明目地黄丸联合玻璃体腔内注射雷珠单抗治疗非增殖期糖尿病视网膜病变伴黄斑水肿临床研究  

Clinical Study on Mingmu Dihuang Pills Combined with Intravitreal Injection of Ranibi⁃zumab for Non-Proliferative Diabetic Retinopathy Complicated with Macular Edema

作　　者：王志勇 戚俊凯 罗顺利 WANG Zhiyong;QI Junkai;LUO Shunli(Zhoukou city eye hospital,Zhoukou He'nan 466000,China)

机构地区：[1]周口市眼科医院,河南周口466000

出　　处：《新中医》2023年第14期82-87,共6页New Chinese Medicine

摘　　要：目的:观察明目地黄丸联合玻璃体腔内注射雷珠单抗治疗非增殖期糖尿病视网膜病变伴黄斑水肿的临床疗效。方法:选取90例肝肾阴虚型非增殖期糖尿病视网膜病变伴黄斑水肿患者,随机分为对照组和观察组各45例。对照组给予玻璃体腔内注射雷珠单抗治疗。观察组在对照组基础上加用明目地黄丸治疗。2组均治疗3个月。对比2组临床疗效,治疗前后评定中医证候积分,检测视功能、黄斑中心视网膜厚度、黄斑视网膜体积、眼底检查相关指标、实验室检查指标[中性粒细胞/淋巴细胞比值(NLR)、单核细胞趋化蛋白-1 (MCP-1)、血管内皮生长因子(VEGF)、晚期糖基化终末产物(AGEs)]。观察治疗期间患者的不良反应发生情况。结果:治疗3个月后,临床疗效总有效率观察组95.24%,对照组80.95%,2组总有效率比较,差异均有统计学意义(P<0.05)。2组中医证候积分均较治疗前降低(P<0.05),观察组中医证候积分低于对照组(P<0.05)。2组最佳矫正视力均较治疗前改善,黄斑视网膜体积、黄斑中心视网膜厚度值均较治疗前下降(P<0.05),观察组最佳矫正视力、黄斑视网膜体积、黄斑中心视网膜厚度值均低于对照组(P<0.05)。2组微血管瘤数均较治疗前减少,血管渗漏面积、毛细血管无灌注区面积均较治疗前缩小,视网膜循环时间均较治疗前缩短,差异均有统计学意义(P<0.05)。观察组微血管瘤数少于对照组,血管渗漏面积、毛细血管无灌注区面积均小于对照组,视网膜循环时间较对照组缩短,差异均有统计学意义(P<0.05)。2组NLR、MCP-1、AGEs、VEGF水平均较治疗前降低(P<0.05),观察组NLR、MCP-1、AGEs、VEGF水平均低于对照组(P<0.05)。2组患者均未发生明显不良反应。结论:明目地黄丸联合玻璃体腔内注射雷珠单抗治疗肝肾阴虚型非增殖期糖尿病视网膜病变伴黄斑水肿患者具有良好的临床疗效,能改善眼底状况,提高视�Objective:To observe the clinical effect of Mingmu Dihuang Pills combined with intravitreal injection of Ranibizumab on non-proliferative diabetic retinopathy complicated with macular edema.Methods:A total of 90 patients with non-proliferative diabetic retinopathy complicated with macular edema of liver-kidney yin deficiency type were selected and randomly divided into the control group and the observation group,with 45 cases in each group.The control group was given the intravitreal injection of Ranibizumab for treatment,and the observation group was additionally treated with Mingmu Dihuang Pills based on the treatment of the control group.The two groups were treated for 3 months.The clinical effects were compared between the two groups;before and after treatment,the traditional Chinese medicine(TCM)syndrome scores were evaluated;the visual function,the thickness of macular central retina,volume of macular retina,related indexes of fundus examination,and indexes of laboratory investigation,including neutrophil-to-lymphocyte ratio(NLR),monocyte chemoattractant protein-1(MCP-1),vascular endothelial growth factor(VEGF)and advanced glycation end products(AGEs)were detected.The incidence of adverse reactions was observed during treatment.Results:After 3 months of treatment,the total effective rate was 80.95%in the control group and 95.24%in the observation group,differences being significant(P<0.05).The TCM syndrome scores in both groups were decreased when compared with those before treatment(P<0.05),and the TCM syndrome score in the observation group was lower than that in the control group(P<0.05).The best corrected vision in the two groups were improved when compared with those before treatment,and the thickness of macular central retina and volume of macular retina were decreased when compared with those before treatment(P<0.05);the best corrected vision,thickness of macular central retina and volume of macular retina in the observation group were lower than those in the control group(P<0.05).The number of micro

关 键 词：非增殖期糖尿病视网膜病变 黄斑水肿 肝肾阴虚证 明目地黄丸 视功能 眼底检查 

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