通络复明方对糖尿病视网膜病变激光术后视功能恢复的影响

Effect of Tongluo Fuming Decoction on Visual Function of Patients with Diabetic Retinopathy after Panretinal Photocoagulation

目的研究通络复明方对糖尿病视网膜病变(DR)患者光凝术后视功能恢复的影响。方法选择2017年11月-2019年5月在北京中医药大学东方医院眼科门诊就诊且符合纳入标准的阴虚夹瘀证糖尿病视网膜病变患者46例,随机分为试验组和对照组,试验组采用通络复明方口服,对照组采用羟苯磺酸钙+迈之灵片治疗,连续治疗2周,停药后随访2周。比较2组患者治疗前后视力、视野、中医证候积分的变化。结果实际纳入42例69眼完成研究,其中试验组21例(34只眼),对照组21例(35只眼)。试验组治疗后2周、4周视力均较治疗前提高(P<0.05),对照组没有统计学差异,治疗后4周试验组视力明显高于对照组(P<0.05)。2组治疗后2周和4周的视野平均缺损(MD)值均较治疗前降低(P<0.05);试验组MD明显低于对照组(P<0.05)。阴虚夹瘀证证候积分,试验组显著低于对照组(P<0.05)。试验组总有效率显著高于对照组(P<0.05)。结论通络复明方治疗可以缓解阴虚夹瘀证DR患者中医证候,对DR患者光凝术后视功能改善有积极作用,可恢复部分患者视力,并使受损的视野得到一定改善。

OBJECTIVE To study the effect of Tongluo Fuming decoction on the recovery of visual function after diabetic retinopathy(DR)photocoagulation.METHODS A total of 46 diabetic retinopathy patients with yin deficiency and blood stasis syndrome,who were admitted in the ophthalmology clinic of Dongfang Hospital,affiliated to Beijing University of Chinese Medicine from November 2017 to May 2019 and met the inclusion criteria,were randomly divided into the experimental group and the control group.The experimental group orally adopted Tongluo Fuming decoction while the control group was treated with calcium dobesilate plus Maizhiling tablets for 2 weeks and followed up for 2 weeks after stopping taking drugs.The changes in vision,visual field,and TCM syndrome scores before and after treatment were compared between the two groups.RESULTS 42 cases of 69 eyes completed the study,including 21 cases(34 eyes)in the experimental group and 21 cases(35 eyes)in the control group.The visual acuities of the experimental group at 2 and 4 weeks after treatment were improved compared with that before treatment(P<0.05).However,there was no statistical difference in the control group.The visual acuity of the experimental group was significantly better than that of the control group at 4 weeks after treatment(P<0.05).The mean defect(MD)values of the visual field at 2 and 4 weeks after treatment in the two groups were lower than those before treatment(P<0.05).MD value in the experimental group was significantly lower than that in the control group(P<0.05).TCM syndrome scores were significantly lower in the experimental group than those in the control group(P<0.05).The total effective rate of the experimental group was 66.7%,which was significantly higher than 28.6%of the control group(P<0.05).CONCLUSION Tongluo Fuming decoction can alleviate the TCM syndromes for DR patients with yin deficiency and blood stasis syndrome and has a positive effect on the improvement of visual function after DR photocoagulation.It can restore the visual power of partial patients and improve the damaged visual field to a certain extent.