| ObjectiveTo observe the effect of the zishen jianpi huayu pian combined with laser photocoagulation treatment of diabetic macular edema and their serum NOS、 VEGF、IL-6.MethodEndocrinologists diagnosed with diabetes, by dilated fundus examination, fundus fluorescein angiography, optical coherence tomography diagnosed as diabetic macular edema, and exclude other causes of macular edema in patients42cases (21eyes) as the object of study, were randomly divided into laser group21cases(21eyes) of patients and combined group of21cases (21eyes), Selected patients had best corrected visual acuity of the treated eyes of the international standard eye chart testing, parallel fundus fluorescein angiography, optical coherence tomography. Laser group:the treatment of retinal laser photocoagulation; combined group:oral zishen jianpi huayu pian jointretinal laser photocoagulation, treatment for two months. The previous month according to the fundus circumstances to take the Panretinal photocoagulation or Subtotal laser photocoagulation treatment, treatment1-3times, once a week, while oral the zishen jianpi huayu pian for two months. After the end of the course of treatment observed in each group of best corrected visual acuity, fundus fluorescein angiography and optical coherence tomography and their serum NOS、VEGF、IL-6changes.Around the group t test was used, between the two groups were compared using two independent sample t-test, Heterogeneity of variance using the Wilcoxon rank sum test, the classification data were analyzed by the x2test, analysis of the effect of the two groups of treatment, and make the appropriate conclusions.ResultsLaser group,21cases of21eyes, men11caseslleyes (52.4%), and female10cases10eyes (47.6%); Age:30-67years old, the average (53.61±11.05), the combined group of21cases21eyes, men13cases13eyes (61.9%), female8cases8eyes(38.1%); Age:31-68years old, the average (53.38±9.32), gender composition of the two groups of patients with and average age differences were notstatistically significant (p>0.05);Vision:After treatment, visual acuity improved, the laser group before treatment(0.29±0.15), acuity after treatment, the difference was statistically significant (p<0.05). the difference of the value of improvement of the two groups was not statistically significant (p>0.05);OCT:the laser group before treatment of the pit of the center of the macular retinal thickness average:(319.90±79.55)um, after treatment (234.96±60.61)um.laser treatment effective(p<0.05). combined group before the treatment of the pit of the center of the macular retinal thickness average (397.62±117.98) um, after treatment (282.62±96.39) um, the zishen jianpi huayu pian combined with laser treatment effective (p<0.05); The value of improvement of the center pit:the laser group (74.16±31.78) um, the combined group (90.26±19.81) um, the difference of the value of improvement of the two groups was statistically significant (p<0.05); the average retinal thickness of lmm diameter of the fovea in the laser group before treatment (377.05±92.09) um, after treatment (331.52±113.90) um, laser treatment effective (p<0.05); foveal retinal thickness in the combined group pre-treatment average of (401.43±93.79) um, after treatment (316.14±114.49) um, the zishen jianpi huayu pian and laser treatment is also effective (p <0.05); The value of improvement of the fovea1mm diameter of retinal:the laser group (45.52±92.82) um, the combined group (118.81±104.55) um, the difference of the value of improvement of the two groups was not statistically significant (p<0.05);Serum NOS activity:the laser group before treatment of the SerumNOS activity:(37.86±9.54)(u/ml), after treatment (38.49±10.16)(u/ml), laser treatment ineffective(p>0.05); combined group before the treatment average(36.91±11.71)(u/ml), after treatment (109.47±16.35)(u/ml), the zishen jianpi huayu pian combined with laser treatment effective(p<0.05);Serum VEGF:the laser group before treatment of the Serum VEGF:(218.24±61.40)(pg/ml), after treatment (235.98±121.15)(pg/ml), laser treatment ineffective(p>0.05); combined group before the treatment average(220.52±55.04(pg/ml)), after treatment (95.62±57.40)(pg/ml), the zishen jianpi huayu pian combined with laser treatment effective(p<0.05);Serum IL-6:the laser group before treatment of the SerumIL-6:(29.37±11.30)(pg/ml), aftertreatment (32.67±10.60)(pg/ml), laser treatment ineffective (p>0.05); combined group before the treatment average(31.39±4.85)(pg/ml), after treatment (16.92±5.79)(pg/ml), the zishen jianpi huayu pian combined with laser treatment effective (p<0.05).Conclusion:1. Zishen jianpi huayu pian with combined laser and laser photocoagulation alone is the effective treatment of DME. Both their can effectively improve Vision.2. Zishenjianpihuayu combined with laser and laser photocoagulation treatment can alleviate macular edema, combined with laser is more significant than the effect on reducing macular edema and laser photocoagulation. Mechanisms for zishenjianpihuayu pills with Supplementing Qi and nourishing Yin, promoting blood circulation and removing blood stasis, can effectively improve diabetic macular edema patients serum NOS activity, inhibition of serum VEGF, IL-6content, to the protection of patients with diabetic macular edema, optic nerve, retina tiny blood vessels, retinal barrier function of blood to repair. |
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