羟苯磺酸钙联合芪明颗粒治疗对非增殖期糖尿病视网膜病变患者脉络膜以及血清支链氨基酸、细胞因子的影响

Effect of calcium dobesilate combined with Qiming granule therapy on choroid as well as serum branched chain amino acids and cytokines in patients with non-proliferative diabetic retinopathy

目的：研究羟苯磺酸钙联合芪明颗粒治疗对非增殖期糖尿病视网膜病变患者脉络膜以及血清支链氨基酸、细胞因子的影响。方法：选择2012年5月-2015年10月期间在江苏省昆山市第一人民医院确诊的76例非增殖期糖尿病视网膜病变患者,分为联合治疗组（羟苯磺酸钙联合芪明颗粒治疗）和西药治疗组（羟苯磺酸钙治疗）。治疗后3个月时,通过OCT扫描测定脉络膜厚度,采集血清并测定支链氨基酸及细胞因子含量。结果：（1）OCT扫描：联合治疗组新生血管数目较少、脉络膜厚度较厚,联合治疗组中心凹下以及鼻侧、颞侧、上方、下方且距离中心凹1 mm处的脉络膜厚度均显著高于西药治疗组;（2）血清指标：联合治疗组治疗后3个月时的血清VEGF、IGF-1、TF、亮氨酸、异亮氨酸、缬氨酸含量低于西药治疗组,PEDF含量高于西药治疗组。结论：羟苯磺酸钙联合芪明颗粒治疗能够改善脉络膜循环、抑制视网膜内多种细胞因子所介导的血管新生、调节支链氨基酸代谢,是治疗非增殖期糖尿病视网膜病变的理想方法。

Objective： To study the effect of calcium dobesilate combined with Qiming granule therapy on choroid as well as serum branched chain amino acids and cytokines in patients with non-proliferative diabetic retinopathy. Methods： A total of 76 patients with non-proliferative diabetic retinopathy were divided into combined treatment group（ calcium dobesilate combined with Qiming granule therapy） and western medicine treatment group（ calcium dobesilate therapy）. Three months after treatment,the thickness of the choroid was determined by OCT scanning,and serum was collected to determine the levels of branched chain amino acids and cytokines. Results： The number of new blood vessels of combined treatment group was fewer,the choroid was thicker,and the thickness of subfoveal as well as the nasal,temporal,superior and inferior choroid 1mm from the central fovea of combined treatment group were significantly higher than those of western medicine treatment group. Serum VEGF,IGF-1,TF,leucine,isoleucine and valine levels ofcombined treatment group 3 months after treatment were lower than those of western medicine treatment group,and PEDF level was higher than that of western medicine treatment group. Conclusions： Calcium dobesilate combined with Qiming granule therapy can improve the choroidal circulation,inhibit the angiogenesis mediated by a variety of cytokines in retina and adjust the branched chain amino acid metabolism,and it is an ideal method for the treatment of non-proliferative diabetic retinopathy.