明目补肾汤治疗糖尿病肾病眼底病变临床研究

Clinical Study of Mingmu Bushen Tang for Fundus Diseases Induced by Diabetic Nephropathy

目的:观察明目补肾汤治疗糖尿病肾病眼底病变的临床疗效及对眼内液促红细胞生成素(EPO)、血管内皮生长因子(VEGF)水平的影响。方法:将2型糖尿病肾病伴眼底病变患者624例(每例患者选取1只眼)随机分为2组,对照组312例采用常规西医治疗,干预组312例在对照组的基础上加用明目补肾汤治疗;2组均以1月为1疗程,共治疗6疗程;观察2组治疗前后视力、血管瘤、出血斑、硬性渗出、棉絮吸收等主要临床症状改善情况,检测治疗前后眼内液EPO、VEGF水平,并评价临床疗效。结果:总有效率干预组为83.97%,对照组为63.14%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组患者视力均较治疗前明显提高(P <0.05),且干预组患者视力提高较对照组更显著(P <0.05)。治疗后,干预组患者血管瘤减少、出血斑减少、硬性渗出减少及棉絮吸收疗效均优于对照组(P <0.05)。治疗后,2组患者VEGF、EPO水平均较治疗前明显降低(P <0.05),且干预组VEGF、EPO水平降低较对照组更显著(P <0.05)。结论:明目补肾汤治疗糖尿病肾病型眼底病变,可抑制VEGF及EPO水平,减少视网膜血管增殖,有效阻止或延缓眼底病变进展,从而提高临床疗效。

Objective:To observe the clinical effect of Mingmu Bushen tang for fundus diseases induced by diabetic nephropathy and the effect on levels of intraocular erythropoietin(EPO)and vascular endothelial growth factor(VEGF).Methods:Divided 624 cases of patients with type 2 diabetic nephropathy with fundus diseases(one eye per patient)randomly into two groups.312 patients in the control group were treated with routine western medicine,while other 312 patients in theintervention group were additionally given Mingmu Bushen tang.The treatment for both groups lasted for 6 courses,one month per course.Observed the improvement of main clinical symptoms such as visual acuity,hemangioma,hemorrhage,blood spots,hard exudation and cotton-like blood clot absorption before and after treatment,detected levels of EPO and VEGF in the ocular fluid before and after treatment,and evaluated the clinical effect.Results:The total effective was 83.97%in the intervention group and 63.14%in the control group,compared the two groups,difference being significant(P<0.05).After treatment,the visual acuity in the two groups was significantly higher than that before treatment(P<0.05);the improvement of the visual acuity in the intervention group was significantly more obvious than that in the control group(P<0.05).After treatment,the hemangioma reduction,hemorrhage reduction,hard exudation reduction and cotton-like blood clot absorption in the intervention group were better than those in the control group(P<0.05).After treatment,the levels of VEGF and EPO in the two groups were evidently lower than those before treatment(P<0.05);the levels of VEGF and EPO in the intervention group were clearly lower than those in the control group(P<0.05).Conclusion:The application of Mingmu Bushen tang for fundus diseases of diabetic nephropathy type can effectively inhibit the VEGF and EPO levels,reduce retinal vascular proliferation,and significantly prevent or delay the progression of fundus diseases,thereby improving clinical efficacy.