驻景丸合温胆汤加减辨治肝肾阴虚、痰瘀互结证糖尿病视网膜病变患者的临床效果及可能机制探讨(1)
摘要目的：探討驻景丸合温胆汤加减辨治肝肾阴虚、痰瘀互结证糖尿病视网膜病变患者的临床效果及可能的作用机制。方法：选取2016年6月至2017年6月日照市中医医院收治的糖尿病视网膜病变患者84例，随机分为对照组和观察组，每组42例。对照组患者给予前列地尔注射液静脉滴注治疗，观察组患者则在此基础上加用由驻景丸合温胆汤加减而成的汤剂内服治疗，连续治疗8周为疗程。通过眼部指标变化比较2组的临床效果，观察治疗前后视网膜血流动力学指标变化，监测血清中超氧化物歧化酶(SOD)、丙二醛(MDA)、趋化素(Chemerin)、单核细胞趋化因子蛋白1(MCP1)水平。结果：观察组的有效率高达905%，显著高于对照组(714%)，差异有统计学意义(P<005)；治疗后观察组患者的黄斑厚度、视野灰度值、血管瘤体积、出血斑面积等眼部指标水平则较对照组明显降低，差异有统计学意义(P<005)；2组患者的视网膜血流动力学指标CRV、PI、RI均较治疗前显著降低，而PSV、EDV、Vm水平则较治疗前显著升高，以观察组患者的上述指标变化更为明显，差异有统计学意义(P<005)；观察组患者血清中氧化应激指标SOD水平明显高于对照组，而氧化应激指标MDA及炎性指标Chemerin、MCP1水平则较对照组明显降低，差异有统计学意义(P<005)。结论：驻景丸合温胆汤加减利于减轻糖尿病视网膜病患者的眼底病变，改善患者的眼部微循环，其机制可能在于通过调控血清中氧化应激指标SOD、MDA及炎性指标Chemerin、MCP1水平而抑制视网膜氧化应激反应，减轻视网膜组织的炎性损伤，有一定的临床应用推广价值。
关键词糖尿病视网膜病变；驻景丸；温胆汤；临床研究
Clinical Effect and Possible Mechanism for Treating Liver Kidney Yin Deficiency and Phlegm Blood Stasis Syndrome Diabetic Retinopathy Patients with Zhujing Pill and Wendan Decoction
Yan Fenghua1，Li Zongzhi2，Zheng Jiajun1，Jiao Luan1
(1 Rizhao Traditional Chinese Medicine Hospital，Rizhao 276800，China； 2 Rizhao Dermatological Disease Prevention and Control Institute，Rizhao 276800，China)
AbstractObjective：To investigate the clinical effect and possible mechanism for treating liver kidney yin deficiency and phlegm blood stasis syndrome diabetic retinopathy patients with Zhujing Pill and Wendan Decoction.Methods：A total of 84 cases From Jun 2016 to Jun 2017 in Rizhao Traditional Chinese Medicine Hospital were randomly divided into the control group of 42 cases and the observation group of 42 cases.Patients in the control group were treated with intravenous drip of alprostadil injection，while patients in the observation group were treated with Zhujing Pill and Wendan Decoction，continuous treatment for 8 weeks.The research was aimed at evaluating the effectiveness by comparing eye index change，observing the hemodynamic parameters before and after treatment of retinal change，and monitoring the levels of serum super oxide dismutase (SOD)，malondialdehyde (MDA)，chemotactic factor (Chemerin) and monocyte chemokine protein1 (MCP1).Results：The efficiency of patients in the observation group was 905%，which was higher than that of the control group 714% (P<005).After treatment，the patients in the observation group were significantly lower than those in the control group，such as the thickness of macula，the gray value of the field of vision，the volume of hemangioma，and the area of the blood spot.Hemodynamic parameters in the two groups of patients with retinal CRV，PI，RI were significantly reduced，while the PSV，EDV，Vm levels were significantly elevated.The index change of patients in the observation group was more obvious (P<005).The SOD level of oxidative stress in the observation group was significantly higher than that in the control group，while the levels of oxidative stress index MDA and inflammatory indicator Chemerin and McP1 were significantly lower than that in the control group (P<005).Conclusion：The therapy is good to reduce fundus lesions of the diabetic retinal disease and improve the patient′s eye microcirculation.Its mechanism may be through regulating oxidative stress indicators in serum SOD，MDA and inflammatory indexes Chemerin and MCP1 levels to inhibits the retinal oxidative stress response and alleviate the inflammatory damage of retinal tissue，which has certain clinical application promotion value., http://www.100md.com(闫丰华 李宗枝 郑加军)
关键词糖尿病视网膜病变；驻景丸；温胆汤；临床研究
Clinical Effect and Possible Mechanism for Treating Liver Kidney Yin Deficiency and Phlegm Blood Stasis Syndrome Diabetic Retinopathy Patients with Zhujing Pill and Wendan Decoction
Yan Fenghua1，Li Zongzhi2，Zheng Jiajun1，Jiao Luan1
(1 Rizhao Traditional Chinese Medicine Hospital，Rizhao 276800，China； 2 Rizhao Dermatological Disease Prevention and Control Institute，Rizhao 276800，China)
AbstractObjective：To investigate the clinical effect and possible mechanism for treating liver kidney yin deficiency and phlegm blood stasis syndrome diabetic retinopathy patients with Zhujing Pill and Wendan Decoction.Methods：A total of 84 cases From Jun 2016 to Jun 2017 in Rizhao Traditional Chinese Medicine Hospital were randomly divided into the control group of 42 cases and the observation group of 42 cases.Patients in the control group were treated with intravenous drip of alprostadil injection，while patients in the observation group were treated with Zhujing Pill and Wendan Decoction，continuous treatment for 8 weeks.The research was aimed at evaluating the effectiveness by comparing eye index change，observing the hemodynamic parameters before and after treatment of retinal change，and monitoring the levels of serum super oxide dismutase (SOD)，malondialdehyde (MDA)，chemotactic factor (Chemerin) and monocyte chemokine protein1 (MCP1).Results：The efficiency of patients in the observation group was 905%，which was higher than that of the control group 714% (P<005).After treatment，the patients in the observation group were significantly lower than those in the control group，such as the thickness of macula，the gray value of the field of vision，the volume of hemangioma，and the area of the blood spot.Hemodynamic parameters in the two groups of patients with retinal CRV，PI，RI were significantly reduced，while the PSV，EDV，Vm levels were significantly elevated.The index change of patients in the observation group was more obvious (P<005).The SOD level of oxidative stress in the observation group was significantly higher than that in the control group，while the levels of oxidative stress index MDA and inflammatory indicator Chemerin and McP1 were significantly lower than that in the control group (P<005).Conclusion：The therapy is good to reduce fundus lesions of the diabetic retinal disease and improve the patient′s eye microcirculation.Its mechanism may be through regulating oxidative stress indicators in serum SOD，MDA and inflammatory indexes Chemerin and MCP1 levels to inhibits the retinal oxidative stress response and alleviate the inflammatory damage of retinal tissue，which has certain clinical application promotion value., http://www.100md.com(闫丰华 李宗枝 郑加军)
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