核桃灸联合羟苯磺酸钙治疗肝肾阴虚型非增殖期糖尿病视网膜病变  

Walnut Moxibustion Combined with Calcium Dobesilate in Treatment of Liver-Kidney-Yin-Deficiency Type Non-Proliferative Diabetic Retinopathy

作　　者：刘丹[1] 许华[1] 孙宇轩 高达[1] 赵璐[1] 孙俊波[3] 庞雨 LIU Dan;XU Hua;SUN Yuxuan;GAO Da;ZHAO Lu;SUN Junbo;PANG Yu(The Third Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450008;Sanquan College of Xinxiang Medical University,Xinxiang Henan China 453003;The Second Affiliated Hospital to Henan University of Chinese Medicine/Henan Provincial Hospital of Chinese Medicine,Zhengzhou Henan China 450002;Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008 [2]新乡医学院三全学院,河南新乡453003 [3]河南中医药大学第二附属医院/河南省中医院,河南郑州450002 [4]河南中医药大学,河南郑州450046

出　　处：《中医学报》2023年第12期2670-2677,共8页Acta Chinese Medicine

基　　金：河南省中医药科学研究专项课题项目(20-21ZY2225);河南省首批拔尖人才培养项目{豫中医科教〔2018〕35号};第五批全国中医优秀临床人才研修项目{国中医药人教函〔2022〕1号}。

摘　　要：目的:观察核桃灸联合羟苯磺酸钙治疗肝肾阴虚型非增殖期糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)的临床疗效。方法:81例肝肾阴虚型NPDR患者按照随机数字表法分为对照组40例和治疗组41例。对照组给予羟苯磺酸钙分散片口服,治疗组在此基础上加用核桃灸,两组均连续治疗2个疗程(28 d)。比较两组患者临床疗效及治疗前后中医证候积分、最佳矫正视力、黄斑中心凹视网膜厚度、视网膜中央动脉血流动力学指标[舒张末期流速(end diastolic velocity,EDV)、收缩峰值流速(peak systolic velocity,PSV)、平均血流速度(mean velocity,MV)、阻力指数(resistance index,RI)和搏动指数(pulsatility index,PI)]。结果:(1)治疗组有效率(95.12%)明显高于对照组(77.50%),差异有统计学意义(P<0.05)。(2)治疗后,对照组和治疗组的中医证候积分[(8.61±3.66)分,(5.61±2.24)分]均明显降低[(16.10±1.77)分,(16.19±1.94)分],差异有统计学意义(P<0.01),且治疗组显著低于同期对照组(P<0.01)。(3)治疗后,对照组和治疗组的最佳矫正视力[(0.44±0.11),(0.52±0.09)]均显著升高[(0.35±0.12),(0.34±0.11)],差异有统计学意义(P<0.05),且治疗组显著高于同期对照组(P<0.01)。(4)治疗后,对照组和治疗组的黄斑中心凹视网膜厚度[(238.54±29.77)μm,(175.66±25.79)μm]均显著减少[(278.64±36.45)μm,(282.06±37.32)μm],差异有统计学意义(P<0.01),且治疗组显著低于同期对照组(P<0.01)。(5)治疗后,对照组和治疗组的EDV水平[(3.78±0.79)cm·s^(-1),(4.16±0.95)cm·s^(-1)]均高于治疗前[(2.94±0.82)cm·s^(-1),(2.92±0.87)cm·s^(-1)],差异有统计学意义(P<0.05),且治疗组显著高于同期对照组(P<0.05);治疗后,对照组和治疗组的PSV水平[(9.94±1.39)cm·s^(-1),(11.59±1.64)cm·s^(-1)]均高于治疗前[(8.77±1.25)cm·s^(-1),(8.75±1.51)cm·s^(-1)],差异有统计学意义(P<0.05),且治疗组显著高于同期对照组(P<0.05);治疗后,对照组和治疗组Objective:To observe the clinical efficacy of walnut moxibustion combined with calcium dobesilate in treatment of liver-kidney-Yin-dificiency type non-proliferative diabetic retinopathy(NPDR).Methods:81 patients with liver-kidney-Yin-dificiency type NPDR were randomly divided into a control group of 40 cases and a treatment group of 41 cases according to the number table method.The control group received oral administration of calcium dobesilate dispersible tablets,while the treatment group received walnut moxibustion on this basis.Both groups were treated continuously for two courses of treatment(28 days).Compare the clinical efficacy,syndrome scores of traditional Chinese medicine(TCM),best corrected visual acuity,macular fovea retinal thickness,and central retinal artery hemodynamic indicators[end-diastolic velocity(EDV),peak systolic velocity(PSV),mean velocity(MV),resistance index(RI),and pulsatility index(PI)]between two groups of patients before and after treatment.Results:(1)The effective rate of the treatment group(95.12%)was significantly higher than that of the control group(77.50%),and the difference was statistically significant(P<0.05).(2)After treatment,the TCM syndrome scores of the control group and the treatment group[(8.61±3.66)points,(5.61±2.24)points]were significantly reduced compared to those before treatment[(16.10±1.77)points,(16.19±1.94)points],with a statistically significant difference(P<0.01),and the treatment group was significantly lower than the control group during the same period(P<0.01).(3)After treatment,the optimal corrected visual acuity of the control group and the treatment group[(0.44±0.11),(0.52±0.09)]significantly increased compared to those before treatment[(0.35±0.12),(0.34±0.11)],with a statistically significant difference(P<0.05),and the treatment group was significantly higher than the control group during the same period(P<0.01).(4)After treatment,the macular fovea retinal thickness of the control group and the treatment group[(238.54±29.77)μm,(175.66±25

关 键 词：非增殖期糖尿病视网膜病变 核桃灸 羟苯磺酸钙 黄斑中心凹视网膜厚度 血流动力学 肝肾阴虚证 

分 类 号：R259.872[医药卫生—中西医结合]