加味桃红四物汤联合激光治疗重度非增生型糖尿病视网膜病变的临床研究
Clinical study on treatment of severe non‑proliferative diabetic retinopathy with modified Taohong Siwu Decoction and laser therapy
- 上海中医药杂志 2023年57卷第10期 页码：54-58
- 作者机构：
1.上海中医药大学附属曙光医院（上海 201203）
2.青岛滨海学院附属医院（山东 青岛 266555）
- 作者简介：
杨宇琴，女，硕士研究生，住院医师，主要从事中西医结合眼底病的临床与研究工作
邹红，主任医师，硕士研究生导师；E-mail：zouhong2007@126.com
- 基金信息：国家自然科学基金面上项目(81874384);上海市浦东新区卫健委联合攻关项目(PW2021D-03)
DOI：10.16305/j.1007-1334.2023.2302009
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杨宇琴,刘吉民,李景景,等.加味桃红四物汤联合激光治疗重度非增生型糖尿病视网膜病变的临床研究[J].上海中医药杂志,2023,57(10):54-58.
YANG Yuqin,LIU Jimin,LI Jingjing,et al.Clinical study on treatment of severe non‑proliferative diabetic retinopathy with modified Taohong Siwu Decoction and laser therapy[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(10):54-58.
杨宇琴,刘吉民,李景景,等.加味桃红四物汤联合激光治疗重度非增生型糖尿病视网膜病变的临床研究[J].上海中医药杂志,2023,57(10):54-58. DOI： 10.16305/j.1007-1334.2023.2302009.
YANG Yuqin,LIU Jimin,LI Jingjing,et al.Clinical study on treatment of severe non‑proliferative diabetic retinopathy with modified Taohong Siwu Decoction and laser therapy[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(10):54-58. DOI： 10.16305/j.1007-1334.2023.2302009.
摘要
目的,2,观察加味桃红四物汤联合全视网膜激光光凝术治疗重度非增生型糖尿病视网膜病变（sNPDR）的临床疗效。,方法,2,将94例气阴两虚、血瘀阻络型sNPDR患者随机分为治疗组47例、对照组47例，对照组采用全视网膜激光光凝术治疗，治疗组在对照组治疗措施的基础上加用加味桃红四物汤，两组疗程均为3个月。观察中医证候疗效，比较两组治疗前、治疗1个月、治疗3个月黄斑中心凹无血管区（FAZ）面积、黄斑FAZ周长、浅层血管线性密度（VD）、浅层血管灌注密度（PD）的变化情况。,结果,2,①治疗组、对照组各脱落病例2例，最终完成试验者90例，其中治疗组、对照组各45例。②治疗组、对照组总有效率分别为73.33%、51.11%；治疗组中医证候疗效优于对照组（,P,<,0.05）。③治疗1个月、治疗3个月与治疗前组内比较，治疗组黄斑FAZ面积缩小（,P,<,0.05），治疗3个月与治疗1个月组内比较，两组黄斑FAZ面积差异无统计学意义（,P,>,0.05）；组间治疗1个月、治疗3个月比较，黄斑FAZ面积差异无统计学意义（,P,>,0.05）。 ④治疗1个月与治疗前组内比较，治疗组黄斑FAZ周长缩小（,P,<,0.05），治疗3个月与治疗前组内比较，两组黄斑FAZ周长缩小（,P,<,0.05），治疗3个月与治疗1个月组内比较，两组黄斑FAZ周长缩小（,P,<,0.05）；组间治疗1个月、治疗3个月比较，治疗组黄斑FAZ周长均小于对照组（,P,<,0.05）。⑤治疗1个月、治疗3个月与治疗前组内比较，两组中心区VD值、外层区VD值升高（,P,<,0.05），治疗3个月与治疗1个月组内比较，两组外层区VD值升高（,P,<,0.05）；组间治疗3个月比较，治疗组中心区VD值高于对照组（,P,<,0.05）。⑥治疗1个月、治疗3个月与治疗前组内比较，两组中心区PD值、外层区PD值、完整区PD值升高（,P,<,0.05），治疗3个月与治疗1个月组内比较，治疗组外层区PD值、完整区PD值升高（,P,<,0.05）；组间治疗1个月、治疗3个月比较，外层区PD值、完整区PD值差异有统计学意义（,P,<,0.05）。,结论,2,与单纯采用全视网膜激光光凝术治疗比较，加用加味桃红四物汤治疗sNPDR疗效满意，能更好地改善患者的眼底微循环，进而保护患者的视功能。
Abstract
Objective,2,To observe the clinical efficacy of modified Taohong Siwu Decoction plus pan-retinal photocoagulation for treating severe non-proliferative diabetic retinopathy （sNPDR）.,Methods,2,Ninety-four cases of sNPDR patients with syndrome of qi-yin deficiency and blood stasis blocking collaterals were randomly divided into treatment group （,n,=47） and control group （,n,=47）. The control group was treated with pan-retinal photocoagulation， and the treatment group additionally used modified Taohong Siwu Decoction besides the treatment measures of the control group， and the treatment course of both groups was 3 months. The improvement of TCM