糖尿病视网膜病变患者三消分型与眼底病变、视功能和黄斑水肿程度的关系

The relationship between the three sub-types and the fundus lesions,visual function and macular edema in DR patients

目的:观察糖尿病视网膜病变(DR)患者三消分型与眼底病变、视功能和黄斑水肿程度的关系。方法:根据中医三消证候将165例DR患者分为上消、中消、下消,分析不同分型患者与年龄、病程、体质量指数(BMI)、血糖指标、眼底病变、视功能和黄斑水肿程度的关系。结果:165例DR患者主要以中消证候较为常见(44.85%),其次为上消证候(30.30%)和下消证候(24.85%)。下消证患者年龄、病程、随机血糖、糖化血红蛋白(HbA1c)最高,中消证患者BMI最高,且上消证和中消证患者病程比较,有统计学差异(P<0.05),但中医三消证候患者空腹、餐后2h血糖及糖化血清蛋白(GSP)比较,无统计学差异(P>0.05)。中消证患者眼底微血管瘤数最多,渗出面积最大,下消证眼底微血管瘤数最少,而上消证眼底渗出面积、出血面积最小,与其他证型比较,均有统计学差异(P<0.05);下消证患者最佳矫正视力、黄斑中心凹视网膜平均厚度(CMT)均高于其他证型,有统计学差异(P<0.05)。结论:DR患者以中消证候较为常见,下消证患者年龄较大,病程较长,视力较差,黄斑水肿较重,眼底改变较复杂,上消证患者病程短,年龄小,眼底改变仅以微血管瘤多见。

Objective:To observe the relationship between the Sanxiao syndromes and fundopathy,visual function and degree of macular edema in patients with diabetic retinopathy(DR).Methods:According to the Sanxiao syndromes of traditional Chinese medicine,165 DR patients were divided into Shangxiao,Zhongxiao and Xiaxiao,and the relationship between different types of patients,age,disease course,body mass index(BMI),glycemic index,fundus lesions,visual function and degree of macular edema was analyzed.Results Among the 165 DR patients,the most common syndrome was the Zhongxiao syndrome(44.85%),followed by the Shangxiao syndrome(30.30%)and the Xiaxiao syndrome(24.85%).The age,course of disease,random blood glucose,and glycosylated hemoglobin(HbA1c)were the highest in patients with Xiaxiao syndrome,and BMI was the highest in patients with Zhongxiao syndrome,and there was a statistical difference between the patients with Shangxiao syndrome and Zhongxiao syndrome(P<0.05).There was no significant difference in fasting,2h postprandial blood glucose and glycated serum protein(GSP)in patients with Sanxiao syndrome(P>0.05).The patients with Zhongxiao syndrome had the largest number of fundus microaneurysms and the largest exudation area,the number of fundus microangiomas was the lowest in the Xiaxiao syndrome,while the area of exudation and hemorrhage in the fundus was the smallest in the Shangxiao syndrome,Compared with other syndromes,there were statistical differences(P<0.05);the best corrected visual acuity and mean macular thickness(CMT)of patients with Xiaxiao syndrome were higher than those of other syndromes,with statistical difference(P<0.05).Conclusion:In DR patients,Zhongxiao syndrome is more common,while Xiaxiao syndrome patients were older,have a longer course of disease,have poorer vision,severe macular edema,and have more complex fundus changes.Microangioma is more common;Shangxiao patients had a shorter disease duration,were younger,and the fundus changes were only prevalent with microangiomas.