明目热奄包联合揿针治疗糖尿病视网膜病变疗效观察及对眼部血管、血流的影响

目的：观察明目热奄包联合揿针治疗糖尿病视网膜病变的临床疗效及对眼部血管、血流的影响。方法：选取60例糖尿病视网膜病变患者为研究对象，按照随机数字表法分为对照组和试验组各30例。对照组给予常规治疗，试验组在对照组基础上给予明目热奄包联合揿针治疗。治疗14 d后，比较2组临床疗效，治疗前后视物模糊、眼睛干涩［视觉模拟评分法（VAS）］ 评分、视盘周围视网膜神经纤维层（RNFL） 厚度、视网膜中央动脉血流动力学［视网膜中央动脉收缩期峰值流速（PSV）、阻力指数（RI）］ 及糖尿病特异性生命质量测定量表（修订版）（A-DQOL） 评分。结果：试验组总有效率93.33%，对照组73.33%，2组比较，差异有统计学意义（P＜0.05）。治疗后，2组视物模糊、眼睛干涩VAS评分均较治疗前降低（P＜0.05），且试验组2 项评分均低于对照组（P＜0.05）。治疗后，2 组30°以内、30°～60°视野视网膜光敏感度均较治疗前升高（P＜0.05）， 且试验组2 项指标均高于对照组（P＜0.05）。治疗后，2 组视盘上方、下方及鼻侧、颞侧RNFL厚度及平均RNFL厚度均较治疗前降低（P＜0.05），且试验组5项指标均低于对照组（P＜0.05）。治疗后，2组PSV、RI水平均较治疗前升高（P＜0.05），且试验组PSV、RI水平高于对照组（P＜0.05）；2组PI水平均较治疗前降低（P＜0.05），且试验组PI水平低于对照组（P＜0.05）。治疗后，2组A-DQOL量表中忧虑程度Ⅰ、忧虑程度Ⅱ、影响程度、满意程度等评分均较治疗前降低（P＜0.05），且试验组上述4项评分均低于对照组（P＜0.05）。结论：明目热奄包联合揿针可有效改善糖尿病视网膜病变患者视功能、眼部血管及血流情况，进而提高患者生活质量，临床疗效显著。

Observation on Curative Effect of Vision-Improving Hot Package Combined withThumb-Tack Needling for Subcutaneous Embedding on Diabetic Retinopathy and ItsEffect on Ocular Vascularity and Blood Flow

Abstract： Objective： To observe the clinical effect of vision-improving hot package combined withthumb-tack needling for subcutaneous embedding on diabetic retinopathy and its effect on ocularvascularity and blood flow. Methods：A total of 60 patients with diabetes retinopathy were selected as theresearch objects， and were divided into the control group and the trial group according to the randomnumber table method，with 30 cases in each group. The control group received routine treatment，and the trial group received treatment with vision-improving hot package combined with thumb-tack needling forsubcutaneous embedding on the basis of the control group. After 14 days of treatment， the scores ofblurred vision and dry eyes [Visual Analogue Scale (VAS)]，retinal nerve fiber layer (RNFL) thickness aroundthe optic disc， central retinal artery hemodynamics [peak systolic velocity (PSV) of central retinal artery，and resistance index (RI)] and Adjusted Diabetes Specific Quality of Life Scale (A-DQOL) scores before andafter treatment，as well as the clinical effects were compared between the two groups. Results：The totaleffective rate was 93.33% in the trial group and 73.33% in the control group，the difference between thetwo groups being significant (P＜0.05). After treatment，the VAS scores for blurred vision and dry eyes inthe two groups were decreased when compared with those before treatment， and the two scores in thetrial group were lower than those in the control group (P＜0.05). After treatment，the retinal photosensitivitywithin 30 ° and 30 ° to 60 ° fields in the two groups were elevated when compared with those beforetreatment，and both indicators in the trial group were higher than those in the control group (P＜0.05). Aftertreatment，the RNFL thickness above and below the optic disc，and on the nasal and temporal sides，aswell as the average RNFL thickness，were declined in the two groups when compared with those beforetreatment，and all the five indicators in the trial group were lower than those in the control group (P＜0.05).After treatment， the levels of PSV and RI in the two groups were uplifted when compared with thosebefore treatment (P＜0.05)， and the levels of PSV and RI in the trial group were higher than those in thecontrol group (P＜0.05)；The PI levels in the two groups were decreased when compared with those beforetreatment (P＜0.05)，and the PI level in the trial group was lower than that in the control group (P＜0.05).After treatment，the scores of anxiety levelⅠ，anxiety levelⅡ，impact level，and satisfaction level in theA-DQOL scales in the two groups were decreased when compared with those before treatment (P＜0.05)，and the scores of the above four items in the trial group were lower than those in the control group (P＜0.05). Conclusion： Vision-improving hot package combined with thumb-tack needling for subcutaneousembedding can effectively improve the visual function， ocular vascularity and blood flow of patients withdiabetic retinopathy，and thus improve the quality of life of patients，with significant clinical effects.