本文選題：復方血栓通 + 臨床研究　； 參考：《北京中醫(yī)藥大學》2012年碩士論文

【摘要】：1研究目的： (1)評價復方血栓通對非增殖期糖尿病視網(wǎng)膜病變患者的視力、眼底、網(wǎng)膜黃斑中心凹厚度以及中醫(yī)癥狀的影響,探討復方血栓通改善視力、眼底情況,減小網(wǎng)膜黃斑厚度的藥物療效以及緩解中醫(yī)癥狀的功效。(2)觀察復方血栓通對NPDR,患者房水中血管內(nèi)皮生長因子(VEGF)的影響差異,探討復方血栓通抑制糖尿病視網(wǎng)膜病變網(wǎng)膜新生血管的可能性。 2研究方法 本研究可分為兩部分,實驗一是在治療前后對所有受試者進行視力、眼底檢查、眼底熒光造影以及OCT網(wǎng)膜黃斑厚度相關(guān)數(shù)據(jù)記錄以及中醫(yī)癥狀進行統(tǒng)計分析,得出結(jié)論。實驗二是：將受試者分為A、B、C三組。對三組患者進行房水取樣檢測,評價房水中VEGF(血管內(nèi)皮生長因子)含量與復方血栓通治療作用的相關(guān)性,來探討復方血栓通改善眼底的作用以及抑制糖尿病視網(wǎng)膜病變網(wǎng)膜新生血管的可能性。 3研究結(jié)果 (1)第一部分：結(jié)果顯示：1)復方血栓通對提高早期糖尿病視網(wǎng)膜病變患者的視力、眼底微血管瘤的數(shù)目減少、眼底出血的吸收增多、黃斑區(qū)熒光滲漏的逐漸減輕、網(wǎng)膜黃斑水腫的改善等臨床癥狀及緩解中醫(yī)癥狀體征有一定作用。2)同時,對于中醫(yī)癥狀如視物模糊、目睛干澀、體虛自汗和便秘等,復方血栓通能較有效地改善減輕癥狀。 (2)第二部分：糖尿病視網(wǎng)膜病變患者房水中VEGF含量檢測的相關(guān)數(shù)據(jù)分析。實驗二中,(對照組)B組房水中VEGF含量大于治療組(A組)和NDR組(C組)(P0.05)。治療組(A組)平均VEGF含量大于NDR組(C組)(P0.05)。在糖網(wǎng)二期患者中,治療組(α1)房水中VEGF含量小于對照組(α2)(P0.05)；在糖網(wǎng)三期患者中,治療組(β1)房水中VEGF含量小于對照組(β2)(P0.05)；α、β兩組房水中平均VEGF含量均大于NDR組(P0.05)。在所有參與實驗者中,VEGF與年齡、性別無關(guān)。 4結(jié)論 4.1在第二部分試驗中,AB兩組,A組患者房水中VEGF降低,B組患者房水VEGF升高,VEGF升高與視網(wǎng)膜新生血管的形成有關(guān),它在非增殖性糖尿病視網(wǎng)膜病變中起著重要作用,并且最終會發(fā)展成增殖性糖尿病視網(wǎng)膜病變。因此,復方血栓通在抑制VEGF等方面可能具有一定的作用,通過減少VEGF的表達,降低發(fā)生新生血管的可能性,大大減少了發(fā)生玻血、網(wǎng)脫的危險,有效阻止了糖尿病視網(wǎng)膜病變從非增殖期向增殖期發(fā)展的步伐。 4.2在α組中,α1組(DR二期治療組)的視力、眼底、黃斑中心凹厚度以及中醫(yī)癥狀評分與α2組(對照組)比較,均有所提高和好轉(zhuǎn)；在β組中,β1組(治療組)的視力、眼底、黃斑中心凹厚度以及中醫(yī)癥狀評分與β2組(對照組)比較,均有所提高和好轉(zhuǎn)。 4.3在所有患者中,房水中VEGF的含量與年齡、性別無關(guān)。研究提示： (1)復方血栓通對提高非增殖期糖尿病視網(wǎng)膜病變患者的視力,眼底(改善眼底微血管瘤、出血、黃斑區(qū)熒光滲漏)、網(wǎng)膜黃斑水腫及中醫(yī)癥狀體征有一定作用。臨床中,可以考慮作為治療非增殖期糖尿病視網(wǎng)膜病變的一種用藥選擇。 (2)通過進行糖尿病視網(wǎng)膜病變患者房水中VEGF含量檢測的相關(guān)數(shù)據(jù)分析,得出結(jié)論：復方血栓通能有效減少房水中VEGF含量,的確可以有效抑制糖尿病視網(wǎng)膜病變網(wǎng)膜新生血管,降低了糖網(wǎng)發(fā)展到增殖期網(wǎng)膜機化條索牽拉、發(fā)生網(wǎng)脫的風險。但是,本研究中非增殖期糖尿病視網(wǎng)膜病變與體質(zhì)、病程、合并內(nèi)科其他疾病等因素的關(guān)系并不確定,而且還存在問題如因患者個人意愿,無法重復按階段取房水檢測VEGF含量,所有這些不確定因素還有待于進一步研究。
[Abstract]:1 Study Purpose :

