丹黄明目汤在糖尿病视网膜病变患者术后的应用效果

Application Effect of Danhuang Mingmu Decoction in Postoperative Patients with Diabetic Retinopathy

目的 探讨糖尿病视网膜病变(DR)术后应用丹黄明目汤的临床疗效,分析其对视力、炎症因子及白细胞介素-33(IL-33)/生长刺激表达基因2蛋白(ST2)信号通路的影响。方法 选取2020年5月至2023年2月医院收治的96例DR患者为研究对象,依据随机单双数分配原则分为对照组和研究组,各48例。对照组经玻璃体注药切除术后接受常规治疗,研究组在此基础上接受丹黄明目汤治疗,连续治疗3个月。比较两组临床疗效及中医证候积分。比较两组视力相关指标[最佳矫正视力(BCVA)、视网膜厚度、视力]、炎症因子[趋化因子样受体1(CMKLR1)、可溶性细胞间黏附分子-1(sICAM-1)]水平及外周血IL-33、ST2 mRNA表达水平。比较两组并发症发生率。结果 研究组总有效率高于对照组(P<0.05);治疗3个月后研究组中医证候积分、BCVA、视网膜厚度低于对照组,视力高于对照组(P<0.05);研究组治疗3个月后血清CMKLR1、sICAM-1水平低于对照组,外周血IL-33、ST2 mRNA表达水平低于对照组(P<0.05)。结论 DR术后应用丹黄明目汤疗效确切,可改善临床症状、视力水平,减轻机体炎症反应程度,其作用机制可能与抑制IL-33/ST2信号通路活化有关。

Objective To investigate the clinical efficacy of Danhuang Mingmu decoction after the operation of diabetic retinopathy(DR),and to analyze the effects of Danhuang Mingmu decoction on visual acuity,inflammatory factors and interleukin-33(IL-33)/growth stimulating expression gene 2 protein(ST2)signaling pathway.Methods A total of 96 DR patients admitted to the hospital from May 2020 to February 2023 were selected as the study subjects.They were randomly divided into a control group and a study group,with 48 patients in each group,based on the principle of odd even distribution.The control group was given routine treatment after vitreous injection resection,and the study group was given Danhuang Mingmu decoction on this basis for continuous treatment for 3 months.The clinical efficacy and TCM syndrome score of the two groups were compared.Vision related indicators[best corrected visual acuity(BCVA),retinal thickness,visual acuity],inflammatory factors[chemokine-like receptor 1(CMKLR1),soluble intercellular adhesion molecule-1(sICAM-1)]and mRNA expression levels of IL-33 and ST2 in peripheral blood of the two groups were compared before treatment and 3 months after treatment.The incidence of complications was compared between the two groups.Results The total effective rate of the study group was higher than that of the control group(P<0.05).After 3 months of treatment,the traditional Chinese medicine syndrome score,BCVA and retinal thickness of the study group were lower than those of the control group,and the visual acuity was higher than that of the control group(P<0.05).After 3 months of treatment,serum CMKLR1 and sICAM-1 levels in the study group were lower than those in the control group,and peripheral blood IL-33 and ST2 mRNA expression levels were lower than those in the control group(P<0.05).Conclusion The application of Danhuang Mingmu decoction after DR can improve the clinical symptoms,visual acuity level,and reduce the degree of inflammatory response of the body.The mechanism of action may be related to inhibiting the activation of IL-33/ST2 signaling pathway.