本文選題：加味補(bǔ)陽(yáng)還五湯　切入點(diǎn)：532nm激光　出處：《福建中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：背景：消渴目病相當(dāng)于現(xiàn)代醫(yī)學(xué)的糖尿病視網(wǎng)膜病變(diabetic retinopathy, DR),隨著現(xiàn)代醫(yī)療水平及細(xì)胞生物學(xué)發(fā)展,血管內(nèi)皮生長(zhǎng)因子(vascular endothelial growth factor, VEGF)和色素上皮衍生因子(pigment epithelium derived factor, PEDF)與糖尿病視網(wǎng)膜病變的關(guān)系越來(lái)越受到重視。研究表明VEGF是導(dǎo)致視網(wǎng)膜新生血管形成的主要原因之一,VEGF也與糖尿病性黃斑水腫關(guān)系密切,PEDF則是對(duì)新生血管生長(zhǎng)有抑制作用的主要因子。目的：研究正常體檢者(以下統(tǒng)稱(chēng)正常對(duì)照組)、糖尿病無(wú)消渴目病患者(以下統(tǒng)稱(chēng)DM組)和氣陰兩虛夾瘀型消渴目病患者(以下統(tǒng)稱(chēng)DR組)血清VEGF、PEDF含量的變化；觀察加味補(bǔ)陽(yáng)還五湯聯(lián)合532nm激光對(duì)氣陰兩虛夾瘀型消渴目病患者治療前后最佳矯正視力、眼底熒光血管造影(fluorescein fundus angiography,FFA)、光學(xué)相干斷層掃描(optical coherence tomography, OCT)等指標(biāo)的變化及血清VEGF、PEDF含量變化,進(jìn)一步認(rèn)識(shí)消渴目病發(fā)病及聯(lián)合治療的機(jī)理,從而提高本病治療效果,降低致盲率,豐富臨床治療方法。方法：(1)在福建中醫(yī)藥大學(xué)附屬人民醫(yī)院體檢中心收集30例正常體檢者,內(nèi)分泌科收集30例糖尿病無(wú)消渴目病患者,眼科門(mén)診及住院部收集30例氣陰兩虛夾瘀型消渴目病患者。采用酶聯(lián)免疫吸附測(cè)定法(enzyme linked immunosorbent assay, ELISA)檢測(cè)正常對(duì)照組、DM組和DR組血清VEGF、PEDF含量。(2)通過(guò)觀察加昧補(bǔ)陽(yáng)還五湯聯(lián)合532m=n激光對(duì)DR組患者治療前及治療1個(gè)月后患者最佳矯正視力、FFA、OCT等指標(biāo)的變化,評(píng)估聯(lián)合治療的療效。(3)采用ELISA法檢測(cè)加味補(bǔ)陽(yáng)還五湯聯(lián)合532nm激光治療的DR組患者治療前及治療1個(gè)月后血清VEGF、PEDF含量。結(jié)果：(1)正常對(duì)照組、DM組和DR組血清VEGF含量逐漸上升,三組間比較,差異有統(tǒng)計(jì)學(xué)意義(Z=35.84,P0.01);正常對(duì)照組、DM組和DR組血清PEDF含量逐漸下降,三組間比較,差異有統(tǒng)計(jì)學(xué)意義(Z=16.29,P0.01)。(2)加味補(bǔ)陽(yáng)還五湯聯(lián)合532nm激光治療DR組患者有顯著療效,其中Ⅲ期有效率可達(dá)100%,Ⅳ期有效率可達(dá)85.71%,V期有效率為33.33%,總有效率可達(dá)89.66%。(3)加味補(bǔ)陽(yáng)還五湯聯(lián)合532nm激光治療1個(gè)月后DR組患者血清VEGF含量較治療前下降,治療前后比較,差異有統(tǒng)計(jì)學(xué)意義(T=2.613,P=0.0140.05)；加味補(bǔ)陽(yáng)還五湯聯(lián)合532nm激光治療1個(gè)月后DR組患者血清PEDF含量較治療前上升,治療前后比較,差異有統(tǒng)計(jì)學(xué)意義(Z=3.363,P=-0.010.05)。結(jié)論：(1)血清VEGF、PEDF含量與消渴目病的發(fā)生、發(fā)展有一定關(guān)系,血清VEGF含量隨著消渴目病病程逐漸上升,血清PEDF含量隨著消渴目病病程逐漸下降,二者可作為消渴目病發(fā)生、發(fā)展評(píng)估的指標(biāo)。(2)加味補(bǔ)陽(yáng)還五湯聯(lián)合532nm激光對(duì)氣陰兩虛夾瘀型消渴目病治療有顯著的療效。(3)加味補(bǔ)陽(yáng)還五湯聯(lián)合532nm激光對(duì)氣陰兩虛夾瘀型消渴目病治療的機(jī)理可能是通過(guò)上調(diào)患者血清VEGF水平及下調(diào)血清PEDF水平來(lái)實(shí)現(xiàn)。
[Abstract]:Background: diabetes retinopathy (DRN) is equivalent to diabetic retinopathy (DRN) in modern medicine, with the development of modern medical treatment and cell biology. The relationship between vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor pigment epithelium derived factor (PEDFs) and diabetic retinopathy has been paid more and more attention. Studies have shown that VEGF is the main cause of retinal neovascularization. VEGF is also closely related to diabetic macular edema. PEDF is the main factor that inhibits the growth of neovascularization. Objective: to study the effect of PEDF on the growth of neovascularization. The changes of PEDF in serum of patients with diabetes mellitus (DM group) and patients with deficiency of Qi and yin (Dr group) and those with deficiency of Qi and Yin (Dr group); To observe the effects of modified Buyang Huanwu decoction and 532nm laser on the best corrected visual acuity, fluorescein fundus angiography-FFAA, optical coherence tomography (Oct) and the content of VEGF PEDF in serum of patients with Qi-Yin deficiency and stagnation syndrome before and after treatment. In order to improve the therapeutic effect, reduce the rate of blindness and enrich the clinical treatment methods, 30 normal people were collected from the people's Hospital of Fujian University of traditional Chinese Medicine. The Endocrinology Department collected 30 patients with diabetes mellitus without diabetes. Thirty patients with dyspepsia with deficiency of qi and yin and blood stasis were collected from ophthalmological outpatient department and inpatient department. Enzyme linked immunosorbent assay (Elisa) was used to detect the content of VEGF immunosorbent PEDF in DM group and Dr group of normal control group. Changes of best corrected visual acuity (BCVA) and FFA-Oct in Dr group before treatment and one month after treatment with decoction and 532m=n laser. To evaluate the curative effect of combined therapy, ELISA method was used to detect the level of serum VEGF VEGF in Dr group before treatment and 1 month after 532nm laser treatment. Results the serum VEGF levels in DM group and Dr group of normal control group increased gradually. The difference among the three groups was statistically significant (P 0.01), the serum PEDF content of DM group and Dr group in the normal control group decreased gradually, and the difference was statistically significant among the three groups (P 0.01, P 0. 01, P 0. 01, P 0. 01, P 0. 01, P 0. 01, P 0. 01, P 0. 01, P 0. 01, P 0. 01, P 0. 01, P 0. 01, P 0. 01, P 0. 01, P 0. 01, P 0. 02). The effective rate of stage 鈪，

本文編號(hào)：1662224