( 1 ) To evaluate the effects of compound thrombus on the visual acuity , fundus , macular hole thickness and the symptoms of TCM in non - proliferative diabetic retinopathy .

2 Study Methods

This study can be divided into two parts . One is to study the visual acuity , fundus examination , fundus fluorescein angiography and the correlation data record of OCT and macular thickness in all subjects before and after treatment . The results are as follows : The subjects are divided into three groups A , B and C .

3 Study Results

( 1 ) The first part : ( 1 ) The results showed that : 1 ) Compound Xuetong can improve the visual acuity of patients with early diabetic retinopathy , decrease the number of fundus microhemangioma , increase the absorption of fundus hemorrhage , decrease the fluorescence leak in macular region , improve the macular edema , and alleviate symptoms and signs of Chinese medicine .

( 2 ) In the second part , the data of VEGF in the patients with diabetic retinopathy were analyzed . The VEGF in the control group ( group A ) was higher than that in the control group ( group A ) and the group C ( P0.05 ) .
In the third phase of sugar net , the content of VEGF in the water of the treatment group ( 尾1 ) was smaller than that in the control group ( P0.05 ) .
The levels of VEGF in both groups were higher than those in the group ( P0.05 ) . VEGF was not related to age and sex in all subjects involved in the experiment .

4 Conclusion

4.1 In the second part of the experiment , the VEGF of the patients in group A and group A is decreased , the VEGF in B group is related to the formation of retinal neovascularization , it plays an important role in the development of non - proliferative diabetic retinopathy . Therefore , compound thrombus can play an important role in inhibiting VEGF and so on .

4.2 In group 偽 , the visual acuity , fundus , macular hole thickness and the score of TCM symptoms were improved and improved compared with group 偽 2 ( control group ) .
In the 尾 - group , the visual acuity , fundus , macular hole thickness and symptom scores of 尾 - 1 group ( treatment group ) were improved and improved compared with that of 尾2 - group ( control group ) .

4.3 In all patients , the level of VEGF in the aqueous humor was not related to age , sex . Study tips :

( 1 ) Fufang Xuetong has a certain effect on improving vision , fundus ( improving fundus microangioma , hemorrhage , macular region fluorescence leak ) , retinal macular edema and symptoms and signs in non - proliferative diabetic retinopathy , and can be considered as a drug choice for treating diabetic retinopathy in non - proliferative phase .

( 2 ) By analyzing the correlation data of VEGF in the patients with diabetic retinopathy , it is concluded that the compound thrombus can effectively reduce the VEGF content in the patients with diabetic retinopathy , reduce the risk of net loss in the development of diabetic retinopathy .
【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R774.1

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