血府逐瘀汤对糖尿病视网膜病变患者视神经形态结构的影响

Effect of Xuefu Zhuyu Decoction on Optic Nerve Morphological Structure in Patients with Diabetic Retinopathy

目的:探讨血府逐瘀汤对糖尿病视网膜病变患者视神经形态结构的影响.方法:2017年11月~2019年12月选择在本院就诊的糖尿病视网膜病变患者76例,根据随机信封抽签原则把患者分为观察组与对照组各38例.对照组给予康柏西普治疗,观察组在对照组治疗的基础上给予血府逐瘀汤治疗,两组都治疗观察2个月,记录视神经形态结构变化情况.结果:治疗后观察组的总有效率为97.37%,显著高于对照组的78.95%(P<0.05).两组治疗后行空腹血糖(fasting blood glucose,FBG)与餐后2h血糖(2 h postprandial blood glucose,2hPG),值都低于治疗前,观察组低于对照组(P<0.05).两组治疗前的视盘周围视网膜神经纤维层(Reti-nal nerve fiber layer,RNFL)厚度在上象限、下象限、颞象限、鼻象限上对比无差异(P>0.05),两组治疗后各个象限的RNFL厚度均显著下降(P<0.05),且观察组各个象限的RNFL厚度均低于对照组(P<0.05).观察组治疗后的红细胞聚集指数与纤维蛋白原低于治疗前,也低于对照组(P<0.05),对照组治疗前后对比无差异(P>0.05).结论:血府逐瘀汤在糖尿病视网膜病变患者中的应用能改善视神经形态结构,促进降低血糖,改善患者的血液流变学状况,从而提高治疗效果.

Objective: To explore the effect of Xuefu Zhuyu Decoction on optic nerve morphology in patients with diabetic retinopathy. Methods: From November 2017 to December 2019, 76 cases of patients with diabetic retinopathy treated in our hospital were selected as the research object. All the cases were divided into the observation group and control group of 38 cases in each groups accorded to the principle of random envelope drawing. The control group were treated with Compacept, and the observation group were given Xuefu Zhuyu Decoction based on the treatment of the control group. Both groups were treated and observed for 2 months, and the changes of optic nerve morphology and structure were recorded. Results: The total effective rates of the observation group after treatment were 97.37 %, which were significantly higher than 78.95 % of the control group(P<0.05). The fasting blood glucose(FBG) and 2 h postprandial blood glucose(2 hPG) values of the two groups after treatment were lower than before treatment, and the observation group were lower than the control group, and compared the difference were statistically significant(P<0.05). There was no difference in the thickness of the retinal nerve fiber layer(RNFL) around the optic disc between the upper quadrant, the lower quadrant, the temporal quadrant, and the nasal quadrant before treatment(P>0.05), and the thickness of the RNFL around the optic disc in each quadrant of the two groups after treatment decreased significantly(P<0.05), and the thickness of RNFL around the optic disc in each quadrant of the observation group was lower than that of the control group(P<0.05). The erythrocyte aggregation index and fibrinogen in the observation group after treatment were lower than before treatment and also lower than the control group, and the compared the difference were statistically significant(P<0.05), and there were no statistical difference comapred between before and after treatment in the control group(P>0.05).Conclusion: The application of Xuefu Zhuyu Decoction in patients with diabetic retinopathy can improve the morphological structure of the optic nerve, promote the reduction of blood glucose, and improve the blood rheology of patients, thereby improving the therapeutic effect.