逐瘀固本方对肾虚血瘀型非增殖期糖尿病视网膜病变临床疗效的影响

Effect of Zhuyu Guben Recipe on Clinical Efficacy of Non Proliferative Diabetic Retinopathy of Kidney Deficiency and Blood Stasis Type

目的:评价逐瘀固本方治疗肾虚血瘀型非增殖期糖尿病视网膜病变(NPDR)的临床疗效,并探讨其可能的治疗机制。方法:采用随机数字表按1∶1将纳入患者随机分为观察组和对照组,每组各40例患者(80只眼睛)。2组均依照中国糖尿病防治指南原则进行常规药物治疗,在此基础上,观察组给予逐瘀固本方口服,每日1剂,每日2次。2组均连续治疗3个月,比较2组治疗前后中医证候积分、视网膜电图隐含期、电反应振幅、不同刺激之间的瞳孔面积比、DR评分、血清总抗氧化能力(TAC)、白介素-6(IL-6)变化。结果:与本组治疗前对比,治疗后观察组中医证候积分明显下降(P<0.05),对照组无明显变化(P>0.05);2组治疗后对比,观察组中医证候积分明显下降(P<0.05)。与本组治疗前对比,治疗后2组视网膜电图隐含期、DR评分均明显下降(P<0.05),不同刺激之间的瞳孔面积比、电反应振幅均明显增高(P<0.05);2组治疗后对比,观察组视网膜电图隐含期、DR评分均明显下降(P<0.05),不同刺激之间的瞳孔面积比、电反应振幅明显增高(P<0.05);与本组治疗前对比,观察组血清TAC明显升高、IL-6明显下降(P<0.05),对照组无明显变化(P>0.05);2组治疗后对比,观察组TAC明显升高、IL-6明显下降(P<0.05)。结论:逐瘀固本方对肾虚血瘀型NPDR有较好疗效,能改善患者症状,减轻血清氧化应激水平,提高患眼视功能。

Objective:To evaluate the clinical efficacy of Zhuyu Guben Recipe in the treatment of non proliferative diabetic retinopathy(NPDR)of kidney deficiency and blood stasis type,and to explore its possible therapeutic mechanism.Methods:The patients were randomly divided into observation group and control group according to 1∶1 random number table,40 patients(80 eyes)in each group.Both groups were treated with conventional medicine according to the principles of Chinese diabetes prevention and treatment guidelines.On this basis,the observation group was given Zhuyu Guben Decoction orally,1 dose a day,2 times a day.Both groups were treated for 3 months continuously.The changes of TCM syndrome score,electroretinogram latent period,electric response amplitude,pupil area ratio between different stimuli,DR score,serum total antioxidant capacity(TAC)and interleukin-6(IL-6)were compared between the two groups before and after treatment.Results:Compared with the group before treatment,the TCM syndrome score in the observation group decreased significantly after treatment(P<0.05),while there was no significant change in the control group(P>0.05);after treatment,the TCM syndrome score of the observation group decreased significantly(P<0.05).Compared with that before treatment in this group,after treatment,the latent period of electroretinogram and DR score in the two groups were significantly decreased(P<0.05),the pupil area ratio and electric response amplitude between different stimuli were significantly increased(P<0.05);after treatment,the latent period of electroretinogram and DR score in the observation group were significantly decreased(P<0.05),and the pupil area ratio and electric response amplitude between different stimuli were significantly lower than those before treatment(P<0.05).Compared with that before treatment,the serum TAC in the observation group was significantly increased,and IL-6 was significantly decreased(P<0.05),but there was no significant change in the control group(P>0.05);after treatment,TAC in the observation group was significantly increased,and IL-6 was significantly decreased(P<0.05).Conclusion:Zhuyu Guben Recipe has a good curative effect on NPDR of kidney deficiency and blood stasis type,can improve the symptoms of patients,reduce the level of serum oxidative stress,and improve the visual function of patients.