复方血栓通胶囊联合前列地尔治疗糖尿病视网膜病变及其对血清活性多肽和SPARC表达的影响

Effect of Compound Xueshuantong Capsules combined with alprostanil on serum Apelin and SPARC expression in diabetic retinopathy

目的探究复方血栓通胶囊联合前列地尔对糖尿病视网膜病变及对患者血清活性多肽(Apelin)和富含半胱氨酸酸性分泌蛋白(SPARC)水平的影响。方法选取2019年6月—2020年3月间在陕西省中医医院接受治疗的糖尿病视网膜病变患者80例为研究对象,按照双盲抽签法将患者分为对照组和观察组,每组各40例。对照组患者缓慢静注前列地尔注射液,10μg溶于5%葡萄糖注射液100 mL中,1次/d。观察组在对照组的基础上口服复方血栓通胶囊,0.5 g/次,3次/d。两组治疗1个月。观察两组患者的临床疗效,同时比较两组治疗前后的血管瘤数量、视野灰度值、出血斑面积;超氧化物歧化酶(SOD)、总抗氧化能力(TAC)、丙二醛(MDA)、白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、Apelin和富含半胱氨酸酸性分泌蛋白(SPARC)水平。结果治疗后,对照组和观察组总有效率分别为80.0%、95.0%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗后,两组患者血管瘤数量、视野灰度值以及出血斑面积均明显下降(P<0.05);且观察组血管瘤数量、视野灰度值以及出血斑面积均显著小于对照组(P<0.05)。治疗后,两组患者SOD、TAC水平均明显升高,MDA水平明显降低(P<0.05);且观察组患者的SOD及TAC水平显著高于于对照组患者,MDA水平显著低于对照组患者(P<0.05)。治疗后,两组患者TNF-α和IL-2水平均显著降低,IL-10水平显著升高(P<0.05);且观察组患者TNF-α和IL-2水平显著低于对照组,IL-10水平显著高于对照组患者(P<0.05)。治疗后,两组血清Apelin和SPARC水平均下降(P<0.05),且观察组患者血清Apelin和SPARC水平显著低于对照组患者(P<0.05)。结论复方血栓通胶囊联合前列地尔治疗糖尿病视网膜病变可有效的降低患者的视野灰度值、血管瘤数量、出血斑面积,同时调节患者体内应激指标、炎性指标以及血清Apelin和SPARC水平来缓解临床症状,并且相对于单一用药,联合用药的疗效更优。

Objective To investigate the effects of Compound Xueshuantong Capsules combined with alprostanil on serum Apelin and SPARC levels in patients with diabetic retinopathy. Methods Eighty patients with diabetic retinopathy who received treatment in Shaanxi Hospital of Traditional Chinese Medicine from June 2019 to March 2020 were selected as the research subjects, and the patients were divided into control group and observation group according to the double-blind lottery method, with 40 cases in each group. Patients in the control group were iv administered with Alprostadil Injection, 10 μg dissolved in 5% 100 mL Glucose injection, once daily. Patients in the observation group were po administered with Compound Xueshuantong Capsules on the basis of control group, 0.5 g/time, three times daily. The two groups were treated for 1 month. The clinical efficacy of two groups was observed, and the number of hemangioma, visual field gray value, bleeding plaque area, and the levels of SOD, TAC, MDA, IL-2,TNF-α, IL-10, Apelin, and SPARC before and after treatment were compared. Results After treatment, the total effective rate of the control group and the observation group was 80.0% and 95.0%, respectively, and the difference of total effective rate between two groups was statistically significant(P < 0.05). After treatment, the number of hemangioma, gray value of visual field, and area of bleeding plaques in two groups were significantly decreased(P < 0.05), and the number of hemangioma, gray value of field, and area of bleeding plaque in the observation group were significantly lower than those in the control group(P < 0.05). After treatment,SOD and TAC levels in two groups were significantly increased, while MDA level was significantly decreased(P < 0.05), the levels of SOD and TAC in observation group were significantly higher than those in control group, and the level of MDA in observation group was significantly lower than that in control group(P < 0.05). After treatment, the levels of TNF-α and IL-2 in two groups were significantly decreased, while the level of IL-10 was significantly increased(P < 0.05), and the levels of TNF-α and IL-2 in observation group were significantly lower than those in control group, and the level of IL-10 in observation group was significantly higher than that in control group(P < 0.05). After treatment, the serum Apelin and SPARC levels in two groups were decreased(P <0.05), and the serum Apelin and SPARC levels in observation group were significantly lower than those in control group(P < 0.05).Conclusion Compound Xueshuantong Capsules combined with alprostanil in treatment of diabetic retinopathy can effectively reduce the patient’s vision of grey value, number of hemangioma, plaque area, at the same time adjust the body stress index and inflammatory index, and serum levels of Apelin and SPARC to relieve the clinical symptoms, and relative to the single drug, the curative effect of combination of better.