清热利湿法治疗糖尿病视网膜病变患者激光术后黄斑水肿的疗效及对视功能、糖代谢、CMT的影响

Curative effect of Qingre Lishi decoction on macular edema and its influences on visual function,glucose metab⁃olism and CMT in patients with diabetic retinopathy after laser surgery

目的 探讨清热利湿法治疗糖尿病视网膜病变(DR)患者激光术后黄斑水肿的疗效及对视功能、糖代谢、黄斑中心凹视网膜厚度(CMT)的影响。方法 选取激光术后黄斑水肿的70例DR患者,将其随机分为激光组(n=35)和中药组(n=35)。激光组行激光治疗,中药组在上述基础上联合清热利湿冲剂口服治疗。治疗1个月后评估两组疗效及中医证候积分变化,并比较治疗后1个月、3个月、6个月两组视功能、糖代谢以及CMT变化。结果治疗1个月后,中药组治疗总有效率为97.14%,高于激光组的82.86%(χ^(2)=3.97,P<0.05),中药组各中医证候积分均低于激光组(t分别=3.51、5.32、2.85、2.25,P均<0.05);治疗后1个月、3个月、6个月中药组最佳矫正视力高于激光组(t分别=5.50、6.12、4.67,P均<0.05),CMT、空腹血糖、餐后2 h血糖均低于激光组(t分别=4.35、5.87、9.59;2.01、2.09、2.04;2.99、2.17、2.93,P均<0.05)。结论 清热利湿法治疗DR患者激光术后黄斑水肿较单激光光凝治疗的效果更佳,能有效提升患者视功能水平,减少CMT,改善患者典型症状,同时能更好地控制血糖水平。

Objective To explore the curative effect of Qingre Lishi decoction on macular edema and its influences on visual function,glucose metabolism and central macular thickness(CMT)in patients with diabetic retinopathy(DR)af⁃ter laser surgery.Methods A total of 70 patients with macular edema and DR after laser surgery were enrolled and ran⁃domly divided into laser group(n=35)and TCM group(n=35).The laser group was treated with laser surgery,while TCM group was additionally treated with Qingre Lishi decoction.After 1 month of treatment,curative effect and changes in scores of TCM syndromes in the two groups were evaluated.The changes of visual function,glucose metabolism and CMT were compared between the two groups at 1 month,3 months and 6 months after treatment.Results After 1 month of treatment,total response rate of treatment in TCM group was higher than that of laser group(97.14%vs 82.86%)(χ^(2)=3.97,P<0.05).The scores of TCM syndromes were lower than those in laser group(t=3.51,5.32,2.85,2.25,P<0.05).At 1 month,3 months and 6 months after treatment,the best corrected visual acuity in TCM group was higher than that in laser group,while CMT,fasting blood glucose and 2 h postprandial blood glucose were lower than those in laser group(t=5.50,6.12,4.67,4.35,5.87,9.59,2.01,2.09,2.04,2.99,2.17,2.93,P<0.05).Conclusion Compared with laser pho⁃tocoagulation alone,Qingre Lishi decoction has better curative effect on macular edema in patients with DR after laser surgery,which can effectively improve visual function,reduce CMT,improve typical symptoms and better control blood glucose level.