目的 探讨复方丹参滴丸对新发2型糖尿病患者视网膜病变(diabetic retinopathy, DR)的影响。方法 选取2010年1-8月医院门诊和住院新发2型糖尿病患者72例,入组前均未诊治。随访7年。随机分为对照组(34例)和观察组(38例)。对照组采用糖尿病常规治疗,观察组在常规治疗6周后口服复方丹参滴丸。比较治疗期间视网膜发生变化情况,并比较空腹血糖(FPG)、糖化血红蛋白(hemoglobin A1c, HbA1c)、血脂、血压等指标。结果 (1)两组患者治疗后TC与本组治疗前比较,差异均有统计学意义(P<0.05);观察组治疗5年后低于治疗前,治疗7年后又高于治疗5年后,差异均有统计学意义(P<0.05);两组患者治疗后与本组治疗前HDL-C比较,差异均有统计学意义(P<0.05);对照组TG治疗后7年略有升高,而观察组TG治疗5年、7年后均有降低,且两组与治疗前比较差异均有统计学意义。两组治疗前、治疗7年后的FPG、HbA1c、血压同期比较均无统计学差异。(2)两组DR发生率均逐渐增高,治疗7年后观察组发生率(9.6%)低于对照组(32.14%),两组比较差异有统计学意义(P<0.05)。(3)对照组患者治疗7年后与本组治疗5年后比较DR发生率有统计学差异(P<0.05),而观察组治疗前后均无统计学意义。结论 复方丹参滴丸治疗可延缓DR的发生及发展。
Abstract
Objective To observe the effect of Compound Danshen Dropping Pills on retinopathy in newly diagnosed patients with type 2 diabetes mellitus.Methods Between January and August 2010, 72 outpatients and inpatients were selected, who received no diagnosis or treatment before being grouped. The follow-up lasted seven years.They were randomly divided into two groups: control group (34 cases) and observation group (38 cases). The control group received routine treatment of diabetes mellitus, while the observation group was treated with Compound Danshen Dropping Pills after six weeks of routine treatment.The changes of retinas during treatment were compared, and the relationships between fasting blood glucose, glycosylated hemoglobin, blood lipid and blood pressure were studied.Results (1) The change of TC in the two groups after treatment was statistically significant (P<0.05). LDL-C in the observation group was significantly different after treatment (P<0.05). After treatment, HDL-C of the two groups was significantly higher (P<0.05). In the control group increased slightly after 7 years of TG treatment, but decreased in the observation group after 5 and 7 years of TG treatment, and the difference between the two groups was statistically significant. However, there was no significant difference in FPG, HbA1c or blood pressure between the two groups before treatment and 7 years after treatment. (2) The incidence of DR in both groups increased gradually. After 7 years of treatment, the incidence in the observation group (9.6%) was lower than that in the control group (32.14%), so there was statistically significant difference between the two groups (P<0.05). 3) The incidence of DR in the control group after 7 years of treatment was significantly different from that in the control group after 5 years of treatment (P<0.05), but there was no statistically significant change in the observation group before and after treatment.Conclusions Compound Danshen Dropping Pills can delay the occurrence and development of DR.
关键词
2型糖尿病 /
复方丹参滴丸 /
视网膜
Key words
type 2 diabetes mellitus /
Compound Danshen Dropping Pills /
retina
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参考文献
[1] 魏莹莹, 顾水昊. 糖尿病性视网膜病变发病机制研究进展[J]. 实用防盲技术, 2016,11(3):127-131.
[2] 马荣炜, 邹大进, 王奇金,等. 复方丹参滴丸对2型糖尿病患者颈动脉内中膜的影响[J]. 中国中西医结合杂志, 2010, 30(8): 833-837.
[3] 叶任高, 陆再英. 内科学[M]. 6版. 北京: 人民卫生出版社,2004: 789-797.
[4] 马荣炜,姚 媛,刘 苔,等.复方丹参滴丸对初发2型糖尿病尿微量白蛋白排泄率的影响[J]. 武警医学,2014,25(5):491-496.
[5] 包银兰, 王立军. 中医药治疗糖尿病性视网膜病变概况[J]. 湖南中医杂志, 2013,29(12):146-148.
[6] 孙 玥, 闫 东. 糖尿病视网膜病变的药物治疗[J]. 中国医药导报,2007,4(32):6-8.
[7] 周丽杰. 复方丹参滴丸治疗糖尿病视网膜病变的临床疗效观察[J]. 中国医药导报, 2008,5(1):77.
[8] 李晓梅, 张文生. 复方丹参滴丸中三七皂苷R1含量测定[J]. 天津药学, 2005, 17(5): 8-10.
[9] 方 卓, 陈宏勃, 刘 斌, 等. 复方丹参滴丸治疗冠心病心绞痛疗效观察[J]. 中国误诊学杂志, 2007, 7(8): 1710-1711.
[10] 唐 彬, 张 莹, 张瑞云. C肽血脂水平血流流变学与2型糖尿病视网膜病变的关系[J].河北医药, 2011,17(3):290-294.
[11] Song A Q, Sun L R, Zhao Y X, et al. Effect of insulin and metformin on methylation and glycolipid metabolism of peroxisome prolifera tor-activation receptor γcoactivator-IA of rat offspring with gestational diabetes mellitus [J]. Asian Pac J Trop Med, 2016, 9(1): 91-95.
[12] Liu Y, Liu S X, Cai Y, et al. Effects of combined aerobic and resistance training on the glycolipid metabolism and inflammation levels in type 2 diabetes mellitus [J]. J Phys Ther Sci, 2015, 27(7): 2365-2371.
[13] Nian X, Zhang X, Wang Y, et al. Correlations of FOXC2 gene expression and polymorphism with type 2 diabetes mellitus [J]. Clin Lab, 2016, 62(5): 781-791.
[14] Lee J Y, Kim M Y, Shin S H, et al. Persicarin isolated from Oenanthe javanica protects against diabetes-induced oxidative stress and inflammation in the liver of streptozotocin-induced type 1 diabetic mice [J]. Exp Ther Med, 2017, 13(4):1194-1202.
[15] Chavez-Talavera O, Tailleux A, Lefebvre P, et al. Bile acid control of metabolism and inflammation in obesity, type 2 diabetes, dyslipidemia, and nonalcoholic fatty liver disease [J]. Gastroenterology, 2017, 152(7): 1679-1694.
[16] Jiang X, Zhou Y, Wu K K, et al. APPL1 prevents pancreatic beta cell death and inflammation by dampening NFkB activation in a mouse model of type 1 diabetes[J]. Diabetologia, 2017, 60(3): 464-474.
[17] Markova M, Pivovarova O, Hornemann S, et al. Isocaloric diets high in animal or plant protein reduce liver fat and inflammation in individuals with type 2 diabetes[J]. Gastroenterology, 2017, 152(3): 3076-3085.
[18] 蒋 蕾, 孙晓明, 迟家敏, 等. 复方丹参滴丸对初诊2型糖尿病病人动脉内中膜厚度的影响[J]. 中国中西医结合心脑血管病杂志, 2008, 6(5): 514-516.