摘要
目的探讨在羟苯磺酸钙基础上联用己酮可可碱对非增殖期糖尿病视网膜病变(DR)的治疗效果。方法选取2022年1月至2024年12月青岛市中医医院收治的DR患者196例,采用随机数表法分为对照组和观察组,每组98例。对照组予以羟苯磺酸钙治疗,观察组在羟苯磺酸钙基础上联用己酮可可碱治疗,两组均治疗12周。评估两组临床疗效;比较两组治疗前后最佳矫正视力(BCVA)、DR严重程度评分(DRSS)、眼底出血面积、眼底渗出面积、微血管瘤、全血黏度、纤维蛋白原(FIB)、血细胞比容(HCT)、白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)水平,以及不良反应发生情况。结果观察组总有效率为79.59%,显著高于对照组的64.29%,差异有统计学意义(χ^(2)=5.687,P<0.05)。观察组治疗后DRSS[(33.29±6.41)分]、眼底出血面积[(28057.31±3987.25)px]、眼底渗出面积[(14282.17±4023.87)px]、微血管瘤数量[(15.98±5.12)个]显著低于或少于对照组的(35.27±5.89)分、(29223.65±4137.89)px、(15614.69±4423.61)px、(18.34±5.42)个,BCVA水平(0.53±0.14)显著高于对照组的(0.48±0.11),差异有统计学意义(P<0.05)。观察组治疗后全血黏度、FIB、HCT、血清IL-1β、TNF-α水平显著低于对照组,差异有统计学意义(P<0.05)。结论在羟苯磺酸钙基础上联用己酮可可碱治疗对DR有较好疗效,能够改善患者视力,减轻眼底病理改变,其机制可能与调节血液流变学、抑制炎症反应有关。
Objective To investigate the therapeutic effect of calcium dobesilate combined with pentoxifylline on non-proliferative diabetic retinopathy(DR).Methods A total of 196 DR patients admitted to Qingdao Hospital of Traditional Chinese Medicine from January 2022 to December 2024 were selected and randomly divided into a control group(98 cases)and an observation group(98 cases)using a random number table.The control group received calcium dobesilate,while the observation group received pentoxifylline in combination with calcium dobesilate.Both groups were treated for 12 weeks.Clinical efficacy was evaluated;best-corrected visual acuity(BCVA),DR severity score(DRSS),fundus hemorrhage area,fundus exudate area,microaneurysms,whole blood viscosity,fibrinogen(FIB),hematocrit(HCT),interleukin-1β(IL-1β),and tumor necrosis factor-α(TNF-α)levels were compared before and after treatment.Adverse reactions were recorded.Results The total effective rate of the observation group was 79.59%,significantly higher than that of the control group(64.29%),with a statistically significant difference(χ^(2)=5.687,P<0.05).After treatment,the observation group showed significantly lower DRSS[(33.29±6.41)points],fundus hemorrhage area[(28057.31±3987.25)px],fundus exudate area[(14282.17±4023.87)px],and fewer microaneurysms[(15.98±5.12)]compared to the control group[(35.27±5.89)points,(29223.65±4137.89)px,(15614.69±4423.61)px,(18.34±5.42)],while BCVA(0.53±0.14)was significantly higher than that of the control group(0.48±0.11),with statistically significant differences(P<0.05).After treatment,whole blood viscosity,FIB,HCT,serum IL-1β,and TNF-αlevels in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).Conclusion Calcium dobesilate combined with pentoxifylline is effective in the treatment of DR,which can improve the visual acuity of patients and reduce the pathological changes of fundus.The mechanism may be related to the regulation of hemorheology and the inhibition of inflammatory response.
作者
胡珊
司红岩
王志国
HU Shan;SI Hongyana;WANG Zhiguo(Blood Purification Room(Department of Nephrology),Qingdao Traditional Chinese Medicine Hospital/Qingdao Haici Hospital Affiliated to Qingdao University,Qingdao,Shandong 266033,China;Department of Imaging,Qingdao Traditional Chinese Medicine Hospital/Qingdao Haici Hospital Affiliated to Qingdao University,Qingdao,Shandong 266033,China)
出处
《转化医学杂志》
2025年第7期155-159,共5页
Translational Medicine Journal
基金
山东省中医药科技项目(Q-2023049)。