symptoms was observed， and the changes in foveal avascular zone （FAZ） area， FAZ circumference， vascular density （VD） and perfusion density （PD） of superficial vascular plexuses of the two groups were compared before treatment， after 1 month and 3 months of treatment， respectively.,Results,2,①There were two drop-out cases in treatment and control groups， respectively， and 90 cases completed the trial， with 45 cases in each group. ②The total effective rate was 73.33% in the treatment group and 51.11% in the control group， and the improvement in TCM symptoms in the treatment group was better than that in the control group （,P,<,0.05）. ③The treatment group had smaller FAZ area after 1-month and 3-month treatment （,P,<,0.05）； but there was no statistic difference in FAZ area between 1-month treatment and 3-month treatment in both groups （,P,>,0.05）. There was no statistic difference in FAZ area between the two groups after 1-month treatment and 3-month treatment， respectively （,P,>,0.05）. ④The treatment group had shorter FAZ circumference after 1-month treatment （,P,<,0.05）， both groups had shorter FAZ circumference after 3-month treatment （,P,<,0.05）， and the FAZ circumference of both groups after 3-month treatment was shorter than that after 1-month treatment （,P,<,0.05）. The treatment group had shorter FAZ circumference than the control group after 1-month treatment and 3-month treatment， respectively （,P,<,0.05）. ⑤Both groups had higher VD at the center and outer areas after 1-month treatment and 3-month treatment， respectively （,P,<,0.05）； and the VD at the outer area in both groups after 3-month treatment was higher than that after 1-month treatment （,P,<,0.05）. The treatment group had higher VD at the center area than the control group after 3-month treatment （,P,<,0.05）. ⑥Both groups had higher PD at the center， outer， and full areas after 1-month treatment and 3-month treatment， respectively （,P,<,0.05）； and in the treatment group， the PD at the outer and full areas after 3-month treatment was higher than that after 1-month treatment （,P,<,0.05）. The differences in PD at the outer and full areas after 1-month treatment and 3-month treatment between two groups were statistically significant （,P,<,0.05）.,Conclusion,2,The combined use of modified Taohong Siwu Decoction and pan-retinal photocoagulation has gained more satisfactory effects on the treatment of sNPDR than the single use of pan-retinal photocoagulation since the modified Taohong Siwu Decoction can better improve patients' fundus microcirculation and protect their visual function.
关键词
糖尿病视网膜病变中西医结合疗法激光桃红四物汤临床试验
Keywords
diabetesretinopathyintegrated traditional Chinese and Western medicine therapylaserTaohong Siwu Decoctionclinical trial
references
CHEUNG N， MITCHELL P， WONG T Y. Diabetic retinopathy［J］. Lancet， 2010， 376（9735）： 124-136.
