明目地黄丸联合羟苯磺酸钙治疗早期糖尿病视网膜病变的临床研究

目的 探讨明目地黄丸联合羟苯磺酸钙胶囊治疗早期糖尿病视网膜病变的临床疗效。方法 选取2016年9月-2018年1月洛阳市第三人民医院收治的2型糖尿病视网膜病变患者108例作为研究对象，将患者随机分为对照组（54例）和治疗组（54例）。对照组口服羟苯磺酸钙胶囊，1粒/次，3次/d。治疗组在对照组治疗的基础上口服明目地黄丸，1丸/次，2次/d。两组患者均连续治疗5个月。观察两组患者的临床疗效，比较两组治疗前后的眼科常规检测结果、血糖指标和血清细胞因子水平。结果 治疗后，对照组总有效率为85.2%，显著低于治疗组的94.4%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的视野灰度值、血管瘤体积、出血斑面积、黄斑厚度均显著下降，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组眼科常规检测值均显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的空腹血糖（FPG）、2 h空腹血糖（2 h FPG）和糖化血红蛋白（HbA1c）水平均显著下降，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组血糖指标水平均显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的骨膜蛋白（periostin）、血管内皮生长因子（VEGF）和胰岛素样生长因子-1（IGF-1）水平均显著下降，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组血清细胞因子水平显著低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 明目地黄丸联合羟苯磺酸钙胶囊治疗早期糖尿病视网膜病变具有较好的临床疗效，可有效改善患者的视力、血糖，抑制内皮细胞增殖和新生血管的形成，具有一定临床推广应用价值。

Clinical study on Mingmu Dihuang Pills combined with calcium dobesilate in treatment of early diabetic retinopathy

Objective To investigate the clinical effect of Mingmu Dihuang Pills combined with Calcium Dobesilate Capsules in treatment of early diabetic retinopathy. Methods Patients (108 cases) with early diabetic retinopathy in Luoyang Third People''s Hospital from September 2016 to January 2018 were randomly divided into control (54 cases) and treatment (54 cases) groups. Patients in the control group were po administered with Calcium Dobesilate Capsules, 1 grain/time, three times daily. Patients in the treatment group were po administered with Mingmu Dihuang Pills on the basis of the control group, 1 pill/time, twice daily. Patients in two groups were treated continuously for 5 months. After treatment, the clinical efficacy was evaluated, routine ophthalmic examination results, blood glucose indexes, and the serum cytokine levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 85.2%, which was significantly lower than 94.4% in the treatment group, and the difference was statistically significant between two groups (P < 0.05). After treatment, visual gray-scale value, hemangioma volume, hemorrhagic plaque area, and macular thickness in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the routine ophthalmic examination values in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, FPG, 2 h FPG, and HbA1c levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the blood glucose indexes in the treatment group weresignificantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, periostin, VEGF, and IGF-1 levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the serum cytokine levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Mingmu Dihuang Pills combined with Calcium Dobesilate Capsules has clinical curative effect in treatment of early diabetic retinopathy, can effectively improve the vision and blood glucose, and inhibit the proliferation of endothelial cells and the formation of new blood vessels, which has a certain clinical application value.