复明片与活血明目片分别治疗糖尿病性视网膜病变临床研究

Clinical Study on Fuming Tablets and Huoxue Mingmu Tablets for Diabetic Retinopathy Respectively

目的:观察复明片与活血明目片对糖尿病性视网膜病变患者黄斑部脉络膜厚度、微循环及炎性因子的影响。方法:选取120例糖尿病性视网膜病变患者,按随机数字表法分为对照组、复明片组和活血明目片组各40例。对照组采用激光光凝术治疗,复明片组在对照组基础上给予复明片治疗,活血明目片组在对照组基础上给予活血明目片治疗。比较3组治疗前后视网膜病变黄斑部脉络膜厚度,检测治疗前后视网膜中央动脉及睫状后动脉的峰值血流速度(PSV)、舒张末期血流速度(EDV)、血流阻力指数(RI)、低氧诱导因子-1(HIF-1)、血管内皮生长因子(VEGF)、白细胞介素-1β(IL-1β)、基质金属蛋白酶-9(MMP-9)水平。结果:治疗后,3组黄斑部脉络膜厚度较治疗前降低(P<0.05),复明片组黄斑部脉络膜厚度低于对照组(P<0.05),活血明目片组黄斑部脉络膜厚度低于对照组和复明片组(P<0.05)。与治疗前比较,治疗后3组视网膜中央动脉及睫状后动脉PSV、EDV增高,RI降低(P<0.05);治疗后复明片组和活血明目片组视网膜中央动脉及睫状后动脉PSV、EDV高于对照组,RI低于对照组(P<0.05);治疗后活血明目片组视网膜中央动脉及睫状后动脉PSV、EDV高于复明片组,RI低于复明片组(P<0.05)。治疗后,3组HIF-1、VEGF、IL-1β、MMP-9水平较治疗前降低(P<0.05),复明片组HIF-1、VEGF、IL-1β、MMP-9水平低于对照组(P<0.05),活血明目片组HIF-1、VEGF、IL-1β、MMP-9水平低于对照组和复明片组(P<0.05)。结论:复明片与活血明目片分别辅助激光光凝术治疗糖尿病性视网膜病变疗效较好,可以降低视网膜病变黄斑部脉络膜厚度,改善眼部动脉血流动力学指标,降低炎症因子水平,但活血明目片的效果更好。

Objective:To observe the effect of Fuming tablets and Huoxue Mingmu tablets on macular choroidal thickness,microcirculation and inflammatory factors in patients with diabetic retinopathy.Methods:A total of 120 patients with diabetic retinopathy were selected and divided into the control group,the Fuming tablets group and the Huoxue Mingmu tablets group according to the random number table method,with 40 cases in each group.The control group was treated with laser photocoagulation,the Fuming tablets group was additionally treated with Fuming tablets based on the treatment of the control group,and the Huoxue Mingmu tablets group was additionally treated with Huoxue Mingmu tablets based on the treatment of the control group.Before and after treatment,the macular choroidal thickness of retinopathy in the three groups was compared.Before and after treatment,the peak systolic velocity(PSV),end-diastolic velocity(EDV),resistance index(RI)of central retinal artery and posterior ciliary artery and hypoxia-inducible factor-1(HIF-1),vascular endothelial growth factor(VEGF),interleukin-1β(IL-1β)and matrix metalloproteinases-9(MMP-9)were detected.Results:After treatment,the macular choroidal thickness in the three groups was decreased when compared with that before treatment(P<0.05),the macular choroidal thickness in the Fuming tablets group was lower than that in the control group(P<0.05),and the macular choroidal thickness in the Huoxue Mingmu tablets group was lower than that in the control group and the Fuming tablets group(P<0.05).After treatment,the PSV and EDV of central retinal artery and posterior ciliary artery in the three groups were increased when compared with those before treatment,and the RI was decreased(P<0.05);after treatment,the PSV and EDV of central retinal artery and posterior ciliary artery in the Fuming tablets group and the Huoxue Mingmu tablets group were higher than those in the control group,the RI was lower(P<0.05);after treatment,the PSV and EDV of central retinal artery and posterior ciliary artery in the Huoxue Mingmu tablets group were higher than those in the Fuming tablest group,and the RI was lower than that in the Fuming tablets group(P<0.05).After treatment,the levels of HIF-1,VEGF,IL-1βand MMP-9 in the three groups were decreased when compared with those before treatment(P<0.05),the above four levels in the Fuming tablets group were lower than those in the control group(P<0.05),and the above four levels in the Huoxue Mingmu tablets group were lower than those in the control group and the Fuming tablets group(P<0.05).Conclusion:The therapies of Fuming tablets and Huoxue Mingmu tablets assisting laser photocoagulation respectively have good curative effects on diabetic retinopathy,which can reduce the thickness of macular choroidal thickness of retinopathy,improve the index of hemodynamic of ophthalmic artery,decrease the level of inflammatory factors,and the effect of Huoxue Mingmu tablets is better.