通窍明目汤联合羟苯磺酸钙治疗糖尿病视网膜病变黄斑水肿临床研究  

Clinical Study on Tongqiao Mingmu Decoction Combined with Calcium Oxybenzoate Capsules for Diabetic Macular Edema

作　　者：李端 张海龙 任晓静 吴学志 LI Duan;ZHANG Hailong;REN Xiaojing;WU Xuezhi

机构地区：[1]驻马店市中心医院,河南驻马店463000

出　　处：《新中医》2023年第11期118-122,共5页New Chinese Medicine

摘　　要：目的:观察通窍明目汤联合羟苯磺酸钙治疗糖尿病视网膜病变黄斑水肿(DME)的临床疗效,分析其对患者眼部症状及血清指标的改善效果。方法:选择80例(80眼)DME患者为研究对象,通过盲选法随机分为对照组与联合组各40例。2组均接受激光治疗,对照组辅助羟苯磺酸钙治疗,联合组在对照组基础上联用通窍明目汤治疗,连续治疗3个月。比较2组临床疗效、用药安全性,并比较2组治疗前后眼部情况及血清指标。结果:联合组治疗总有效率为92.50%,高于对照组70.00%(P<0.05)。治疗前,2组最佳矫正视力、黄斑中心厚度与黄斑区荧光面积比较,差异无统计学意义(P>0.05);治疗后,2组最佳矫正视力均提高(P<0.05),黄斑中心厚度均变薄(P<0.05),黄斑区荧光面积均减小(P<0.05),且联合组最佳矫正视力高于对照组(P<0.05),黄斑中心厚度薄于对照组(P<0.05),黄斑区荧光面积小于对照组(P<0.05)。治疗前,2组血清一氧化氮合成酶(NOS)、脂联素(APN)、血管内皮生长因子(VEGF)、白细胞介素-6(IL-6)、同型半胱氨酸(Hcy)水平比较,差异无统计学意义(P>0.05);治疗后,2组血清NOS、APN水平均升高(P<0.05),且联合组高于对照组(P<0.05),2组VEGF、IL-6、Hcy水平均下降(P<0.05),且联合组低于对照组(P<0.05)。治疗期间,对照组与联合组眼压>21 mm Hg的患者分别为16例(40.00%)与6例(15.00%),2组比较,差异有统计学意义(χ2=6.270,P=0.012)。经处理后眼压均恢复正常。期间并未出现视网膜脱落、眼内炎、白内障等并发症情况。结论:通窍明目汤联合羟苯磺酸钙治疗DME患者,能够提高视力,减少黄斑中心厚度,其作用机制可能与抑制炎性反应及视网膜血管异常增生,改善眼底循环有关。Objective:To observe the clinical effect of the therapy of Tongqiao Mingmu Decoction combined with Calcium Oxybenzoate Capsules on diabetic macular edema(DME),and to analyze the improving effect of Tongqiao Mingmu Decoction on patients'eye symptoms and serum indexes.Methods:A total of 80 cases(80 eyes)of DME patients were selected as research objects,and were randomly divided into the control group and the combination group by blind selection,with 40 cases in each group.The two groups received laser treatment;the control group was assisted with Calcium Oxybenzoate Capsules,and the combination group was adopted with Tongqiao Mingmu Decoction based on the treatment of the control group.They were treated for three months.The clinical effects and medication safety,and the ocular conditions and serum indexes in the two groups were compared before and after treatment between the two groups.Results:The total effective rate was 92.50%in the combination group,higher than that of 70.00%in the control group(P<0.05).Before treatment,there was no significant difference in the best corrected visual acuity,macular central thickness and fluorescence area of macular region between the two groups(P>0.05).After treatment,the best corrected visual acuity was improved(P<0.05);the central thickness of macula got thinner(P<0.05),and the fluorescence area of macular region was decreased in both groups(P<0.05);the best corrected visual acuity in the combination group was better than that in the control group(P<0.05),the central thickness of macula was thinner than that in the control group(P<0.05),and the fluorescence area of macular region was smaller than that in the control group(P<0.05).Before treatment,there was no significant differences in serum levels of nitric oxide synthetase(NOS),adiponectin(APN),vascular endothelial growth factor(VEGF),interleukin-6(IL-6)and homocysteine(Hcy),between the two groups(P>0.05).After treatment,the levels of serum NOS and APN in the two groups were increased(P<0.05),and the levels of VEGF,IL-6 and

关 键 词：糖尿病视网膜病变黄斑水肿 通窍明目汤 羟苯磺酸钙 一氧化氮合成酶 血管内皮生长因子 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]