益气养阴化瘀法对糖尿病视网膜病变患者微血管功能、动脉血流、微视野及血清Vaspin和SCUBE2水平的影响

Effects of Supplementing Qi,Nourishing Yin and Removing Blood Stasis on Microvascular Function,Arterial Blood Flow,Microvisual Field and Serum Vaspin and SCUBE2 Levels in Diabetic Retinopathy

目的:观察益气养阴化瘀法对糖尿病视网膜病变患者微血管功能、动脉血流、微视野及血清脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)和骨形态发生蛋白1-表皮生长样结构域蛋白2(SCUBE2)水平的影响。方法:选择2021年1月至2022年12月于该院治疗的糖尿病视网膜病变患者102例,以随机数字表法分组。对照组50例患者给予常规西医治疗,观察组52例患者在对照组的基础上给予益气养阴化瘀方治疗。比较两组患者的临床疗效、治疗前后的中医证候评分,检测视野平均敏感度、视力、收缩期血流速度峰值、眼动脉阻力指数(RI)和舒张期血流速度峰值,检测患者Vaspin、低氧诱导因子-1(HIF-1)、可溶性细胞黏附分子(sICAM-1)、SCUBE2、外周血内皮细胞(CEC)和循环祖细胞(CPC)水平。结果:观察组患者总有效率为98.08%(51/52),高于对照组的84.00%(42/50),差异有统计学意义(P<0.05)。治疗后,观察组患者的中医证候评分较对照组降低,差异有统计学意义(P<0.05)。治疗后,观察组患者的RI低于对照组,收缩期血流速度峰值、舒张期血流速度峰值、视野平均敏感度和最佳矫正视力高于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者的CPC水平较对照组升高,CEC水平较对照组降低,Vaspin、HIF-1、sICAM-1和SCUBE2水平较对照组降低,差异均有统计学意义(P<0.05)。结论:益气养阴化瘀法治疗糖尿病视网膜病变,可改善患者微血管功能、动脉血流、微视野和视力,提高临床疗效。

OBJECTIVE:To observe the effects of supplementing Qi,nourishing Yin and removing blood stasis on microvascular function,arterial blood flow,microvisual field and serum lipid specific serine protease inhibitor(Vaspin)and signal peptide-CUB-EGF-like domain-containing protein(SCUBE2)levels in diabetic retinopathy.METHODS:A total of 102 patients with diabetic retinopathy were selected for hospital treatment from Jan.2021 to Dec.2022.All patients were grouped by random number table method.Fifty patients in the control group were given conventional Western medicine treatment,while 52 patients in the observation group received supplementing Qi,nourishing Yin and removing blood stasis formula on the basis of control group.Clinical efficacy,traditional Chinese medicine syndrome scores before and after treatment were compared between two groups,and the average sensitivity of visual field,visual acuity,peak systolic blood flow velocity,ocular arterial resistance index(RI)and peak diastolic blood flow velocity were detected.The proportions of Vaspin,hypoxic-inducible factor-1(HIF-1),soluble cell adhesion molecule(sICAM-1),SCUBE2,peripheral blood endothelial cell(CEC)and circulating progenitor cell(CPC)were measured.RESULTS:The total effective rate of observation group was 98.08%(51/52),higher than 84.00%(42/50)of control group,the difference was statistically significant(P<0.05).After treatment,traditional Chinese medicine syndrome score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).After treatment,RI in observation group was lower than that in control group,peak systolic blood flow velocity,peak diastolic blood flow velocity,average sensitivity of visual field and BCVA were higher than those in control group,with statistically significant difference(P<0.05).After treatment,the CPC level in observation group was higher than that in control group,the CEC level was lower than that in control group,and levels of Vaspin,HIF-1,sICAM-1 and SCUBE2 were lower than those in control group,with statistically significant differences(P<0.05).CONCLUSIONS:Supplementing Qi,nourishing Yin and removing blood stasis formula in the treatment of diabetic retinopathy can improve the microvascular function,arterial blood flow,microvisual field and visual acuity of patients with diabetic retinopathy and improve the clinical efficacy.