复方樟柳碱对早期糖尿病视网膜病变多焦视网膜电图的影响

摘要

目的：观察复方樟柳碱穴位注射对早期DR的多焦视网膜电图( mfERG)一阶Kernel反应的改变。方法：连续选取Ⅰ~Ⅱ期糖尿病视网膜病变患者48例48眼,分为对照组和注射组,其中对照组采用控制血糖药物治疗,注射组除采用药物控制血糖外接受复方樟柳碱穴位注射。治疗后行多焦电生理检查,分析参数为mfERG产生的4个象限、6环以及总和反应的波形,对总和反应平均密度、P1和N1的潜伏期与振幅结果进行统计学分析。结果：注药组和对照组 P1波的总和反应平均密度为39.42±6.46、28.50±3.73nV/deg2,N1波为11.12±1.34、6.33±1.14nV/deg2。注药组P1波和N1波总和反应平均密度均高于对照组( P1：t=6.230,P<0.01；N1：t=3.526,P<0.01)。注药组SN、IN、IT和ST象限P1反应波平均密度分别为32.61±9.62、32.31±7.94、29.24±7.84、28.09±5.38nV/deg2,均高于对照组(P<0.05),各象限两组N1反应波平均密度比较均无明显差异。注药组R1~R6P1、R1~R3 N1反应波平均密度分别为98.11±17.53、73.95±17.20、64.09±14.13、49.43±10.08、40.24±11.55、36.86± ；6.43、25.27±12.81、21.31±6.76、14.86±5.06nV/deg2,均高于对照组( P<0.05),两组R4~R6 N1反应波平均密度比较无明显差异。注药组 IT 和 ST 中 P1和 N1波幅值1.37±0.35、1.28±0.29、0.31±0.05和0.30±0.10μV,明显高于对照组( P<0.05),两组SN和IN中P1和N1波幅值差异无统计学意义。结论：复方樟柳碱穴位注射可以改善早期DR部分视网膜功能损伤。%Abstract• AlM: To observe the clinical effect of compound anisodine hydrobromide acupoint injection therapy on the changes of the multifocal electroretinography ( mfERG ) waves in patients with diabetic retinopathy ( DR) .•METHODS: ln this prospective control study, 48 cases (48 eyes) with DR Ⅰ ~ Ⅱ period were divided into the injection group ( 24 eyes of 24 cases ) and the control group ( 24 eyes of 24 cases ) . The cases in the control group were treated by conventional glucose- lowering therapeutic scheme. Those in the injection group were treated by compound anisodine hydrobromide acupoint injection 2mL and conventional glucose - lowering therapeutic scheme. The mfERG examination system (RETlscan 3. 15 version, Roland, Germany) was applied. These waves of four quadrants of SN, lN, lT and ST, 6 rings and the sum responses from the mfERG examinations were observed and the average density of the sum response, the latent period and amplitude of P1 and N1 waves were analyzed by SPSS 13. 0.•RESULTS:The average density of the sum response of P1 and N1 waves in the injection group were 39. 42 ± 6. 46 and 11. 12 ± 1. 34nV/deg2 respectively, which were higher than those in the control group (28. 50 ± 3. 73 and 6. 33 ± 1. 14nV/deg2 ) ( P1:t= 6. 230, P<0. 01;N1: t= 3. 526, P<0. 01). The average density of P1 in SN, lN, lT and ST quadrants in the injection group were 32. 61 ± 9. 62, 32. 31 ± 7. 94, 29. 24 ± 7. 84 and 28. 09 ± 5. 38nV/deg2 respectively, which were higher than those in the control group ( P<0. 05), while there were no statistic differences in the N1 waves between two groups. The average density of P1 in R1~R6 and N1 in R1~R3 in the injection group were 98. 11± 17. 53, 73. 95 ± 17. 20, 64. 09 ± 14. 13, 49. 43 ± 10. 08, 40. 24 ± 11. 55, 36. 86 ± 6. 43, 25. 27 ± 12. 81, 21. 31 ± 6. 76 and 14. 86 ± 5. 06nV/deg2 respectively, which were higher than those in the control group (P<0. 05). There was no significant difference on the average density of N1 in R4 ~ R6 between the two groups. The wave amplitude of P1 and N1 in lT and ST in the injection group were 1. 37 ± 0. 35, 1. 28± 0. 29, 0. 31 ± 0. 05 and 0. 30 ± 0. 10μV respectively, which were significantly higher than those in the control group (P<0. 05) while there were no statistic differences in the P1 and N1 in SN and lN between two groups.•CONCLUSlON:The compound anisodine hydrobromide acupoint injection can improve the retinal function of DR in the early period.