中药联合视网膜光凝治疗糖尿病视网膜病变Ⅳ期（肝肾阴虚兼血瘀型）临床研究
发布时间：2019-05-19 12:47
【摘要】：目的：观察研究视网膜光凝术联合中药(补益肝肾,活血化瘀)治疗糖尿病视网膜病变增殖期(Ⅳ期)肝肾阴虚兼血瘀型的临床疗效。 方法：选2010年12月至2012年3月云南省第二人民医院眼科眼底病区门诊及住院的糖尿病增殖型视网膜病变Ⅳ期证属肝肾阴虚兼血瘀型的患者60例(76眼),按随机均等原则分为治疗组与对照组,治疗组30例40只眼,应用中成药(杞菊地黄丸及血塞通分散片)配合视网膜光凝治疗；对照组30例36只眼仅接受视网膜光凝治疗。治疗组每1-2周进行一次光凝,根据情况分次完成,术后第一天开始服用杞菊地黄丸(浓缩丸)及血塞通分散片,三个月为一个疗程,一疗程结束后随访；观察组仅进行光凝术治疗,术后三个月随访。通过对这两组患者进行治疗前后视力、眼底改变及眼底荧光造影结果的客观比较,观察两组的有效率,并做出相应的结论。 结果： 1.视力：治疗3个月后,治疗组视力(屈光不正者用最佳矫正视力)为0.50±0.50,对照组0.40±0.38,两组组比较有统计学意义(P0.05),治疗组视力提高优于对照组。 2.用检眼镜观察糖尿病患者治疗前后眼底出血、渗出及水肿等的变华情况,经相关统计学分析,治疗组有效率为92.5%,对照组有效率为75%,两组相比较有统计学意义(P0.05) 3.眼底荧光血管造影检查：治疗3个月后,治疗组渗漏面积为1.75±1.50,对照组总渗漏面积为2.00±1.50,两组比较有统计学差异性(P0.05),治疗组优于对照组。 4.新生血管消退比较：治疗3个月后,治疗组有效率为90.0%,对照组有效率为72.2%,两组比较有统计学差异性(P0.05),治疗组优于对照组。 5.黄斑水肿疗效比较：治疗3个月后,治疗组有效率为86.4%,对照组有效率为68.4%,两组比较有统计学差异性(P0.05),治疗组优于对照组。 6.总体疗效：治疗组总体疗效的有效率是75%,对照组总体疗效的有效率是52.8%,两组比较有统计学差异性(P0.05),治疗组优于对照组。 结论：在视网膜光凝治疗与中药的联合疗法中,中药的药效可与视网膜光凝术产生协同作用,弥补治疗的不足。与单纯激光治疗相比,联合疗法能更有效的促使增殖期糖网病新生血管的消退,减轻黄斑水肿,能更好的改善患者视功能。因此,视网膜光凝术后联合中药治疗增殖型糖尿病视网膜病变具有一定优势。
[Abstract]:Objective: to observe the clinical effect of retinal photocoagulation combined with traditional Chinese medicine (tonifying liver and kidney, promoting blood circulation and removing blood stasis) in the treatment of diabetic Retinopathy with deficiency of liver and kidney yin and blood stasis. Methods: from December 2010 to March 2012, 60 patients (76 eyes) with stage IV syndrome of diabetic hyperplasia with deficiency of liver and kidney yin and blood stasis were selected from the outpatients and inpatients of ophthalmic fundus disease area of the second people's Hospital of Yunnan Province. According to the principle of random equality, 30 patients (40 eyes) in the treatment group were randomly divided into treatment group and control group. The patients in the treatment group were treated with Chinese patent medicine (Qiju Dihuang Pill and Xuesaitong dispersible tablet) combined with retinal photocoagulation. In the control group, 30 cases (36 eyes) were treated with retinal photocoagulation only. In the treatment group, photocoagulation was performed every 1 week and completed according to the situation. Qiju Dihuang pills (concentrated pills) and Xuesaitong dispersible tablets were taken on the first day after operation, three months as a course of treatment, and followed up at the end of a course of treatment. The observation group was treated with photocoagulation only and followed up three months after operation. Through the objective comparison of visual acuity, fundus changes and fundus fluorescein angiography between the two groups before and after treatment, the effective rate of the two groups was observed and the corresponding conclusions were drawn. Result: 1. Visual acuity: after 3 months of treatment, the visual acuity of the treatment group (ametropia group with best corrected visual acuity) was 0.50 卤0.50, and that of the control group was 0.40 卤0.38. There was significant difference between the two groups (P 0.05). The visual acuity of the treatment group was better than that of the control group. 2. The fundus bleeding, exudation and edema of diabetic patients before and after treatment were observed by ophthalmoscope. The effective rate was 92.5% in the treatment group and 75% in the control group. There was significant difference between the two groups (P 0.05). Fundus fluorescein angiography: after 3 months of treatment, the leakage area of the treatment group was 1.75 卤1.50, and the total leakage area of the control group was 2.00 卤1.50. There was significant difference between the two groups (P 0.05). The treatment group was better than the control group. 4. Comparison of neovascularization regression: after 3 months of treatment, the effective rate was 90.0% in the treatment group and 72.2% in the control group. There was significant difference between the two groups (P 0.05). The treatment group was superior to the control group. 5. Comparison of the curative effect of macular edema: after 3 months of treatment, the effective rate was 86.4% in the treatment group and 68.4% in the control group. There was significant difference between the two groups (P 0.05). The treatment group was better than the control group. 6. The overall curative effect: the effective rate of the treatment group was 75%, and that of the control group was 52.8%. There was significant difference between the two groups (P 0.05). The treatment group was better than the control group. Conclusion: in the combined therapy of retinal photocoagulation and traditional Chinese medicine, the efficacy of traditional Chinese medicine can have synergistic effect with retinal photocoagulation, and make up for the deficiency of treatment. Compared with laser alone, combined therapy can promote the regression of neovascularization in proliferating glycoreticular disease, reduce macular edema and improve the visual function of patients. Therefore, retinal photocoagulation combined with traditional Chinese medicine has certain advantages in the treatment of proliferating diabetic Retinopathy.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R587.2;R774.1
