益气活血通络方治疗糖尿病视网膜病变临床研究

Clinical Study on Yiqi Huoxue Tongluo Recipe in Treatment of Diabetic Retinopathy

目的:观察益气活血通络方治疗糖尿病视网膜病变(diabetic retinopathy,DR)的临床疗效,并分析血清C肽、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、白细胞介素-1β(interleukin-1 beta,IL-1β)的变化。方法:124例DR患者按照随机数字表法分为观察组和对照组各62例。对照组给予常规西药治疗,观察组在对照组基础上联合益气活血通络方治疗。观察两组中医证候积分、空腹血糖(fasting blood-glucose,FPG)、餐后2小时血糖(2 hours post-prandial glucose,2h PG)、糖化血红蛋白(hemoglobin Alc,HbA1c)、视力、视网膜黄斑中心凹厚度、收缩期峰值流速(peak systolic velocity,PSV)、舒张期末流速(end of diastolic velocity,EDV)、阻力指数(resistance index,RI)、临床疗效、血清C肽、TNF-α、IL-1β水平。结果:治疗后两组中医证候积分显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);治疗后两组FPG、2h PG、HbA1c水平显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);治疗后两组视力显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05);治疗后两组黄斑中心凹厚度显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);治疗后两组PSV、EDV显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05);治疗后两组RI显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);观察组有效率为95.16%,显著高于对照组的82.26%(P<0.05);治疗后两组血清C肽显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05);治疗后两组TNF-α、IL-1β显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05)。结论:益气活血通络方治疗DR临床疗效显著,可有效改善DR患者血清C肽、TNF-α、IL-1β水平。

Objective：To observe clinical effect of Yiqi Huoxue Tongluo recipe in treatment of diabetic retinopathy（DR） and to analyze the changes of serum C peptide,tumor necrosis factor-α（TNF-α） and interleukin-1β（IL-1β）.Methods：124 cases of patients with DR treated in our hospital were selected as the study objects,and were divided into the observation group and the control group according to random number table method,62 cases in each group.All the two groups were given basic intervention such as health education,diet and exercise,and on the basis of that,the control group was given routine western medicine treatment,and the observation group was given Yiqi Huoxue Tongluo recipe on the basis of the control group.TCM syndrome scores,fasting blood glucose（FPG）,2 h postprandial blood glucose（2 h PG）,glycosylated hemoglobin（HbA1c）,visual acuity,retinal foveal thickness,systolic peak flow velocity（PSV） and resistance index（RI）,end diastolic velocity（EDV）,clinical effect,serum C peptide,TNF-α and IL-1β levels were observed in the two groups.Results：After treatment,TCM symptom scores were significantly lower than those before treatment in the two groups（P0.05）,and those in the observation group were significantly lower than those in the control group（P0.05）.After treatment,FPG,2 h PG and HbA1c levels were significantly lower than those before treatment in the two groups（P0.05）,and those in the observation group were significantly lower than those in the control group（P0.05）.Visual acuity was significantly higher than that before treatment in the two groups（P0.05）,and that in the observation group was significantly higher than that in the control group（P0.05）.Foveal thickness was significantly lower than that before treatment in the two groups（P0.05）,and that in the observation group was significantly lower than that in the control group（P0.05）.PSV and EDV were significantly higher than those before treatment in the two groups（P0.05）,and those in the observation group were significantly higher than those in the control group（P0.05）.RI was significantly lower than that before treatment（P0.05）,and that in the observation group was significantly lower than that in the control group（P0.05）.The effective rate of observation group was 95.16%,significantly higher than that of 82.26% of the control group（P0.05）.After treatment,serum C peptide was significantly higher than that before treatment in the two groups（P0.05）,and that in the observation group was significantly higher than that in the control group（P0.05）.TNF-α and IL-1β were significantly lower than those before treatment（P0.05）,and those in the observation group were significantly lower than those in the control group（P0.05）.Conclusion：Yiqi Huoxue Tongluo recipe can effectively improve serum C peptide,TNF-α and IL-1β levels of patients with DR,and which has significant clinical effect.