复方丹参滴丸治疗早期糖尿病视网膜病变的临床疗效观察
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复方丹参滴丸治疗早期糖尿病视网膜病变的临床疗效观察
目的 观察复方丹参滴丸治疗早期糖尿病视网膜病变的临床疗效。方法 糖尿病性视网膜病变Ⅰ-Ⅲ期 患者52例 随机分成2组,治疗组26例,给予口服复方丹参滴丸10粒/次,3次/日,连续用药90天;对照组26例,给予维生素B1片 20mg/次、维生素C片0.2/次、肌苷片 0.2/次,均3次/日口服,连续用药90天。通过眼底、荧光素眼底血管造影、视力、视野检查,对其疗效进行评价。结果 治疗组眼底视网膜微血管瘤数目、视力、视野较治疗前明显改善,与对照组相比差异有显著性。结论 复方丹参滴丸对早期糖尿病视网膜病变有明显治疗作用。
关键词 复方丹参滴丸 糖尿病视网膜病变 疗效
Clinical Curative Effect Observation on Compound Danshen Dripping Pills in
Treating the Early Diabetic Retinopathy
Meiying Liu,Juan Hao
Department of Ophthalmology ,Puyang People’s Hospital ,Henan 457000
【Objective】 To observe the curative effect of compound danshen dripping pills
in Treating the early Diabetic Retinopathy (DR).Methods: Collected 52 cases with
Ⅰ~Ⅲ DR degree were colleted. There were 26 cases in the treatment group and 26
cases in the contrast group. The cases in treatment group were treated with compound
danshen dripping pills, 10pills each time, 3times a day. The cases in contrast group
were treated with vitamin B1, 20mg each time, vitamin C, 0.2g each time and inosine
tablets, 0.2g each time, 3 times one day. Administer these drugs to the patients for 90
days continuously and the changes in vision, vision fields andangiography fiurescence
fundus were observed before and after treatment .Results: Compared with the results
before treatment ,the treatment group vision was improved obviously, P<0.05, visual
fields (MD),decreased ,P<0.05 ,and the quantity of retinal mieroanearysm decreased,
P<0.01 ,after taking the drugs for 90 days. The results for treatment group were
obviously different from that of contrast group, P 0.05。 (详见表1)
表1两组视力及视野灰度值(MD)比较
2.2 荧光血管造影及眼底
治疗组眼底病变得到改善,与治疗前相比差异有显著性P<0.05。而对照组在治疗前后差异无显著性P>0.05。(详见表2)
表2两组眼底荧光血管造影比较
讨论:
DR是糖尿病最常见和最严重的并发症之一。其发病机理较为复杂,普遍认为其发生与微循环障碍有关,表现为血小板聚集亢进,纤维蛋白溶解活性降低,红细胞变形能力降低,全血粘度升高;同时,高血糖可损害血管内皮,造成内皮细胞肿胀,分离、脱离,引起微血管阻塞,导致视网膜组织缺血缺氧,因而导致视网膜微动脉瘤、出血及渗出等病变形成。
复方丹参滴丸由丹参、三七、冰片等药物组成,其中丹参的有效成分为水溶性丹参素,具有提高机体抗凝和纤溶活性、抗凝血和抑制血栓形成,抑制血小板合成和释放前列环素类物质,阻断羟自由基的产生,阻止脂质过氧化,是一种有效的氧自由基清除剂【4】。通过其自由基清除功能而达到保护内皮细胞功能,改善微循环障碍作用。
复方丹参滴丸通过多部位、多途径、多靶点对DR这一微血管病变起到了治疗作用。本次为期90天的临床观察结果显示,复方丹参滴丸治疗糖尿病视网膜病变,在改善视力、视野灰度值及眼底微血管瘤与对照组比较差异有显著性。疗效可靠,未发现不良反应,药物价格低廉,易被患者接受,适合糖尿病患者长期服用,对糖尿病视网膜病变患者治疗有积极意义。
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