二甲双胍联合中药治疗气阴两虚型糖尿病视网膜病变的疗效研究

Clinical Effect of Metformin Combined with Traditional Chinese Medicine on Diabetic Retinopathy with Qi-yin Deficiency

目的探讨盐酸二甲双胍片联合中药治疗气阴两虚型糖尿病视网膜病变的疗效及安全性。方法将116例2型糖尿病视网膜病变患者(中医辨证均为气阴两虚型)随机分为两组,均给予降脂、降压治疗,在此基础上对照组(58例)给予生物合成人胰岛素皮下注射;治疗组(58例)给予盐酸二甲双胍片及中药糖视明方口服,均14d为1个疗程,连续治疗3个疗程。观察治疗前后生化指标、视网膜病变、低视力生活质量表(CLVQOL)评分及中医症状积分。结果治疗后两组患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、糖化血红蛋白(HbA1 c)、尿微量蛋白(UAER)、胰岛素敏感指数(ISI)、胰岛素抵抗指数(HOMA-IR)、收缩压、舒张压比较,差异均有统计学意义(P<0.05)。治疗后两组患者微动脉瘤、眼底出血、黄斑水肿、糖尿病失明的发生率以及视力下降程度比较,差异均有统计学意义(P<0.05)。两组治疗后CLVQOL评分及中医症状积分比较,差异均有统计学意义(P<0.05)。结论盐酸二甲双胍片联合中药糖视明方治疗气阴两虚型糖尿病视网膜病变疗效较胰岛素治疗效果好。

Objective To observe the efficacy of metformin hydrochloride tablets combined with Traditional Chinese Medicine（TCM） on diabetic retinopathy（DR） with Qi-yin deficiency and its safety.Methods A total of 116 DR patients（Qi-yin deficiency by TCM） were randomized into groups control,therapy,58 in each.Based on lipid-lowering,antihypertension treatment,group control were given subcutaneous injection of biosynthetic human insulin,while group therapy given metformin hydrochloride tablets and Tangshiming recipe,orally,14d as a course of treatment,3 courses continuously.Biochemical indices,retinopathy,low vision quality of life score（CLVQOL） and TCM symptom score were observed before and after treatment.Results There was significant difference between 2 groups in total cholesterol,triglyceride,low density lipoprotein cholesterol,high density lipoprotein cholesterol,fasting blood glucose,glycosylated hemoglobin,microalbuminuria,insulin sensitivity index,insulin resistance index,systolic blood pressure,diastolic blood pressure after treatment（P0.05）,and in incidence of micro-aneurysms,subhyaloid hemorrhage,macular edema,diabetic blindness and visual impairment level（P0.05）,and in CLVQOL and TCM symptom score（P0.05）.Conclusion Metformin Hydrochloride Tablets combined with TCM Tangshiming recipe is effective in treatment of diabetic retinopathy with Qi-yin deficiency..