丹红化瘀口服液对非增生性糖尿病视网膜病变血管生成的影响

目的:探讨丹红化瘀口服液对非增生性糖尿病视网膜病变(NPDR)络脉瘀阻证患者血管内皮细胞生长因子(VEGF),血管生成素蛋白,促血管生成素等因子影响。方法:129例NPDR患者随机分为对照组64例(115眼),观察组65例(116眼)。对照组采用羟苯磺酸钙胶囊和胰激肽原酶肠溶片内服;观察组加用丹红化瘀口服液。疗程均为12周。测量两组患者视力、眼压,进行眼底检查、络脉瘀阻证评分、相干光断层扫描检查和眼底荧光血管造影检查;检测治疗前后促血管生成素-2(Ang-2),促血管生成素-1(Ang-1),血管生成素蛋白-3(ANGPT-3),血管生成素蛋白-4(ANGPT-4)和VEGF水平。结果:治疗后观察组视力好于对照组(P0.05),黄斑水肿情况和络脉瘀阻证评分低于对照组(P0.01);观察组黄斑中心凹厚度和黄斑视网膜体积均低于对照组(P0.05);观察组血管渗漏面积和毛细血管无灌注区面积均明显小于对照组(P0.01),微血管瘤数量和臂视网膜循环时间少于/短于对照组(P0.05);观察组VEGF,ANGPT-3和Ang-2水平低于对照组,ANGPT-4和Ang-1水平高于对照组(P0.01)。结论:丹红化瘀口服液治疗NPDR络脉瘀阻证患者,能提高患者视力,减轻黄斑水肿,改善眼底循环障碍,并能调节VEGF,ANGPT-3/ANGPT-4和Ang-1/Ang-2等血管生成影响因子,抑制血管新生成,延缓NPDR病情进展。

Effect of Danhong Huayu Oral on Angiogenesis of Non-proliferative Diabetic Retinopathy

Objective: To discuss the effect of Danhong Huayu oral on levels of vascular endothelial growth factor (VEGF), angiopoietin protein and angiopoietin in patients of non-proliferative diabetic retinopathy (NPDR) with collaterals stagnation syndrome. Method: One hundred and twenty-nine NPDR patients were randomly divided into control group (64 cases, 115 eyes) and observation group (65 cases, 116 eyes) by random number table. Patients in control group took dobesilate calcium capsules, 0.5 g/time, 3 times/day, pancreatic kallikrein enteric-coated tablets, 1 tablet/time, 3 times/day. In addition to the therapy of control group, observation group was also given Danhong Huayu oral, 20 mL/time, 3 times/day. Courses of treatment were 12 weeks. Vision, intraocular pressure and fundus examination after dilated were detected. Scores of collaterals stagnation syndrome were graded. Optical coherence tomography (OCT) and fundus fluorescein angiography were conducted. Before and after treatment, levels of Angiopoietin-2 (Ang-2), Angiopoietin-1 (Ang-1), Angiopoietin protein-3 (ANGPT-3), Angiopoietin protein-4 (ANGPT-4) and VEGF were detected. Result: After treatment, vision in observation group was better than that in control group (P<0.05), and scores of macular edema and ollaterals stagnation syndrome were lower than those in control group (P<0.01). Foveal thickness and macular volume in observation group were lower than those in control group (P<0.05). Retinal vascular leakage area and etinal capillary non-perfusion area in observation group were less than those in control group (P<0.01), the number of tumor microvessels and arm retinal circulation time were less and shorter than those in control group (P<0.05). Levels of VEGF, ANGPT-3 and Ang-2 were lower than those in control group, while ANGPT-4 and Ang-1 were higher than those in control group (P<0.01). Conclusion: Danhong Huayu oral can improve patients'' vision, relieve edema caused by macular, ameliorate retinal circulatory disorders, and regulate VEGF, ANGPT-3/ANGPT-4 and Ang-1/Ang-2, inhibit generating new blood vessels, and delay progression of NPDR.