益气养阴活血汤辅助康柏西普治疗糖尿病性视网膜病变并发玻璃体积血临床研究

Clinical Study on Yiqi Yangyin Huoxue Tang Assisting Conbercept for Diabetic Retinopathy Complicated with Vitreous Hemorrhage

目的:观察益气养阴活血汤辅助康柏西普治疗糖尿病性视网膜病变(DR)并发玻璃体积血(VH)的临床疗效。方法:选取127例DR并发VH患者,按随机数字表法分为观察组65例和对照组62例。2组均行玻璃体切除术治疗,在此基础上,对照组采用康博西普治疗,观察组在对照组基础上采用益气养阴活血汤辅助治疗,治疗3个月。比较2组临床疗效、中医证候积分、最佳矫正视力(BCVA)、眼动脉血流动力学指标及晚期糖基化终末产物(AGEs)水平。结果:观察组临床总有效率优于对照组(χ^(2)=4.262,P=0.039)。治疗后,2组中医证候积分低于治疗前,BCVA高于治疗前(P<0.05);组间比较,观察组治疗后中医证候积分低于对照组,BCVA高于对照组(P<0.05)。治疗后,2组眼动脉搏动指数(PI)、血流阻力指数(RI)水平低于治疗前,收缩期峰值流速(PSV)、舒张末期流速(EDV)水平高于治疗前(P<0.05);组间比较,观察组治疗后眼动脉PI、RI水平低于对照组,PSV、EDV水平高于对照组(P<0.05)。治疗后,2组血清AGEs水平低于治疗前(P<0.05);组间比较,观察组治疗后血清AGEs水平低于对照组(P<0.05)。结论:益气养阴活血汤辅助康柏西普治疗DR并发VH疗效确切,可有效减轻临床症状,提高视力,改善眼底循环,控制DR病情进展,在DR并发VH临床治疗中具有重要价值。

Objective:To observe the clinical effect of the therapy of Yiqi Yangyin Huoxue tang assisting conbercept on diabetic retinopathy(DR) complicated with vitreous hemorrhage(VH). Methods:A total of 127 DR patients complicated with VH were selected and divided into the observation group and the control group according to the random number table method,with 65 and 62 cases in each group respectively. Both groups were treated with vitrectomy. The control group was additionally treated with Kangbosipu,and the observation group was additionally treated with Yiqi Yangyin Huoxue tang based on the treatment of the control group. Both groups were treated for three months. The clinical effects,Chinese medicine syndrome scores,best corrected visual acuity(BCVA),hemodynamic indexes of ophthalmic artery and advanced glycation end products(AGEs) in the two groups were compared. Results:The total clinical effective rate in the observation group was better than that in the control group(χ^(2)=4.262,P=0.039). After treatment,the Chinese medicine syndrome scores in the two groups were lower than those before treatment,and the BCVA was higher(P<0.05);after treatment,the Chinese medicine syndrome score in the observation group was lower than that in the control group,and the BCVA was higher(P<0.05). After treatment, the ophthalmic artery levels of pulsatility index(PI) and blood flow resistance index(RI) in the two groups were lower than those before treatment,the levels of peak systolic velocity(PSV) and end-diastolic velocity(EDV) were higher(P<0.05);after treatment,the ophthalmic artery levels of PI and RI in the observation group were lower than those in the control group,and the levels of PSV and EDV were higher(P<0.05). After treatment,the serum AGEs levels in the two groups were lower than those before treatment(P<0.05);after treatment,the serum AGEs level in the observation group was lower than that in the control group(P<0.05). Conclusion: The therapy of Yiqi Yangyin Huoxue tang assisting conbercept for DR complicated with VH has a definite curative effect,which can effectively reduce the clinical symptoms,improve the vision acuity,enhance the fundus circulation,and control the DR disease progression,with great value in the clinical treatment of DR complicated with VH.