养血滋阴方联合针刺治疗糖尿病眼底出血临床研究
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R779.6

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浙江省中医药科技计划(2022ZA100)


Clinical Study on Yangxue Ziyin Prescription Combined with Acupuncture for Diabetic Fundus Hemorrhage
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    摘要:

    目的:观察养血滋阴方联合针刺治疗糖尿病眼底出血的临床疗效及对动脉血流、视野的影响。方 法:采用随机数字表法将124 例糖尿病眼底出血患者分为对照组、观察组各62 例。2 组均给予常规西药治疗, 对照组在常规西药治疗基础上联用针刺治疗,观察组在对照组基础上联用养血滋阴方治疗,2 组连续治疗1 个 月。比较2 组治疗前后眼动脉血流指标(舒张期血流速度峰值、收缩期血流速度峰值、阻力指数)、眼底出血面 积、黄斑厚度、视野灰度值、血管瘤体积、视网膜电图振荡电位(OPs);比较2 组治疗前后最佳矫正视 力(BCVA)、视功能相关的生活质量量表(VFQ-25)、中医证候评分;比较2 组治疗前后趋化因子样受体 1(CMKLR1)、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)、血小板源性生长因子-BB(PDGF-BB) 水 平,并评估2 组临床疗效及不良反应发生情况。结果:观察组总有效率96.77%,高于对照组83.87%(P< 0.05)。2 组治疗后CMKLR1、TNF-α、VEGF、PDGF-BB 水平及眼底出血面积、黄斑厚度、视野灰度值、血管 瘤体积、阻力指数、OPs、VFQ-25、中医证候评分均较治疗前降低(P<0.05),观察组治疗后CMKLR1、TNF-α、 VEGF、PDGF-BB 水平及眼底出血面积、黄斑厚度、视野灰度值、血管瘤体积、阻力指数、OPs、VFQ-25、中 医证候评分均低于对照组(P<0.05)。2 组治疗后舒张期血流速度峰值、收缩期血流速度峰值、BCVA 水平升 高(P<0.05),观察组治疗后舒张期血流速度峰值、收缩期血流速度峰值、BCVA 水平高于对照组(P<0.05)。 结论:养血滋阴方联合针刺治疗糖尿病眼底出血疗效确切,能够抑制机体炎症,保护患者视网膜屏障,改善眼 动脉血流、视力,提高生活质量。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Yangxue Ziyin Prescription combined with acupuncture on diabetic fundus hemorrhage and its effect on artery blood and visual field. Methods:A total of 124 cases of patients with diabetic fundus hemorrhage were divided into the control group and the observation group according to random number table method, with 62 cases in each group. Both groups were given routine western medicine treatment. The control group received acupuncture based on routine western medicine treatment, and the observation group was additionally treated with Yangxue Ziyin Prescription based on the treatment of the control group. Both groups were treated continuously for one month. The ophthalmic artery blood flow indexes (peak diastolic blood flow velocity, peak systolic blood flow velocity, and resistance index), fundus hemorrhage area, macular thickness, gray values of visual field, hemangioma volume, and oscillatory potentials (OPs) were compared between two groups before and after treatment. The best-corrected visual acuity (BCVA),Visual Function Questionnaire 25 (VFQ-25), and traditional Chinese medicine (TCM) syndrome scores were compared between two groups before and after treatment. The levels of chemokine-like receptor 1 (CMKLR1), tumor necrosis factor- α(TNF- α), vascular endothelial growth factor (VEGF) and platelet-derived growth factor-BB (PDGF-BB) were compared between the two groups, and the clinical effects and incidence of adverse reactions were evaluated in the two groups. Results:The total effective rate was 96.77% in the observation group,higher than that of 83.87% in the control group (P<0.05). The levels of CMKLR1,TNF-α,VEGF and PDGF-BB, as well as the fundus hemorrhage area, macular thickness, gray values of visual field, hemangioma, resistance index, OPs, VFQ-25, and TCM syndrome scores were all decreased when compared with those before treatment (P<0.05),and the levels of CMKLR1,TNF- α,VEGF and PDGF-BB,as well as the fundus hemorrhage area, macular thickness, gray values of visual field, hemangioma, resistance index,OPs,VFQ-25,and TCM syndrome scores in the observation group were all lower than those in the control group (P<0.05). After treatment, the peak diastolic blood flow velocity, peak systolic blood flow velocity,and BCVA levels were increased in two groups (P<0.05),and the peak diastolic blood flow velocity,peak systolic blood flow velocity,and BCVA level in the observation group were higher than those in the control group (P<0.05). Conclusion: Yangxue Ziyin Prescription combined with acupuncture has a definite curative effect on diabetic fundus hemorrhage, which can inhibit inflammation, protect retinal barrier,improve ophthalmic artery blood flow and vision,and improve the quality of life.

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陈俊卿,来坚,张蕊,杜海英.养血滋阴方联合针刺治疗糖尿病眼底出血临床研究[J].新中医,2024,56(7):92-97

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  • 在线发布日期: 2024-04-11
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