Clinical Study Of Doxium In The Treatment Of Diabetic Retinopathy

The diabetes mellitus (DM) is idiopathic metabolic disorder ofthe glycogen with many causes. The diabetic retinopathy (DR) is themost common and serious capillaries complications in diabetesmellitus, and the incidence can increase with the developing of courseof disease. It is the main reason of ablepsia that DR develops to theproliferous diabetic retinopathy. Its basic pathology changes includethe selective reducing of pericyte, the thickening of blood capillarybase membrane, the creation of the arteriole lump,proliferating ofendothelioid cell and the creation of new blood vessel. The selectivereducing of pericyte is the earliest pathology change, and then thecreation of the arteriole lump and the thickening of blood capillarybase membrane cause the damage of blood-retinal barrier, theocclusion of capillary vessels and the change of arteries and veins.Last the new-born blood vessels come into being and fibers proliferate,which causes the retina is disengaged and sight is lost. It is proved thatthe occurrence and progress of DR is related to hyperglycemia,disorder of lipid metabolizing and polyalchol-myoalcholmetabolizing, formation and accumulation of advanced glycation endproducts (AGEs), increasing of oxidative stress, activating ofdiacylglycerol-protein kinase-C (DG-PKC) system and abnormalchanges of various cellular factors. But the pathogeny of DR is notclear, the recent study indicate that the pathological changes of tinyblood vessels and thrombosis of retinal blood circulation make a rolein the beginning and developing of DR. High plasma glucoseconcentration affect retinal blood circulation, which include theincreasing in the osmosis of capillary vessel, the glutinosity of bloodand the congregating of platelet, and so on. Now some study aboutDoxium indicate that its main functionary mechanism as follows: â‘ Itcan restrain aldose invert enzyme and restrain increasing polyalcholbypass in the metabolizing on glucose in DM, which reduce sorbitolinside the erythrocyte and the endothelioid cell. So it can help todecrease osmotic edema and disfunction of the erythrocyte and theendothelioid cell. â‘¡ It can activate adenylaty cyclase,increase cAMPinside the platelet and prevent the thrombosis induced by ADP. â‘¢Itcan obviously reduce the glutinosity of blood and plasma and packederythrocyte volume. So it can dilute blood and increase circularhaemic capacity. Doxiumd can correct the change of AGEs, lipid,haemorheology and hemodynamics overleaf the eyeballs, whichimprove the patient's eyesight, the sensitivity of visual field andretinal pathological changes.Objective: To observe the effect of Doxium in the Treatment ofDiabetic Retinopathy.Object and method: From March 2005 to April 2006,selectedbetween the out-patient or in-patient treatment center diabetespatients 30 patients (60 eyes). All research in the study applied theDoxium oral treatment for one month. Throughout the study did notuse any impact lipid metabolism and hemorheology index drugs.Applications insulin injections and oral drug control blood sugar,blood-fasting sugar control in 7.0-8.0mmol/L, postprandial bloodsugar control in 11.1mmol/L within. Taking medication before andafter one month, respectively, studied the following related indicators:AGEs, hemorheology, blood fat, the ball after origin dynamics, visualfield, vision and the condition of eyeground.Results: (1) The eyes conditions in DR patients after takingDoxium orally: the percentage of amelioration is 13.3%, thepercentage of stabilization is 78.3%,the percentage of aggravation is8.3%, total effective rate (amelioration and stabilization) is 91.6%.(2)The level of serum AGEs:After using Doxium the level of serumAGEs declined than the former, without statistical significance(P>0.05). (3) The hemorheology index:After using Doxium HRV,MRV, LRV, SR-K, RE and AE declined than the former, withoutstatistical significance (P>0.05). DE rise than the former, withoutstatistical significance (P>0.05). (4) The level of blood fat:Use ofserum CHOL, TG, HDL-C and apolipoprotein B, low-densitylipoprotein levels declined more medication before, without statisticalsignificance (P>0.05). Apolipoprotein A1, high-density lipoproteinraise somewhat more medication before, without statisticalsignificance (P>0.05). (5) The index of hemodynamics behind theeyeball: The blood flow rate peak amplitude of arteria centralisretinae period of contraction and the blood flow rate peak amplitudeof arteria ophthalmica period of contraction increase than before, butwithout statistical significance (P>0.05). (6) The visual field test: theaverage variation of visual field improved over drug use than theformer vision, but do not have the statistical significance (P>0.05);the standard models variations of visual field significant decline thanbefore, and have statistical significance (P<0.05).Conclusion: In short term Doxium can improve the level ofserum AGEs and blood fat, the abnormality of hemorheology andhemodynamics behind the eyeball down in DR patients, but thedifference has no statistically significance. Doxium makes raise thephotaesthesia of visual field of DR patients obviously and improvepart of patients' eyesight and eyeground disease. It is needed to treatDR patients to take Doxium long term.