津力达联合通心络胶囊治疗非增殖期2型糖尿病视网膜病变气阴两虚、络脉瘀阻证疗效观察

Observation on the therapeutic effect of Jinlida combined with Tongxinluo capsule on non-proliferative type 2 diabetic retinopathy with syndrome of Qi-Yin deficiency and collaterals stasis

目的观察津力达联合通心络胶囊治疗非增殖期2型糖尿病视网膜病变气阴两虚、络脉瘀阻证患者的临床疗效。方法将2017年2月—2018年9月石家庄市第二医院收治的86例气阴两虚、络脉瘀阻型非增殖期2型糖尿病视网膜病变患者随机分为对照组与治疗组,每组43例。对照组给予羟苯磺酸钙胶囊治疗,治疗组给予津力达联合通心络胶囊治疗,2组疗程均为12周。观察2组治疗前后血糖、血脂指标、胰岛素敏感性指标、视力、眼压、眼底检查、中医症状评分以及临床疗效。结果与治疗前相比,治疗后2组空腹血糖(FPG)、餐后2 h血糖(2hPG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、血浆胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、C肽水平均显著降低,胰岛β细胞功能指数(HOMA-β)显著增高,且治疗组治疗后血糖、FINS、HOMA-IR、C肽水平、HOMA-β改善情况均显著优于对照组,差异均有统计学意义(P均<0.05)。与治疗前相比,治疗后2组视力均显著升高(P均<0.05),血管渗漏面积、毛细血管无灌注区面积、微血管瘤个数均显著减少(P均<0.05),视网膜循环时间显著缩短(P均<0.05),中医症状总分明显降低(P均<0.05),且治疗组各指标改善较对照组更明显(P均<0.05)。治疗后,治疗组总有效率为90.7%(39/43),对照组为72.1%(31/43),2组比较差异有统计学意义(P<0.05)。结论津力达联合通心络胶囊能够有效调节气阴两虚、络脉瘀阻型非增殖期2型糖尿病视网膜病变患者的血糖血脂水平,可显著提高患者的视力,减轻眼底病变和中医症状,显著提高临床疗效。

Objective It is to observe the clinical efficacy of Jinlida combined with Tongxinluo capsule in the treatment of non-proliferative type 2 diabetic retinopathy with with syndrome of Qi-Yin deficiency and collaterals stasis.Methods Eighty-six patients with non-proliferative type 2 diabetic retinopathy with with syndrome of Qi-Yin deficiency and collaterals stasis admitted to the Second Hospital of Shijiazhuang from February 2017 to September 2018 were randomly divided into a control group and a treatment group,each group had 43 cases.The control group was treated with calcium dobesilate capsules,and the treatment group was treated with Jinlida combined with Tongxinluo capsules.The course of treatment in both groups was 12 weeks.The indexes of blood glucose,blood lipid,insulin sensitivity index,visual acuity,intraocular pressure,fundus examination,scores of traditional Chinese medical symptom beforea and after treatment were observed in the two groups and the clinical efficacy of the two groups was compared.Results Compared with before treatment,the levels of fasting plasma glucose(FPG),postprandial 2h blood glucose(2hPG),triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),plasma insulin(FINS),insulin resistance index(HOMA-IR),and C peptide were significantly reduced decreased,pancreaticβcell function index(HOMA-β)was significantly increased in the two groups,and the improvements of blood glucose,FINS,HOMA-IR,C peptide,HOMA-βafter treatment were significantly better in the treatment group than those in the control group,and the differences were statistically significant(all P<0.05).Compared with before treatment,the visual acuity was significantly increased(both P<0.05),the area of vascular leakage,the area of capillary non-perfusion area,and the number of microangiomas were significantly reduced after treatment in the two groups(all P<0.05),and the retinal circulation time was significantly shortened(P<0.05),the scores of each traditional Chinese medical symptom were significantly reduced(all P<0.05),and the improvement of each index in the treatment group was more obvious than that of the control group(all P<0.05).After treatment,the total effective rate was 90.7%(39/43)in the treatment group and 72.1%(31/43)in the control group,the difference between the two groups was statistically significant(P<0.05).Conclusion Jinlida combined with Tongxinluo capsules can effectively regulate the blood glucose and blood lipid levels,significantly improve the vision of patients and relieve ocular fundus diseases and traditional Chinese medical symptoms,and significantly improve the clinical efficacy in patients with non-proliferative type 2 diabetic retinopathy with syndrome of Qi-Yin deficiency and collaterals stasis with syndrome of Qi-Yin deficiency and collaterals stasis.