中药达明饮对NPDR气阴两虚，瘀血阻络证MPV、PDW、P-LCR的影响

发布时间：2018-04-17 03:01

本文选题：非增殖期糖尿病视网膜病变 + 达明饮　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:观察中药达明饮对非增殖期糖尿病视网膜病变(NPDR)气阴两虚、瘀血阻络证血小板平均体积(MPV)、血小板分布宽度(PDW)、及大型血小板比率(P-LCR)的影响,探讨该药可能的作用机理。方法:将符合入选标准的非增殖期糖尿病视网膜病变气阴两虚、瘀血阻络证患者共31例(62只眼),随机分为治疗组16例(32只眼)和对照组1 5例(30只眼)。治疗组予达明饮口服,对照组予羟苯磺酸钙口服,此两组疗程均为30天。观察治疗前后两组MPV、PDW、P-LCR、视力、眼底、FFA、中医证候等临床症状的改善情况,并将两组结果进行统计学分析。结果:(1)经30日治疗后,治疗组的总有效率为87.5%,对照组总有效率为76.7%,且治疗组疗效明显优于对照组,说明两组之间差异有统计学意义(P0.05)。(2)治疗后,两组的MPV、PDW均有改善,治疗组的改善情况优于对照组,两组的疗效差异具有统计学意义(P0.05)。(3)治疗前后对比,两组的P-LCR均有改善,治疗组的改善情况优于对照组,但治疗后两组的疗效差异不具有统计学意义(P0.05)。(4)用药30天后,两组视力均有提高,且二者差异有统计学意义(P0.05);治疗组视力的提高优于对照组。(5)治疗后,治疗组与对照组眼底均有改善,治疗组对眼底改善优于对照组,有统计学意义(P0.05)。(6)治疗后,治疗组中医证候积分有改善,对照组中医证候积分无明显改善,治疗组治疗前后差异有统计学意义(P0.01),治疗组明显优于对照组。(7)治疗后,治疗组的中医证候疗效总有效率为81.3%,对照组总有效率为13.3%,且治疗组中医证候疗效明显优于对照组,两组之间差异有统计学意义(P0.01)。结论:中药达明饮对气阴两虚、瘀血阻络证NPDR的患者的MPV PDW、P-LCR有明显的干预作用,同时改善NPDR的证候及视功能。其作用机制可能是从整体上调节机体内环境,减轻毛细血管壁的阻塞及损伤,降低毛细血管通透性,保护血管内屏障,改善视网膜的微循环从而治疗并控制NPDR的发生和发展。
[Abstract]:Objective: to observe the effects of Daming decoction on the average volume of platelet MPV, platelet distribution width and large platelet ratio P-LCRs in patients with non-proliferative diabetic retinopathy with deficiency of qi and yin, blood stasis and obstruction of collaterals, and to explore the possible mechanism of the drug.Methods: a total of 31 cases (62 eyes) of diabetic retinopathy with deficiency of qi and yin and stagnation of blood and collaterals were randomly divided into treatment group (n = 16, n = 32) and control group (n = 15, n = 30).The treatment group was treated with Daming Yin and the control group with calcium dobesilate for 30 days.The improvement of clinical symptoms such as MPV PDWN P-LCR, visual acuity, fundus FFAand TCM syndromes were observed before and after treatment, and the results of the two groups were analyzed statistically.Results after 30 days of treatment, the total effective rate of the treatment group was 87.5, and the total effective rate of the control group was 76.70.The curative effect of the treatment group was obviously better than that of the control group, which indicated that the difference between the two groups was statistically significant (P 0.05).The improvement of the treatment group was better than that of the control group, and the difference between the two groups was statistically significant. The P-LCR of the two groups was improved, and the improvement of the treatment group was better than that of the control group.However, the difference of curative effect between the two groups was not statistically significant 30 days after treatment, the visual acuity of the two groups was improved, and the difference was statistically significant (P 0.05), the improvement of visual acuity in the treatment group was better than that in the control group (P 0.05).Both the treatment group and the control group improved the fundus, the treatment group improved the fundus better than the control group, there was statistical significance after treatment, the treatment group improved the score of TCM syndromes, the control group did not improve the score of TCM syndromes.After treatment, the total effective rate of TCM syndrome in the treatment group was 81.3 and that in the control group was 13.3.The curative effect of TCM syndrome in the treatment group was obviously better than that in the control group.The difference between the two groups was statistically significant (P 0.01).Conclusion: Daming Yin has obvious intervention effect on MPV PDWN P-LCR in patients with deficiency of qi and yin and blood stasis obstruction of collaterals. Meanwhile, it can improve the syndromes and visual function of NPDR.The mechanism may be to regulate the internal environment, reduce the obstruction and injury of capillary wall, reduce the permeability of capillary, protect the intravascular barrier, improve the retinal microcirculation and control the occurrence and development of NPDR.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R276.7

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