| Objective Diabetic retinopathy(DR)is a kind of many complications of diabetes is more common in clinical,pathological changes of small vessels belonging to the human body.In recent years,the living environment,human mentality,population age structure and eating habits change,the incidence of diabetes and DR compared with previous years showed an increasing tendency.Proliferative diabetic retinopathy(NPDR)is an early stage of development of DR,visual acuity changes in patients in stable stage,can be reversed by intervention,therefore,positive and effective intervention at this stage is an important stage of successful rescue of the quality of life of the patients.But the treatment in diabetic retinopathy,photocoagulation is only symptomatic treatment,it is not for the cause,and the cost is higher,and not all DR patients were effective.With the new era,Shinco The advent of technology and research,exploration of the Chinese medicine people have never stopped the pace,through the treatment of DR increasing the experiment and the accumulation of experience,found that Chinese medicine has considerable advantages in the prevention and treatment of DR,we should continue to dig,to bring the gospel to the patients.The purpose of this experiment and is the basis of nourishing yin and activating blood circulation principle,the use of traditional Chinese medicine combined western medicine calcium dobesilate for the treatment of patients with NPDR,observation and research of relevant experimental index and the experimental results,in order to be able to find or improve the clinical approach to the treatment of this disease by combining traditional Chinese and Western medicine treatment.Methods From September 2014 to September 2016 in the Department of endocrinology of Hubei Provincial Traditional Chinese Medical Hospital medical treatment and diagnosis of 67 patients with non proliferative diabetic retinopathy patients,and the TCM syndrome differentiation,were syndrome of yin deficiency of liver and kidney and blood stasis type in this study.All patients were to maintain the original sugar reducing treatment,including the use of hypoglycemic drugs,insulin the injection of hypoglycemic,their control over food,a reasonable amount of regular exercise,as well as rich and colorful content of health education.67 patients(random number table method)were divided into experimental group and control group.The control group: Calcium Dobesilate Capsules(Guizhou Cheonan pharmaceutical Limited by Share Ltd,[approval]quasi famous Chinese medicine H20010481)0.25g/ tablets)3 times/ day,2 capsules per time.The experimental group: the experimental group in the use of Calcium Dobesilate Capsules at the same time combined with traditional Chinese medicine of nourishing yin and promoting blood circulation Tongluo Decoction(rehmannia,Radix Astragali The fruit of Chinese wolfberry,Eclipta,pseudo-ginseng,safflower,pollen Typhae,Salvia miltiorrhiza,radix puerariae, radix paeoniae rubra,paeonol,etc.),patients were drinking the decoction to 200 ml by decocting unified designated units,two times a day.Two patients in the experimental group were treated for 12 weeks.The related indexes of two groups of patients were examined compared with before and after treatment,such as fasting blood glucose,2 hour postprandial blood glucose,HBA1 C,lipid four,TCM syndrome score,visual acuity,fundus signs score changes.Results(1)Comparison of visual acuity after treatment in two groups: the distribution of visual effects in the two groups were compared by the Wilcoxon rank sum test,P <0.05,the difference was statistically significant.Ziyin Huoxue Tongluo decoction combined with calcium dobesilate treatment is better than using hydroxy benzene sulfonic acid calcium alone in non proliferative diabetic retinopathy.(2)Comparison of TCM syndromes before and after treatment in two groups: two groups of patients before treatment of TCM syndrome integral with independent sample t test,P >0.05,no significant difference between the two groups were comparable.After treatment,two groups of patients with TCM syndrome integral were significantly lower than before(P <0.05),TCM syndrome in experimental group the integral and after treatment was significantly lower than the control group(P <0.05),which indicates that the two kinds of treatment can improve the clinical symptoms of NPDR patients,but the efficacy of the test group than the control group.(3)Comparison of NPDR fundus signs scores before and after treatment in two groups: two groups of patients before treatment of fundus signs points by the statistical test showed no significant difference,comparable.After treatment,the experimental group and control group scores were decreased compared with before treatment(P <O.05),and the experimental group after treatment volume was significantly lower than the control group(integral P <O.05),the experimental group showed that treatment is more efficient compared to improve the non proliferative diabetic retinopathy fundus signs and the control group.(4)Comparison of TCM syndromes after treatment in two groups: the experimental group,the total effective rate was 79.41%,control group total effective rate was 54.55%,two groups of TCM syndromes distribution of patients by P <0.05 test,the difference was statistically significant,nourishing yin and activating blood and collaterals combined with calcium dobesilate treatment of NPDR in improving TCM syndrome than the use of calcium dobesilate alone has a high efficiency,is an effective therapy method in clinic.(5)Comparison of curative effect of fundus signs in two groups after treatment of NPDR patients: two patients in group NPDR fundus signs curative effect by rank sum test,P <0.05,and the total efficiency of experimental group was significantly higher than the control group,showed that the experimental group therapy in improving patients with fundus signs than the control group,it is worthy of clinical promotion.(6)Two groups of patients after treatment blood glucose level comparison: the fasting blood glucose,postprandial blood glucose and glycosylated hemoglobin in the two groups after treatment were decreased compared with before treatment,but there was no statistical significance(P >0.05).(7)Two groups of patients after treatment of blood lipids: two groups of patients after treatment,TC,TG,HDL-C,LDL-C were improved compared with before,but no statistical significance(P >0.05).(8)The adverse reactions in two groups: from the beginning to the end of the treatment medication for 12 weeks,the treatment group without any discomfort,mild stomach discomfort occurred in 1 patients in the control group,no treatment discontinuation,then the symptoms subside spontaneously.(9)Safety observation: 12 weeks after treatment,the patients in the two groups of urine analysis,stool analysis,blood analysis,liver and kidney function and ECG and other safety indicators were not significantly abnormal.Conclusions Ziyin Huoxue Tongluo prescription,the prescription combined with microcirculation medicine(calcium dobesilate)for the treatment of non proliferative diabetic retinopathy,the combination of Western medicine and Chinese traditional medicine,it can make patients benefit from the use of Western medicine than calcium dobesilate alone,especially in improving patients have damage eyesight,related to traditional Chinese medicine DR's syndrome,microvascular bleeding fundus,exudation and other aspects shows certain advantages,provides an effective method for the clinical improvements in patients with diabetic retinopathy more effectively the quality of life. |
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