【作者】 李雪莹；

【导师】 孙河；

【作者基本信息】 黑龙江中医药大学 ， 中医五官科学， 2006， 硕士

【摘要】 目的:比较氩激光光凝结合益气养阴,化瘀止血中药(自拟方—达明饮1号)与单纯氩激光光凝治疗糖尿病性视网膜病变的疗效。 方法:临床采集Ⅱ型糖尿病并发糖尿病性视网膜病变Ⅲ、Ⅳ期眼底改变的糖尿病性视网膜病变患者46例73只眼,按随机原则采用分组治疗方法,其中23例37眼为治疗组(中药联合氩激光组),23例36眼为对照组(单纯氩激光组)。治疗前和治疗3个月后分别对46例患者进行视力,视网膜振荡电位,眼底照相及眼底荧光造影检查,记录视网膜出血及渗出的范围、微血管瘤的数量、荧光素渗漏等情况。每周检眼镜检查眼底,观察记录水肿、出血、渗出吸收时间,观察疗效。 结果:(1)治疗组总有效率为89.19%,对照组的总有效率为75%,两组相比有统计学意义(P<0.05);(2)治疗组视力提高与对照组比较有统计学意义(P<0.05);(3)眼底照相检查中,两组治疗后出血量与渗出量的疗效比较有统计学意义(P<0.05);(4)眼底荧光血管造影检查中,两组微动脉瘤数、渗漏面积的疗效比较,P<0.05,差异有统计学意义,无灌注面积的疗效比较无统计学意义(P>0.05);同组治疗前后视网膜微血管瘤数、渗漏面积比较有统计学意义(P<0.05),而无灌注面积比较无统计学意义(P>0.05);治疗后两组间视网膜微血管瘤数、渗漏面积比较有统计学意义(P<0.05),而无灌注面积比较无统计学意义(P>0.05);(5)治疗组治疗前后OPs总振幅比较有统计学意义(P<0.05),治疗后两组间OPs总振幅比较有统计学意义(P<0.05)。(6)光凝结合中药治疗组较光凝组眼底水肿、出血、渗出吸收时间缩短,两组间比较有统计学意义(P<0.05)。 结论:氩激光光凝结合益气养阴,化瘀止血中药(自拟方—达明饮1号)治疗糖尿病性视网膜病变的疗效优于单纯氩激光光凝。更多还原

【Abstract】 Objective: To observe the clinical curative effect of the two methods to treat the diabetic retinopathy between the therapy effect of the Chinese native medicine (decoction—DaMingYin) combined with argon laser photocoagulation and the effect of the argon laser photocoagulation only. The decoction has the effect of removing extravasted blood and stoping bleeding ,and can pass winds the clear vision.Method: Clinically gathered the diabetic retinopathy patients 46 examples 73 eyes which Ⅱ diabetes concurrent with diabetic retinopathy Ⅲ,Ⅳ issue of eyeground changes .The 73 eyes were divided into treatment group and control group at random.The treatment group had 23 examples 37eyes(the traditional Chinese medicine uniting with argon laser photocoagulation group),the control group had 23 examples 36 eyes(the pure argon laser photocoagulation group),and we observed the effectiveness of the two groups.The therapy course is three months. Before and after three months of treating, the vision , oscillatory potentials , eyeground photography and eyeground fluorescence radiography of the 46 examples were checked and recorded the scope of retina hemorrhage and infiltration, the quantity of capillaries lump and the situation of fluorescein leakage and appraised the curative effect finally. Result:(1)The total effectiveness of the treatment group was 89.19%,the total effectiveness of the control group was 75%,there were significant diffience between the two groups(P<0.05);(2)The corrective eyesight improvement of the treatment group had remarkable difference compared with the control group(P<0.05);(3)The eyeground photograph inspection indicated that there was remarkable difference on the effectiveness comparison of the quantity of hemorrhage and infiltration after treating between the two groups(P<0.05);(4) The eye ground fluorescence angiography inspection indicated that before and after treating,there was significant difference on the therapy effectiveness of the capillaries lump quantity and the leakage area(P<0.05) between the two groups,but there was no statistics significance in the effectiveness comparison in the area that was not poured (P>0.05). After treating there were remarkable difference between the two groups in the comparison of the capillaries lump quantity and leakage aera (P<0.05),but it had no significant difference in the comparison of the area that was not poured (P>0.05);(5)Before and after treating ,there was significant difference in the comparison of altitude sum of OPs in the treatment group (P<0.05) ,and there was remarkable difference between the two groups in the OPs comparison after treating (P<0.05);(6)The laser photocoagulation uniting with the traditional Chinese medicine treatment group surpass the laser photocoagulation on shortening the absorption time of the eyeground hemorrhage > dropsy and infiltration,there was a prominent difference between thetwo groups (P<0.05).Conclusion: Argon laser photocoagulation uniting with traditional Chinese medicine (decoction—DaMingYin)which has the effect of removing extravasted blood> stoping bleeding and can pass winds the clear vision has more superior curative effect than the argon laser photocoagulation only on treating the diabetic retinopathy.更多还原