“肝脾同调-血水同治”对增殖性糖尿病性视网膜病变PPV围手术期的影响  

Effect of liver and spleen-regulating and blood stasis and phlegm-dispelling on perioperative period of pars plana vitrectomy in proliferative diabetic retinopathy

作　　者：陈丽[1] 周莅斌[1] 冉起[1] 吴成富[1] CHEN Li;ZHOU Libin;RAN Qi;WU Chengfu(Department of Ophthalmology,Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine,Panzhihua 617000,China)

机构地区：[1]四川省攀枝花市中西医结合医院眼科,四川攀枝花617000

出　　处：《长春中医药大学学报》2024年第5期542-546,共5页Journal of Changchun University of Chinese Medicine

基　　金：四川省中医药管理局科学技术研究专项课题计划(2021MS402)。

摘　　要：目的探究“肝脾同调-血水同治”对增殖性糖尿病性视网膜病变(proliferative diabetic retinopathy,PDR)玻璃体切除术(pars plana vitrectomy,PPV)患者围手术期的影响。方法选取2021年6月—2023年6月本院收治的63例PDR患者,按照简单随机法分为常规组(n=31)和同调组(n=32),常规组给予常规围术期治疗(术前3~5 d至术后7 d),同调组在常规组基础上实施“肝脾同调-血水同治”治法,比较2组临床指标、并发症(高眼压、玻璃体积血、视力下降)、眼压、炎症反应分级(前房闪辉、前房炎症细胞、纤维蛋白渗出),干预前后炎症因子水平[前房液白细胞介素-6(Interleukin-6,IL-6)、血清C反应蛋白(C-reactive protein,CRP)]。结果同调组手术时间、住院时间低于常规组(P<0.05);2组并发症总发生率比较无统计学意义(P>0.05);术后1 d、3 d,2组眼压均随时间延长而下降(P<0.05),且术后1 d同调组低于常规组(P<0.05);术后1 d、1周,2组前房闪辉、前房炎症细胞和纤维蛋白渗出评级随时间延长明显减轻(P<0.05),且术后1 d同调组前房闪辉评级明显低于常规组(P<0.05);术后1 d、1周,2组前房液IL-6、血清CRP均随时间延长而降低(P<0.05),且同调组均低于常规组(P<0.05)。结论“肝脾同调-血水同治”应用于PPV治疗的PDR患者,可减少患者围术期并发症,有效控制炎症反应,缩短手术时间和住院时长,具有临床应用价值。Objective To explore the effect of"liver and spleen-regulating and blood stasis and phlegm-dispelling"on the perioperative period of patients with proliferative diabetic retinopathy(PDR)undergoing pars plana vitrectomy(PPV).Methods 63 patients with PDR admitted to Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine from June 2021 to June 2023 were selected and divided into the conventional group(n=31)and the simultaneous regulating group(n=32)according to the simple randomization method.The conventional group received rutine perioperative treatment(3-5 days before surgery to 7 days after surgery),while the simultaneous regulating group received"liver and spleen-regulating and blood stasis and phlegmdispelling"on the basis of the treatment of the conventional group.The clinical indicators,complications(high intraocular pressure,vitreous hemorrhage,decreased visual acuity),intraocular pressure and inflammatory response grading(anterior chamberflare,anterior chamber inflammatory cells,fibrin exudation),and levels of inflammatory factors[anterior chamber fluid interleukin-6(IL-6),serum C-reactive protein(CRP)]before and after intervention were compared between two groups.Results The surgical time and hospital stay in the simultaneous regulating group were shorter than those in the conventional group(P<0.05).There was no statistically significance diference in the total incidence rate of complications between two groups(P>0.05).At 1 day and 3 days after surgery,the intraocular pressure in two groups decreased with time(P<0.05),and at 1 day after surgery,the simultaneous regulating group was lower than the conventional group(P<0.05).At 1 day and 1 week after surgery,the anterior chamberflare,anterior chamber inflammatory cells and fibrin exudation ratings in both groups were obviously relieved with time(P<0.05),and at 1 day after surgery,the anterior chamberflare rating in the simultaneous regulating group was significantly lower than that in the conventional group(P<0.05).At 1 day and 1 week

关 键 词：增殖性糖尿病性视网膜病变 玻璃体切除术 肝脾同调 血水同治 

分 类 号：R774.13[医药卫生—眼科]