元芪祛瘀方治療增生性糖尿病視網膜病變玻璃體切除術后的療效隨機對照觀察

王雁　阿依努·努拉厚　何佳佳　高云仙

摘要?目的：觀察元芪祛瘀方治療增生性糖尿病視網膜病變玻璃體切除術后的臨床療效。方法：選取2016年1月至2017年12月收治的增生性糖尿病視網膜病變行玻璃體切割手術患者70例（70眼）作為研究對象，隨機分為觀察組和對照組，每組35例。觀察組采用玻璃體切除術聯合口服元芪祛瘀方治療;對照組單純采用玻璃體切除術。術前及術后第2、5個月時進行結局指標檢測。結果：與對照組比較，治療術后2個月和術后5個月觀察組眼底熒光血管造影改變差異均有統計學意義（P<0.05）;觀察組療效好于對照組，差異有統計學意義（P<0.05）。結論：元芪祛瘀方減少了視網膜微動脈瘤的數量、改善了視網膜出血及滲出，以輔助提高了總體療效。

關鍵詞?增生性糖尿病視網膜病變;玻璃體切除術;元芪祛瘀方;眼底熒光血管造影;中藥治療;臨床療效;糖尿病;白內障

Efficacy of Yuanqiquyu Prescription on Proliferative Diabetic Retinopathy after Vitrectomy：A Randomized Controlled Trial

Wang Yan，AYinu Nulahou，He Jiajia，Gao Yuxian

（Hospital of Chinese Medicine Affiliated to Xinjiang Medical University，Urumqi 830054，China）

Abstract?Objective：To observe the clinical efficacy of Yuanqiquyu prescription in the treatment of proliferative diabetic retinopathy after vitrectomy. Methods：A prospective randomized controlled study was adopted. A total of 70 cases（70 eyes）of proliferative diabetic retinopathy after vitrectomy were randomly divided into the observation group（n=35）and the control group（n=35）from January 2016 to December 2017. The observation group was treated with vitrectomy and Yuanqiquyu prescription，while the control group were treated with vitrectomy. The outcome indicators were detected before and after the second and the fifth month′s operation. Results：The changes of fundus fluorescein angiography in the observation group were significantly different than those of the control group（P<0.001）after two months and five months′ treatment. The difference of the total efficacy of the two groups were statistically significant（P<0.001）. Conclusion：Yuanqiquyu prescription improves the number of retinal microaneurysms，reduces retinal hemorrhage and exudation，and improves overall efficacy，which is worthy of further clinical promotion.

Key Words?Proliferative diabetic retinopathy; Vitrectomy; Yuanqiquyu prescription; Fundus fluorescein angiography; Traditional Chinese Medicine treatment; Clinical efficacy; Diabetes mellitus; Cataract

中圖分類號：R289.4;R587.2文獻標識碼：Adoi：10.3969/j.issn.1673-7202.2019.03.040

增生性糖尿病視網膜病變（Proliferative Diabetic Retinopathy，PDR）是一種因血糖代謝紊亂導致視網膜微循環異常，眼底新生血管形成從而進一步導致玻璃體積血，牽拉性視網膜脫離的常見糖尿病并發癥。近年來隨著人們生活水平的不斷提高，糖尿病的發病率也迅速上升，糖尿病視網膜病變（Diabetic Retinopathy，DR）成為很多國家致盲的主要原因[1]，給患者個人和家庭帶來沉重的經濟負擔和社會負擔[2]。我中心通過回顧性研究發現，元芪祛瘀方在治療非增生性糖尿病視網膜病變一定療效[3]，隨著玻璃體切除術越來越廣泛用于治療各種PDR，術后應用元芪祛瘀方的干預是否同樣有利于視網膜微循環的改善需要進一步臨床驗證。……