逐瘀明目方联合西药治疗糖尿病视网膜病变临床观察

Zhuyu Mingmu Recipe Combined with Western Medicine in the Treatment of Diabetic Retinopathy

目的探讨糖尿病视网膜病变(DR)患者应用逐瘀明目方联合西药治疗的临床效果。方法采用随机数字表法,将乐平市中医医院2020年4月—2022年6月收治的94例DR患者分为两组,每组47例。对照组口服羟苯磺酸钙胶囊治疗,观察组在对照组基础上加服逐瘀明目方治疗,均连续治疗12周。比较两组临床疗效、中医证候积分、视网膜病变指标、血管新生因子水平及不良反应。结果观察组临床总有效率为95.74%(45/47),高于对照组的80.85%(38/47)(P<0.05)。治疗后,观察组中医证候积分、黄斑厚度、视野灰度值、血管瘤体积、出血斑面积及胰岛素样生长因子(IGF-1)、血管内皮生长因子(VEGF)水平均低于对照组,差异有统计学意义(P<0.05)。两组均未见明显不良反应。结论DR患者应用逐瘀明目方联合西药治疗效果较佳,利于改善其视网膜病理变化,降低IGF-1、VEGF的表达,且安全性好,值得推广。

Objective To explore the clinical efficacy of Zhuyu Mingmu recipe combined with Western medicine in the treatment of diabetic retinopathy(DR).Methods The 94 DR patients in Leping Hospital of Traditional Chinese Medicine from April 2020 to June 2022 were randomly divided into two groups,with 47 patients in each group.The control group was treated with calcium dobesilate orally,and the observation group was treated with Zhuyu Mingmu recipe for 12 consecutive weeks.The clinical efficacy,TCM syndrome score,retinopathy index,angiogenic factor level and adverse reactions of the two groups were compared.Results The total effective rate of the observation group was 95.74%(45/47),which was higher than that of the control group(80.85%,38/47)(P<0.05).After treatment,TCM syndrome score,macular thickness,visual field gray value,hemangioma volume,blood spot area,insulin-like growth factor(IGF-1)and vascular endothelial growth factor(VEGF)levels in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).No obvious adverse reactions were observed in both groups.Conclusion The combination of Zhuyu Mingmu recipe and Western medicine has a better effect on DR patients,which is beneficial to improve the pathological changes of retina,reduce the expression of IGF-1 and VEGF,and is safe and worth promoting.