目的:评价蒙药明目十一味丸治疗糖尿病视网膜病变(DR)Ⅰ期的临床疗效。
方法:前瞻性临床研究。选取2016年7月至2017年3月在内蒙古民族大学附属医院眼科就诊的DRⅠ期患者120例(120眼),通过随机数字表法将其分成蒙药组和对照组各60例,蒙药组加用明目十一味丸,对照组加用羟苯磺酸钙胶囊,一个疗程28 d,共3个疗程。分别在治疗前后对2组患者进行多焦视网膜电图(mfERG)及超广角眼底照相检查,记录N1区域和P1区域的潜伏期、振幅变化及视网膜微动脉瘤和出血点的数目。采用 t检验、 χ 2检验对数据进行分析。
结果:对照组和蒙药组在治疗前后mfERG测得的R1~R5 P1区域的振幅密度值差异有统计学意义( t 对照组=66.86、18.05、36.33、47.43、30.56, P<0.001; t 蒙药组=31.52、54.56、101.98、127.02、45.74, P<0.001),N1区域的振幅密度值差异有统计学意义( t 对照组=70.18、47.02、78.08、57.44、64.51, P<0.001; t 蒙药组=46.09、140.47、145.14、50.46、73.94, P<0.001)。与对照组相比,蒙药组治疗前后R1~R5 P1、R1~R3 N1区域的振幅密度值差值差异有统计学意义( t P1=8.96、23.96、25.10、28.80、13.67, P<0.001; t N1=9.38、30.34、52.06, P<0.001),R4~R5 N1区域的振幅密度值差值差异无统计学意义。2组治疗前后潜伏期比较,R1~R5 P1区域、N1区域的差异均无统计学意义。2组治疗前后微动脉瘤及出血点数目比较,差异有统计学意义( t=2.08, P=0.042; t=2.07, P=0.043)。眼底照相蒙药组与对照组有效率分别达88%、73%,差异有统计学意义( χ 2=4.36, P=0.037)。
结论:蒙药明目十一味丸能明显改善Ⅰ期DR视网膜功能的损伤,疗效显著,可作为治疗DRⅠ期的常规用药。
Objective:To evaluate the clinical effects of Ming Mu-11 (MM-11) in the treatment of stage Ⅰ diabetic retinopathy (DR).
Methods:One hundred twenty patients (120 eyes) with stage Ⅰ DR in the Affiliated Hospital of Inner Mongolia University for the Nationalities were selected from July 2016 to March 2017. The 120 eyes with stage Ⅰ DR were divided into two groups: a Mongolian medicine group and a control group (60 eyes each). The control group was treated with calcium dobesilate capsules and the Mongolian medicine group was also treated with MM-11 pills. There were three courses of treatment in total and 28 days in each course. Patients in both groups underwent multifocal electroretinogram (mfERG) and ultra-wide angle fundus photography examinations before and after the treatment. The latencies and amplitudes of the N1 wave and P1 wave were recorded as well as the number of retinal microaneurysms and hemorrhagic spots. Data were analyzed by t-test and Chi-square test.
Results:The results of mfERG were as follows. There were significant differences in the amplitude density values of P1 in the R1-R5 regions before and after treatment ( t control group=66.86, 18.05, 36.33, 47.43, 30.56, P<0.001; t mongolian medicine group=31.52, 54.56, 101.98, 127.02, 45.74, P<0.001). There were significant differences in the amplitude density value of N1 in the R1-R5 regions before and after treatment ( t control group=70.18, 47.02, 78.08, 57.44, 64.51, P<0.001; t mongolian medicine group=46.09, 140.47, 145.14, 50.46, 73.94, P<0.001). Compared to the control group, the amplitude density value differences in the R1-R5 P1 and R1-R3 N1 regions in the Mongolian medicine group were significantly different before and after treatment ( t P1=8.96, 23.96, 25.10, 28.80, 13.67, P<0.001; t N1=9.38, 30.34, 52.06, P<0.001). However, there was no significant difference in the amplitude density value in the R4-R5 N1 regions. There was no significant difference in the latency of P1 in the R1-R5 regions before and after treatment. There was no significant difference in the latency of N1 in the R1-R5 regions before and after treatment. The results of fundus color photography were as follows. The difference in microaneurysms and number of bleeding points before and after treatment were statistically significant in the Mongolian medicine group ( t=2.08, P=0.042; t=2.07, P=0.043). The effective rates of the eye fundus photography in the Mongolian medicine group and the control group were 88% and 73%, respectively, which were analyzed by a chi-square test. The difference was statistically significant ( χ 2=4.36, P=0.037).
Conclusions:MM-11 is very effective for treating the damage of retinal functions in stage Ⅰ DR and therefore can be considered as a drug for routine use.
鲁占军,马瑞彤,晓琴,等. 蒙药明目十一味丸对糖尿病视网膜病变Ⅰ期视网膜功能的影响[J]. 中华眼视光学与视觉科学杂志,2019,21(6):444-450.
DOI:10.3760/cma.j.issn.1674-845X.2019.06.008版权归中华医学会所有。
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鲁占军,马瑞彤,晓琴,等.蒙药明目十一味丸对糖尿病视网膜病变Ⅰ期视网膜功能的影响.中华眼视光学与视觉科学杂志, 2019, 21(6): 444-450. DOI: 10.3760/cma.j.issn.1674-845X.2019.06.008.
鲁占军:收集数据;参与选题、设计及资料的分析和解释;撰写论文;对编辑部的修改意见进行修改。马瑞彤:参与选题、设计和修改论文的结果结论。晓琴、陶春、白玉玲、王额尔敦:参与选题、设计、资料的分析和解释;修改论文中关键性结果、结论;对编辑部的修改意见进行核修

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