芪明颗粒联合羟苯磺酸钙治疗非增殖性糖尿病性视网膜病变

摘要

目的:探讨芪明颗粒联合羟苯磺酸钙治疗非增殖性糖尿病性视网膜病变(NPDR)的临床效果.方法:收集我院2014-01/2016-05确诊收治的94例Ⅰ~Ⅲ期NPDR患者,均为单眼,采用随机平行对照法将其分为对照组和观察组各47例47眼.两组均给予控制血糖、饮食运动疗法等常规治疗处理,对照组口服常规西药羟苯磺酸钙治疗,0.5g/次,3次/d,观察组在对照组基础上加用芪明颗粒联合治疗,均持续治疗3 mo.观察两组治疗前后视野敏感度和相关血清细胞因子[血管内皮生长因子(VEGF)、胰岛素样生长因子-1(IGF-1)、色素上皮衍生因子(PEDG)]变化,综合评估并比较两组治疗效果及安全性.结果:观察组治疗后视野平均敏感度较治疗前、对照组治疗后低,差异具有统计学意义(P<0.05);观察组治疗后VEGF、IGF-1、PEDG较对照组均有显著改善,差异具有统计学意义(P<0.05);两组均未出现明显不良反应,观察组治疗总有效率(89%)较对照组(72%)高,差异有统计学意义(P<0.05).结论:芪明颗粒联合西药治疗NPDR可有效改善视网膜功能和缓解病情进展,且安全性较好,临床治疗效果显著.%·AIM:To investigate the clinical effect of Qi Ming granule combined with calcium dobesilate in treatment of non-proliferative diabetic retinopathy( NPDR) . ·METHODS:Totally 94 patients with Ⅰ~Ⅲ stage NPDR in our hospital from January 2014 to May 2016 were collected and randomly divided into control group and observation group, all were unilateral, with 47 eyes in each group. The two groups were given control of blood glucose, diet and exercise therapy and other conventional treatment. The control group were treated with conventional western medicine calcium dobesilate treatment, 0. 5g,3 times per day, the observation group combined with Qi Ming granule treatment based on control group treatment. Both groups were treated for 3mo. Two groups were observed before and after treatment for visual sensitivity and changes of serum cytokines [ vascular endothelial growth factor( VEGF) and insulin-like growth factor-1 ( IGF-1 ) , pigment epithelium derived factor ( PEDG ) ] . Therapeutic effect and safety of the two groups were comprehensively evaluated and compared. ·RESULTS: The average sensitivity of the observation group after treatment was lower than that before treatment and the control group after treatment, the difference were statistically significant ( P < 0. 05 ) . The VEGF,IGF-1,PEDG of observation group after treatment, were significantly improved compared with the control group, the difference were statistically significant ( P <0. 05). There were no obvious adverse reactions in the two groups, the total effective rate was 89% in the observation group, which was higher compared with the control group 72%, and the difference was statistically significant(P<0. 05). ·CONCLUSION:Qi Ming granule combined with western medicine in the treatment of DR can effectively improve the function of the retina and ease the progress of the disease, and the safety is good, the clinical treatment effect is remarkable.