MORENO A， LOZANO M， SALINAS P. Diabetic retinopathy［J］. Nutr Hosp， 2013， 28（Suppl 2）： 53-56.
KOLLIAS A N， ULBIG M W. Diabetic retinopathy： Early diagnosis and effective treatment［J］. Dtsch Arztebl Int， 2010， 107（5）： 75-84.
HOU Y， CAI Y， JIA Z， et al. Risk factors and prevalence of diabetic retinopathy： A protocol for meta-analysis［J］. Medicine （Baltimore）， 2020， 99（42）： e22695.
秦瑜，陈瑜，李春霞. 金钗石斛治疗糖尿病及其相关病变的实验研究进展［J］. 上海中医药杂志，2023， 57（2）： 21-25.
NISSEN T P H， VORUM H， AASBJERG K. Biologic therapy and treatment options in diabetic retinopathy with diabetic macular edema［J］. Curr Drug Saf， 2021， 16（1）： 17-31.
梁晓春. 糖尿病视网膜病变与消渴兼证“视瞻昏渺”及其中医治疗［J］. 中国临床医生，2006， 34（6）： 12-14.
GAN Y， ZHANG X， SU Y， et al. OCTA versus dye angiography for the diagnosis and evaluation of neovascularisation in punctate inner choroidopathy［J］. Br J Ophthalmol， 2022， 106（4）： 547-552.
中华医学会糖尿病学分会. 中国2型糖尿病防治指南（2020年版）［J］. 中华内分泌代谢杂志，2021， 37（4）： 311-398.
国家药品监督管理局. 中药新药临床研究指导原则（试行）［M］. 北京：中国中医药科技出版社，2002： 181-182.
吴勉华，王新月. 中医内科学［M］. 9版. 北京：中国中医药出版社，2012： 118.
王蕾蕾，俞莹，缪晚虹. 中药单体对抑制糖基化终末产物改善糖尿病视网膜病变作用机制研究进展［J］. 上海中医药杂志，2017， 51（S1）： 213-216.
HAMMES H P. Diabetic retinopathy： hyperglycaemia， oxidative stress and beyond［J］. Diabetologia， 2018， 61（1）： 29-38.
SAHAJPAL N S， GOEL R K， CHAUBEY A， et al. Pathological perturbations in diabetic retinopathy： hyperglycemia， ages， oxidative stress and inflammatory pathways［J］. Curr Protein Pept Sci， 2019， 20（1）： 92-110.
KANG Q， YANG C. Oxidative stress and diabetic retinopathy： Molecular mechanisms， pathogenetic role and therapeutic implications［J］. Redox Biol， 2020， 37： 101799.
LONG L， LI Y， YU S， et al. Scutellarin prevents angiogenesis in diabetic retinopathy by downregulating VEGF/ERK/FAK/Src pathway signaling［J］. J Diabetes Res， 2019， 2019： 4875421.
D'AMICO A E， WONG A C， ZAJD C M， et al. PKC-ε regulates vesicle delivery and focal exocytosis for efficient IgG-mediated phagocytosis［J］. J Cell Sci， 2021， 134（21）： jcs258886.
吕小利，邹红，黎蕾，等. 加味桃红四物汤灌胃治疗视网膜静脉阻塞大鼠的实验研究［J］. 上海中医药杂志，2019， 53（8）： 81-88.
ARYA M， RASHAD R， SOROUR O， et al. Optical coherence tomography angiography （OCTA） flow speed mapping technology for retinal diseases［J］. Expert Rev Med Devices， 2018， 15（12）： 875-882.
DENG X， CHENG Y， ZHU X M， et al. Foveal structure changes in infants treated with anti-VEGF therapy or laser therapy guided by optical coherence tomography angiography for retinopathy of prematurity［J］. Int J Ophthalmol， 2022， 15（1）： 106-112.
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