Drug Observation Of Early Diabetic Retinopathy And Its Related Factors

Diabetic retinopathy(DR) is one of the common and serious complications of diabetes mellitus(DM).It' s blindness ranks the first in the lateral blindness of ophthalmology.The population of blind people because of DR is five times than the population of blind people because of other diseases.The incidence of DR is higher as the longer of course of DM.It is 44.4%with the course of DM within 5 years,and this rate will increase to 56%with the course of DM longer than 7 years.The pathogenesia of DR is unclear.Hyperglycemic is the pathogenesis basis of DR.Researches imply that blood glucose,cource of DM,blood pressure,blood lipid,urinary albumin excretion rate and body mass index are related with occurrence and development of DR.There also are relations between TCM syndromes and DR.Controlling blood glucose level,blood pressure,blood lipid are the bases of DR treatment.Medicines of improveing microcirculation and anti-thrombosis are used in the therapy of early DR.Visual acuity is influenced by diabetic macular edema.Laser photocoagulation will be used when the visual acuity is lower than 0.5.Intravitreal injection with drugs and vitrectomy will be combined when the macular edema is more serious.The stage of visual acuity higher than 0.5 with diabetic macular edema is not emphasized by doctors because there are no effective medicines,the positive therapy of which will delay the development of diabetic macular edema.This stage is the research emphasis of controlling diabetic macular edema.1 Objective(1) To observe the effect of compound danshen dripping pills on treating mild diabetic macular edema.The effect of compound danshen dripping pills on visual acuity,fundus fluorescein angiography,visual field and clinical symptoms of patients with diabetic macular edema will be evaluated.(2) To analyze the relevant factors of early diabetic retinopathy.The relations of early diabetic retinopathy with other diseases,DM course,fasting blood glucose,active amount,body mass index and TCM syndromes will be researched.2 Methods(1) Research objective:95 patients(190 eyes) with early diabetic retinopathy visting the ophthalmology department of China-Japan Friendship Hospital from March 2007 to January.There are 41 men,54 women.The average age is 63.55±8.83 years.(2) Methods:The study is composed by two parts,One part is analysis of the relevant factors of early diabetic retinopathy,rhe other part is clinical observation of compound danshen dripping pills on patient which with mild diabetic macular edema.1) The first part:Clinical observation on treating mild diabetic macular edema with compound danshen dripping pi11.90 eyes with mild diabetic macular edema were observed and treated for 90 days.Treated group(50 eyes)were treated with compound danshen dripping pills.control group(40 eyes)were treated with calcium dobesila.Therapeutic effect of compound danshen dripping pills was evaluated by visual acuity,fundus fluorescein angiography,visual field and clinlcal symptoms.2) The second part:Analysis of the relevant factors of early diabetic retinopathy.The informations of 95 patients' medical history,quality of life,ophthalmological examinations and laboratory examinations were collected.The relations of early diabetic retinopathy with other diseases, DM course,fasting blood glucose,active amount,body mass index and TCM syndromes were researched.3 Results(1) The first part:Clinical observation on treating mild diabetic macular edema with compound danshen dripping pill.Results show compound danshen dripping pills is effective on elevating visual acuity,decreasing the number of microaneurysm,promoting the disappearance of fundus bleeding, decreasing fluorescein leakage of macular,improveing mean defect(MD) of visual fieldand improving clintcat symptoms of mild diabetic macular edema patients.The comparations of treated group with control group show that there is difference in elevating visual acuity(p＜0.05) between these two groups,and there are no differences in other aspects.Also,compound danshen dripping pills can improve some clinlcal symptoms,such as unclear when watching matter,dryness of the eyes,fatigue,mouth dryness and constipation.(2)The second part:Analysis of the relevant factors of early diabetic retinopathy.Results show that early diabetic retinopathy with high prevalence of hypertension and hyperlipidemia,there are revelations between diabetic macular edema and hypertension,hard exudates and hyperlipidemia,early diabetic retinopathy and DM course,early diabetic retinopathy and fasting blood glucose,active amount can influence the development of diabetic retinopathy by regulating fasting blood glucose.The results also show there are relations between early diabetic retinopathy and TCM syndromes,the blood stasis syndrome is more significant when there are microaneurysms in fundus,the phlegm dampness syndrome is more significant when there are hard exudates and cottonwool patches in fundus,The relation of early diabetic retinopathy and body mass index is not sure.It maybe coursed by few sample size,short observation time and the unreasonable designs in this research.4 ConsultsThe two parts of this study are about the therapy and relevant factors of early diabetic retinopathy.We can get some consults from the results.(1) Compound danshen dripping pill is effective on elevating visual acuity,decreasing the number of microaneurysm,promoting the disappearance of fundus bleeding,decreasing fluorescein leakage of macular,improveing mean defect(MD) of visual fieldand improving clinlcal symptoms of mild diabetic macular edema patients.It could be choosed in therapy of mild diabetic macular edema patients.(2) In the development of early diabetic retinopathy,DM course,fasting blood glucose,blood pressure,blood lipid and active amount may play important roles.In the prevention and treatment of early diabetic retinopathy,more attentions should be payed on control of fasting blood glucose,blood pressure,blood lipid and active amount.The relation of early diabetic retinopathy and TCM syndromes tell us that in the treatment of early diabetic retinopathy,we should combine integral syndrome differentiation and local syndrome differentiation,and we should prevent and treat the changes in fundus of early diabetic retinopathy by conditioning integral syndromes.