护网明目汤对糖尿病视网膜病变患者血流动力学及血清ICAM-1、ET-1变化的临床观察

Influence of Huwang Mingmu Tang on hemodynamics and serum ICAM-1 and ET-1 changes in patients with diabetic retinopathy

目的探讨护网明目汤联合羟苯磺酸钙对糖尿病视网膜病变(DR)患者局部血流动力学,血清炎症因子及血管内皮因子的改善作用。方法选取80例DR患者,按随机数字表法将其随机分为治疗组和对照组各40例,80只眼。对照组患者口服羟苯磺酸钙胶囊,每次1粒,1日3次。治疗组患者在此基础上服用护网明目汤(石斛15 g、赤芍12 g、葛根12 g、天花粉12 g、楮实子12 g、丹参12 g、决明子15 g、黄精12 g)水煎剂,1日1剂,早晚分服。10 d为1个疗程,共治疗3个疗程。观察2组患者治疗前后局部血流动力学,血清炎症因子及血管内皮因子的变化。结果 2组患者视网膜中央动脉(CRA)、睫状后动脉(PCA)、眼动脉(OA)中收缩期最大流速(PSV)、舒张末期血流速度(EDV)在治疗后均较治疗前升高,血管阻力指数(RI)均较治疗前降低,差异具有统计学意义(P<0.01);治疗后2组患者组间对比,治疗组患者CRA、PCA、OA中PSV、EDV均较对照组高,差异有统计学意义(P<0.01),且治疗组,RI降低也更显著(P<0.01)。2组患者治疗后肿瘤坏死因子-α(TNF-α)、细胞间黏附分子-1(ICAM-1)、白细胞介素-6(IL-6)均较治疗前降低,差异具有统计学意义(P<0.01);治疗组与对照组组间相比,治疗组降低更为显著(P<0.01)。2组患者治疗后血管内皮生长因子(VEGF)、内皮素-1(ET-1)均较治疗前降低,差异具有统计学意义(P<0.01);且治疗后2组患者组间相比,治疗组降低更加显著(P<0.01)。结论护网明目汤联合羟苯磺酸钙可通过改变血流动力,降低血清炎症因子及血管内皮因子来治疗DR,疗效明确,有较好临床应用前景。

ObjectiveTo investigate the improving effects of Huwang Mingmu Tang （Protecting Retina and Improving Eyesight Decoction） combined with calcium dobesilate on local hemodynamics, serum inflammatory factors and vascular endothelial factors in patients with diabetic retinopathy （DR）. Methods DR patients （n = 80） were chosen and divided, according to random digital table, into treatment group and control group （each n = 40, 80 eyes）. The control group was orally given calcium dobesilate capsules 1 capsule/time and 3 times/d. The treatment group was additionally given Huwang Mingmu Tang 1 dose/d, 2 times/d and 10 d/course for 3 courses. The changes of local hemodynamics, serum inflammatory factors and vascular endothelial factors were observed in 2 groups before and after treatment. Results The levels of peak systolic velocity （PSV） and end-diastolic velocity （EDV） of central retinal artery （CRA）, posterior ciliary artery （PCA） and ophthahnic artery （OA） increased, and vascular resistance index （RI） decreased in 2 groups after treatment （P 〈 0.01 ）. The levels of PSV and EDV of CRA, PCA and OA were all higher （P 〈 0.01 ）, and RI was lower （P 〈 0.01 ） in treatment group than those in control group after treatment. The levels of tumor necrosis factor-（x （TNF-c~）, intercellular adhesion molecule-1 （ICAM-1） and interleukin-6 （IL-6） were lower in 2 groups after treatment than before （P 〈 0.01 ）, which was more significant in treatment group （ P 〈 0.01 ）. The levels of vascular endothelial growth factor （VEGF） and endothelin-1 （ET-1） decreased in 2 groups after treatment than before （P 〈 0. 01 ）, which was more significant in treatment group （P 〈 0. 01 ）. Conclusion Huwang Mingmu Tang combined with calcium dobesilate can treat DR effectively through changing hemodynamics and reducing levels of serum inflammatory factors and VEGF, and has good application prospect in clinic.