2型糖尿病视网膜病变黄斑形态与中医证型的相关性

Correlation on Macular Morphology and TCM Syndromes of Type 2 Diabetic Retinopathy

目的:探讨糖尿病视网膜病变(diabetic retinopathy,DR)黄斑形态与其中医证型的相关性,以明确DR黄斑区不同视网膜形态病理改变的中医证型特点、发展变化规律。方法:60例(96眼) 2型糖尿病患者,记录患者的最佳矫正视力、+90D裂隙灯前置镜视网膜形态,DR分期、中医证型,并做黄斑区OCT扫描,分析黄斑形态与其中医证型相关性。结果:黄斑形态与中医证型具有相关性(r=0. 668 0,P=0. 000 7 <0. 05);湿浊中阻证主要表现为黄斑渗出、黄斑水肿;气阴两虚证主要表现为黄斑水肿、局部视网膜变薄;瘀血阻滞证主要表现为黄斑水肿、视网膜出血、硬性渗出。DR中医证型与视力具有相关性(P=0. 014 <0. 05);瘀血阻滞证者视力低于气阴两虚证者,气阴两虚证者视力低于湿浊中阻证者。结论:2型糖尿病视网膜病变黄斑形态与DR中医证型具有相关性。DR中医证型与视力相关。频域OCT能定量定性地观察糖尿病患者黄斑区形态的细微变化,是糖尿病患者黄斑病变早期诊断及治疗的可靠检测手段。

Objective: To investigate the correlation between diabetic retinopathy( DR) macular morphology and TCM syndromes,and to clarify the characteristics and developmental changes of TCM syndromes of different retinal morphological changes in DR macular area. Methods: 60 patients( 96 eyes) with type 2 diabetes mellitus were enrolled in this study. The patient’s best corrected visual acuity,+ 90 D slit lamp pre-mirror retinal morphology,D R staging,TCM syndrome type,and OCT scan of the macular area were recorded,and the correlation between the macular morphology and the medical syndrome type was analyzed. Results: Macular morphology and TCM syndromes were correlated( r = 0. 668 0,P = 0. 000 7 < 0. 05). The main manifestations of dampness obstruction of middle jiao syndrome are macular exudation and macular edema. The main manifestations of Qi-Yin deficiency syndrome are macular edema and local retinal thinning. The main manifestations of blood stasis syndrome are macular edema,retinal hemorrhage and rigid exudation. DR TCM syndrome type has a correlation with visual acuity( P = 0. 014 < 0. 05). The visual acuity of the blood stasis syndrome is lower than that of the Qi-Yin deficiency syndrome. The visual acuity of the Qi-Yin deficiency syndrome is lower than that of the dampness obstruction of middle jiao syndrome. Conclusion: Macular morphology of type 2 diabetic retinopathy is correlated with TCM syndrome type DR. The syndrome type of DR is related to vision. Frequency domain OCT can quantitatively and qualitatively observe the subtle changes of macular morphology in diabetic patients,which is a reliable method for early diagnosis and treatment of diabetic macular lesions.