益气滋阴化瘀方治疗非增殖期糖尿病视网膜病变的临床观察

发布时间：2018-05-15 20:13

本文选题：益气滋阴化瘀 + 非增殖期糖尿病视网膜病变　；参考：《华北理工大学》2016年硕士论文

【摘要】：目的观察益气滋阴化瘀方对非增殖期糖尿病视网膜病变(Non-proliferative diabetic retinopathy,NPDR)(属气阴两虚、瘀血阻络证型)患者的临床治疗效果。方法选取2014年7月至2015年7月于唐山市中医医院内分泌科住院治疗的非增殖期糖尿病视网膜病变患者75例,按照随机数字表法随机分为治疗组(n=37)和对照组(n=38)。两组均给予常规降糖治疗及其它疾病对症治疗,治疗组在此基础上服用益气滋阴化瘀方,500ml/剂,1剂/日,250ml/次,2次/天。治疗前及治疗1个月后分别观察患者中医症状、视力及眼底病变、眼动脉血流动力学、FBG、PBG、HbA1c、肝功能、肾功能等的变化。结果1中医证候积分及疗效的比较:两组患者在治疗后较治疗前中医证候积分均有所下降(P0.05),但治疗组中医证候积分明显低于对照组(7.24±5.75 vs11.77±6.79,P0.05)。且相对于对照组,加用益气滋阴化瘀方的患者中医症状治疗效果明显改善(82.3%vs 42.8%,P0.05)。2视力及眼底疗效的比较:治疗后两组患者视力较治疗前均有提高(P0.05),且治疗组提高幅度明显大于对照组(P0.05)。治疗组眼底疗效总有效率为85.3%,显效27只(39.7%),有效31只(45.6%),无效10只(14.7%),未出现恶化的病例;对照组总有效率为48.6%,显效14(20.0%),有效20只(28.6%),无效36只(51.4%),未出现恶化病例;治疗组眼底病变改善情况明显优于对照组(P0.05)。3眼动脉血流动力学的比较:治疗后两组患者的眼动脉血流动力学指标明显比治疗前有所改善(P0.05),且治疗组血流速度提高及阻力指数降低的程度明显大于对照组(P0.05)。4血糖和糖化血红蛋白的比较:两组在治疗后比治疗前血糖、糖化血红蛋白均有所改善(P0.05),与对照组相比,治疗组血糖、糖化血红蛋白下降明显,差异有统计学意义(P0.05)。5肝功能和肾功能的比较:两组患者治疗前后肝功能和肾功能指标比较无差异(P0.05)。结论益气滋阴化瘀方可以降低血糖,改善中医临床症状,加快眼动脉血流速度,减轻眼底病变程度,缓解或者逆转糖尿病视网膜病变进展,提高视力。
[Abstract]:Objective To observe the effect of Yiqi nourishing Yin Huayu Recipe on patients with non proliferative diabetic retinopathy (Non-proliferative diabetic retinopathy, NPDR) (belonging to deficiency of Qi and Yin, blood stasis syndrome). Methods the non proliferative diabetic retina hospitalized in the Department of Endocrinology, Tangshan City Hospital of traditional Chinese medicine from July 2014 to July 2015 75 patients were randomly divided into the treatment group (n=37) and the control group (n=38) according to the random number table. The two groups were given conventional hypoglycemic treatment and other diseases and symptomatic treatment. On this basis, the treatment group took Yiqi nourishing Yin Huayu Recipe, 500ml/ agent, 1 doses / day, 250ml/ times, 2 times. The patients' symptoms were observed before and after 1 months of treatment, respectively. Changes in visual acuity and fundus lesions, ophthalmic artery hemodynamics, FBG, PBG, HbA1c, liver function and renal function. Results 1 TCM syndrome scores and curative effects were compared: the scores of TCM syndrome in the two groups were decreased after treatment (P0.05), but the score of TCM syndrome in the treatment group was significantly lower than that of the control group (7.24 + 5.75 vs11.77 + 6.79, P0.05). Compared with the control group, the curative effect of TCM symptom treatment was obviously improved (82.3%vs 42.8%, P0.05).2 visual acuity and fundus curative effect. The visual acuity of the two groups was improved after treatment (P0.05), and the improvement of the treatment group was significantly greater than that of the control group (P0.05). The total effective rate of the treatment group was 85.. 3%, 27 (39.7%), 31 effective (45.6%), 10 ineffective (14.7%) and no worsening cases; the control group had a total effective rate of 48.6%, an effective 14 (20%), an effective 20 (28.6%), no invalid 36 (39.7%), no worsening cases; the improvement of the fundus disease in the treatment group was significantly better than the comparison group (P0.05).3 ophthalmic hemodynamic comparison: treatment after treatment The hemodynamic indexes of the two groups were significantly better than those before the treatment (P0.05), and the improvement of blood flow velocity and resistance index in the treatment group was significantly greater than that of the control group (P0.05).4 blood sugar and glycosylated hemoglobin: the two groups improved after treatment than before the treatment of blood sugar and glycosylated hemoglobin (P0.05), and the control group. Compared with the treatment group, the blood sugar, glycated hemoglobin decreased significantly, the difference was statistically significant (P0.05).5 liver function and renal function comparison: the two groups of patients before and after treatment of liver function and renal function indexes have no difference (P0.05). Conclusion Yiqi nourishing yin and Huayu Recipe can reduce blood sugar, improve the clinical symptoms of traditional Chinese medicine, speed up the velocity of ocular artery blood flow, reduce the blood flow rate and decrease the blood flow rate of the ophthalmic artery. The degree of mild fundus lesions relieves or reverses the progression of diabetic retinopathy and improves vision.

【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R276.7

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