Efficiency observation of Compound Danshen Dropping Pills, Mingmu Dihuang Pills and calcium dobesilate capsules in treating patients with diabetic retinopathy at stage Ⅲ
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摘要:目的 探讨复方丹参滴丸、明目地黄丸、羟苯磺酸钙联合治疗Ⅲ期糖尿病性视网膜病变(DR)的临床效果。方法 将76例(76眼)Ⅲ期DR患者随机分为2组。对照组(n=35)在常规治疗基础上服用羟苯磺酸钙片治疗, 研究组(n=41)在服用羟苯磺酸钙片的同时加用复方丹参滴丸、明目地黄丸。比较2组治疗效果、治疗前后出血斑面积、视觉灰度值、血管瘤体积、黄斑厚度。比较2组治疗前及治疗后血管内皮生长因子(VEGF)、视黄醇结合蛋白4(RBP4)、胰岛素生长因子-1(IGF-1)表达水平。结果 研究组临床效果显著优于对照组(P < 0.05)。治疗后，研究组出血斑面积、血管瘤体积和黄斑厚度显著小于对照组，视觉灰度值及log MAR视力显著低于对照组(P < 0.05)。治疗1、2、3个月时, 2组血清VEGF、RBP4、IGF-1水平均呈显著下降趋势(P < 0.05), 且研究组上述指标均显著低于对照组(P < 0.05)。结论 复方丹参滴丸、明目地黄丸及羟苯磺酸钙联合治疗Ⅲ期DR疗效确切，能有效抑制视网膜内各类细胞因子介导的血管新生过程，改善患者眼底症状，提高患者视力。Abstract:Objective To explore the clinical effect of Compound Danshen Dripping Pills, Mingmu Dihuang Pills and calcium dobesilate capsules in the treatment of patients with diabetic retinopathy (DR) at stage Ⅲ.Methods Totally 76 patients (76 eyes) with DR at stage Ⅲ were randomly divided into two groups. In the control group, 35 patients were treated with calcium dobesilate capsules on the basis of routine treatment. In the study group, 41 patients were treated with Danshen Dripping Pills and Mingmu Dihuang Pills on the basis of control group. The therapeutic effect, bleeding spot area, visual gray value, hemangioma volume and macular thickness before and after treatment were compared between the two groups. The expression levels of vascular endothelial growth factor (VEGF), retinol binding protein 4 (RBP4) and insulin growth factor-1 (IGF-1) were compared between the two groups before and after treatment.Results The clinical effect of the study group was significantly better than that of the control group (P < 0.05). After treatment, the hemorrhagic plaque area, hemangioma volume and macular thickness in the study group were significantly smaller than those in the control group, and the visual gray value and logMAR visual acuity were significantly lower than those in the control group (P < 0.05). After 1, 2 and 3 months of treatment, the serum levels of VEGF, RBP4 and IGF-1 in both groups showed a significant downward trend (P < 0.05), and the above indexes in the study group were significantly lower than those in the control group (P < 0.05).Conclusion Combination of compound Danshen dropping pills, Mingmu Dihuang pills and calcium dobesilate are effective in the treatment of patients with DR at stage Ⅲ, which can effectively inhibit the angiogenesis mediated by various cytokines in retina, improve fundus symptoms and visual acuity of patients.
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表 1 2组治疗效果比较[n(%)]
组别 n 显效 有效 无效 对照组 35 7(20.00) 19(54.29) 9(25.71) 研究组 41 15(36.58) 22(53.66) 4(9.76)* 与对照组比较, *P < 0.05。 
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表 2 2组治疗前后眼底及视力变化比较(x±s)
组别 时点 出血斑面积/mm2 视觉灰度值/% 血管瘤体积/μm3 黄斑厚度/μm Log MAR视力 对照组(n=35) 治疗前 3.21±0.47 4.43±0.41 20.07±3.11 408.62±22.24 0.62±0.10 治疗后 2.05±0.41* 2.71±0.32* 15.21±2.54* 355.28±20.37* 0.48±0.06* 研究组(n=41) 治疗前 3.26±0.45 4.47±0.40 20.13±3.07 410.09±22.05 0.65±0.09 治疗后 1.12±0.26*# 1.33±0.25*# 10.82±2.21*# 281.58±15.35*# 0.31±0.05*# 与治疗前比较, *P < 0.05;与对照组比较, #P < 0.05。
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表 3 2治疗前后血清细胞因子水平变化比较(x±s)
组别 时点 VEGF/(pg/mL) RBP4/(mg/L) IGF-1/(ng/mL) 对照组(n=35) 治疗前 142.35±26.94 50.29±5.77 141.62±28.55 治疗1个月 131.42±22.11* 48.32±4.51* 136.36±24.57* 治疗2个月 118.03±19.48*# 44.48±3.65*# 128.74±20.13*# 治疗3个月 106.37±17.55*#△ 41.75±3.41*#△ 123.91±16.09*#△ 研究组(n=41) 治疗前 140.51±27.43 50.61±5.73 143.17±27.72 治疗1个月 124.75±22.38*▲ 45.52±4.73*▲ 130.06±23.03*▲ 治疗2个月 110.26±16.87*#▲ 41.10±3.23*#▲ 122.64±18.85*#▲ 治疗3个月 94.96±14.84*#△▲ 36.37±3.51*#△▲ 114.52±15.33*#△▲ VEGF:血管内皮生长因子; RBP4:视黄醇结合蛋白4; IGF-1:胰岛素生长因子-1。
与治疗前比较, *P < 0.05;与治疗1个月比较, #P < 0.05;与治疗2个月比较, △P < 0.05;与对照组比较, ▲P < 0.05。
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