[關(guān)鍵詞]
[摘要]
目的 觀察芪明顆粒聯(lián)合胰激肽原酶腸溶片治療2型糖尿病視網(wǎng)膜病變的臨床療效。方法 選擇2018年5月-2020年12月河南科技大學(xué)第一附屬醫(yī)院接收的2型糖尿病視網(wǎng)膜病變患者100例(158眼),根據(jù)信封抽簽法將患者分為對照組(50例, 76眼)和治療組(50例, 82眼)。對照組患者口服胰激肽原酶腸溶片, 1片/次, 3次/d。治療組在對照組的基礎(chǔ)上溫水沖服芪明顆粒, 1袋/次, 3次/d。兩組均連續(xù)用藥6個月。觀察兩組患者療效,比較兩組的視力情況、視網(wǎng)膜血流動力學(xué)、血清炎性因子、新生血管指標(biāo)水平。結(jié)果 治療后,對照組、治療組的總有效率分別為50.00%、74.39%,組間比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者視野灰度值、視野平均缺損指數(shù)較治療前下降,視力值較治療前升高(P<0.05);并且治療組的視野灰度值、視野平均缺損指數(shù)低于對照組,視力值高于對照組(P<0.05)。治療后,兩組眼動脈、視網(wǎng)膜中央動脈的阻力指數(shù)(RI)較治療前下降,峰值血流速度(PSV)較治療前升高(P<0.05);治療組的眼動脈、視網(wǎng)膜中央動脈的RI低于對照組,眼動脈、視網(wǎng)膜中央動脈PSV高于對照組(P<0.05)。治療后,兩組血清白細胞介素-6(IL-6)、超敏C反應(yīng)蛋白(hs-CRP)、腫瘤壞死因子-α(TNF-α)水平較治療前下降(P<0.05);且治療組的血清IL-6、hsCRP、TNF-α水平顯著低于對照組(P<0.05)。治療后,兩組血清血管內(nèi)皮生長因子(VEGF)、血管生成素-2(Ang-2)水平較治療前下降(P<0.05),且治療組的血清VEGF、Ang-2水平低于對照組(P<0.05)。結(jié)論 芪明顆粒聯(lián)合胰激肽原酶腸溶片治療2型糖尿病視網(wǎng)膜病變具有較好的臨床療效,可改善患者眼底微循環(huán)和視功能,降低機體炎癥反應(yīng),減少血管的過度增生,且不增加不良反應(yīng)發(fā)生。
[Key word]
[Abstract]
Objective To observe the clinical effect of Qiming Granules combined with Pancreatic Kininogenase Enteric-coated Tablets in treatment of type 2 diabetic retinopathy.Methods Patients (100 cases, 158 eyes) with type 2 diabetic retinopathy in the First Affiliated Hospital of Henan University of Science and Technology from May 2018 to December 2020 were randomly divided into the control group (50 cases, 76 eyes) and the treatment group (50 cases, 82 eyes). Patients in the control group were po administered with Pancreatic Kininogenase Enteric-coated Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Qiming Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and the visual acuity, retinal hemodynamics, serum inflammatory factors and neovascularization indexes in two groups were compared.Results After treatment, the total effective rates of the control group and the treatment group were 50.00% and 74.39%, respectively, and there was significant difference between two groups (P < 0.05). After treatment, the gray value of visual field and the average defect index of visual field in two groups were decreased, but the visual acuity in two groups were increased (P < 0.05). The gray value of visual field and the average defect index of visual field in the treatment group were lower than those in the control group, but the visual acuity in the treatment group was higher than that in the control group (P < 0.05). After treatment, the RI of ophthalmic artery and central retinal artery in two groups were decreased, but the PSV in two groups were increased (P < 0.05). The RI of ophthalmic artery and central retinal artery in the treatment group were lower than those in the control group, but the PSV of ophthalmic artery and central retinal artery in the treatment group were higher than those in the control group (P < 0.05). After treatment, the serum levels of IL-6, hs-CRP, and TNF-α in two groups were decreased compared with those before treatment (P < 0.05), and the serum levels of IL-6, hs-CRP, and TNF-α in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of VEGF and Ang-2 in two groups were decreased compared with those before treatment (P < 0.05), and the serum levels of VEGF and Ang-2 in the treatment group were lower than those in the control group (P < 0.05).Conclusion Qiming Granules combined with Pancreatic Kininogenase Entericcoated Tablets has clinical curative effect in treatment of type 2 diabetic retinopathy, can improve the fundus microcirculation and visual function, reduce the inflammatory reaction, reduce the excessive proliferation of blood vessels, and do not increase the incidence of adverse reactions.
[中圖分類號]
R988.1
[基金項目]
河南省醫(yī)學(xué)科技攻關(guān)計劃項目(2016020354)