清热利湿法联合视网膜激光光凝术治疗糖尿病性视网膜病变的效果观察  

Observation on the efficacy of clearing heat and removing dampness combined with photocoagulation in the treatment of diabetic retinopathy

作　　者：刘博[1] 来坚[1] 朱琳 Liu Bo;Lai Jian;Zhu Lin(Department of Ophthalmology,Hangzhou Municipal Traditional Chinese Medicine Hospital,Hangzhou 310000,China)

机构地区：[1]杭州市中医院眼科,杭州310000

出　　处：《中华眼外伤职业眼病杂志》2023年第11期821-826,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：杭州市科技计划引导项目(20191231Y056)。

摘　　要：目的观察清热利湿法联合视网膜激光光凝术治疗糖尿病视网膜病变(DR)的效果。方法前瞻性随机对照研究。选取杭州市中医院2020年1月-2022年12月收治的DR患者98例,按照随机数字表法分为两组,每组49例。对照组应用视网膜激光光凝术治疗,治疗组在对照组基础上联合清热利湿法治疗。随访比较两组视力(logMAR)、黄斑中心区视网膜厚度、中医证候评分及并发症。结果治疗前两组之间视力、黄斑中心区视网膜厚度及中医证候评分比较差异均无统计学意义(P=0.374、0.694、0.774);治疗后4周,视力[治疗组(0.39±0.11)vs对照组(0.43±0.09)]、黄斑中心区厚度[治疗组(433.10±47.01)μm vs对照组(449.08±52.10)μm]及中医证候评分[治疗组(11.06±3.00)分vs对照组(12.02±3.10)分]均低于治疗前(均P<0.001),但组间比较差异无统计学意义(P>0.05)。治疗后3个月,治疗组视力、黄斑中心区厚度及中医证候评分[0.25±0.03、(224.02±38.10)μm、(5.82±0.81)分]分别与对照组相比[0.34±0.06、(267.06±42.06)μm、(8.14±1.40)分],差异均有统计学意义(t=9.00、5.31、10.07,均P<0.001)。两组患者的并发症总发生率[治疗组8.16%(4/49)vs对照组12.24%(6/49)],差异无统计学意义(χ^(2)=0.45,P=0.505)。结论清热利湿法联合视网膜光凝术治疗DR疗效确切,可改善患者视力、黄斑中心区厚度及中医证候评分,且不增加术后并发症。Objective To observe the efficacy of clearing heat and removing dampness combined with retinal photocoagulation in the treatment of diabetic retinopathy(DR).Methods This was a prospective randomized controlled study.A total of 98 cases of DR from Jan.2020 to Dec.2022 in Hangzhou Hospital of Traditional Chinese Medicine were selected and divided into two groups based on random number table method,with 49 cases in each group.The control group was treated with retinal photocoagulation,while the treatment group was treated with clearing heat and removing dampness additionally.Visual acuity(logMAR),retinal thickness in macular center,Traditional Chinese Medicine(TCM)syndrome score and complications were compared between the two groups.Results Before treatment,there was no significant difference in visual acuity,retinal thickness in macular central area or TCM syndrome score between the two groups(P=0.374,0.694,0.774).At 4 weeks after treatment,visual acuity[(0.39±0.11)in the treatment group vs(0.43±0.09)in the control group],central macular area thickness[(433.10±47.01)μm in the treatment group vs(449.08±52.10)μm in the control group],and TCM syndrome score[(11.06±3.00)in the treatment group vs(12.02±3.10)in the control group]were all lower than those before treatment.But there was no statistical significance between the two groups(P>0.05).At 3 months after treatment,visual acuity,central macular thickness and TCM syndrome score of the treatment group were 0.25±0.03,(224.02±38.10)μm,(5.82±0.81)point respectively,compared with those of the control group[0.34±0.06,(267.06±42.06)μm,(8.14±1.40)points],and the difference was statistically significant(t=9.00,5.31,10.07;all P<0.001).There was no significant difference in the total incidence of complications between the two groups[8.16%(4/49)in treatment group vs 12.24%(6/49)in the control group(χ^(2)=0.45,P=0.505)].Conclusion Clearing heat and removing dampness combined with retinal photocoagulation in the treatment of DR has a definite effect,which can impr

关 键 词：视网膜 激光凝固术 糖尿病视网膜病变 疗效 并发症 

分 类 号：R587.2[医药卫生—内分泌] R779.6[医药卫生—内科学]