本文编号：2480736
[Abstract]:Objective: to observe the clinical effect of retinal photocoagulation combined with traditional Chinese medicine (tonifying liver and kidney, promoting blood circulation and removing blood stasis) in the treatment of diabetic Retinopathy with deficiency of liver and kidney yin and blood stasis. Methods: from December 2010 to March 2012, 60 patients (76 eyes) with stage IV syndrome of diabetic hyperplasia with deficiency of liver and kidney yin and blood stasis were selected from the outpatients and inpatients of ophthalmic fundus disease area of the second people's Hospital of Yunnan Province. According to the principle of random equality, 30 patients (40 eyes) in the treatment group were randomly divided into treatment group and control group. The patients in the treatment group were treated with Chinese patent medicine (Qiju Dihuang Pill and Xuesaitong dispersible tablet) combined with retinal photocoagulation. In the control group, 30 cases (36 eyes) were treated with retinal photocoagulation only. In the treatment group, photocoagulation was performed every 1 week and completed according to the situation. Qiju Dihuang pills (concentrated pills) and Xuesaitong dispersible tablets were taken on the first day after operation, three months as a course of treatment, and followed up at the end of a course of treatment. The observation group was treated with photocoagulation only and followed up three months after operation. Through the objective comparison of visual acuity, fundus changes and fundus fluorescein angiography between the two groups before and after treatment, the effective rate of the two groups was observed and the corresponding conclusions were drawn. Result: 1. Visual acuity: after 3 months of treatment, the visual acuity of the treatment group (ametropia group with best corrected visual acuity) was 0.50 卤0.50, and that of the control group was 0.40 卤0.38. There was significant difference between the two groups (P 0.05). The visual acuity of the treatment group was better than that of the control group. 2. The fundus bleeding, exudation and edema of diabetic patients before and after treatment were observed by ophthalmoscope. The effective rate was 92.5% in the treatment group and 75% in the control group. There was significant difference between the two groups (P 0.05). Fundus fluorescein angiography: after 3 months of treatment, the leakage area of the treatment group was 1.75 卤1.50, and the total leakage area of the control group was 2.00 卤1.50. There was significant difference between the two groups (P 0.05). The treatment group was better than the control group. 4. Comparison of neovascularization regression: after 3 months of treatment, the effective rate was 90.0% in the treatment group and 72.2% in the control group. There was significant difference between the two groups (P 0.05). The treatment group was superior to the control group. 5. Comparison of the curative effect of macular edema: after 3 months of treatment, the effective rate was 86.4% in the treatment group and 68.4% in the control group. There was significant difference between the two groups (P 0.05). The treatment group was better than the control group. 6. The overall curative effect: the effective rate of the treatment group was 75%, and that of the control group was 52.8%. There was significant difference between the two groups (P 0.05). The treatment group was better than the control group. Conclusion: in the combined therapy of retinal photocoagulation and traditional Chinese medicine, the efficacy of traditional Chinese medicine can have synergistic effect with retinal photocoagulation, and make up for the deficiency of treatment. Compared with laser alone, combined therapy can promote the regression of neovascularization in proliferating glycoreticular disease, reduce macular edema and improve the visual function of patients. Therefore, retinal photocoagulation combined with traditional Chinese medicine has certain advantages in the treatment of proliferating diabetic Retinopathy.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R587.2;R774.1
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