were higher than before treatment(P<0.05),and the experimental group was higher than that in the control group(P<0.05).The levels of serum CysC and TM in the two groups were lower than before treatment(P<0.05),and those in the experimental group were lower than the control group(P<0.05).The area of exudation,the number of microangioma,and the area of hemor

关 键 词：糖尿病视网膜病变 羟苯磺酸钙 中药疗法 

分 类 号：R587.260.58[医药卫生—内分泌]