| Objective:To evaluate the clinical efficacy of oral Aldose reductase inhibitors (ARIs, Domestic Epalrestat Capsules-Tanglin) combined photocoagulation and simple photocoagulation on treating serve NPDR, To make up for deficiency of a simple laser photocoagulation treatment on severe NPDR and look for a better regimen treatment for diabetic retinopathy.Method:The patients diagnosed as type two diabetes mellitus who are concurrent with severe NPDR were collected, and all patients were divided into 4 groups namely according to their order of hospitalization and the control of their blood glucose randomly:the good blood glucose control and oral Aldose reductase inhibitors group (experimental group), the good blood glucose control without taking Aldose reductase inhibitors (Tanglin control group), the poor blood glucose control but oral Aldose reductase inhibitors group (glycemic control), the poor glycemic control without taking Aldose reductase inhibitors group(complete control group), all patients had received therapy of photocoagulation. The patients’right eyes were regarded as experimental object, if their both two eyes suffered from severe NPDR; the left eyes were chosed as the observing object, if only their left eyes suffered from severe NPDR. The data in the experiment was rigorously recorded and analyzed before and after treatment, the evaluation of effect of oral Tanglin was made through relevant statistic methods.Results:160 patients were collected and there were 40 patients in each group. According to the exclusion criteria of the experiment, two cases in the experimental group were excluded, three cases in the Tanglin control group were excluded, two cases in the glycemic control group were excluded and four cases in the control group were excluded,149 cases completed the experiment finally, the completion rate was 93.1%. The experimental group had 38 cases,31 cases of the right eye and 7 cases of left eye were included; the Tanglin control group had 37 cases, 29 cases of the right eye and 8 cases of left eye were included; the blood sugar control group had 38 cases,30 cases of the right eye and 8 cases of the left eye were included; the completely control group had 36 cases,31 cases of the right eye and 5 cases of the left eye were included. At the end of 4 and 12 weeks after the treatment, glycemic control and taking Aldose reductase inhibitors (Tanglin 50 mg/time, tid, preprandial oral administration) orally:①Whether the control of blood glucose and the adoption of Tanglin were no interaction on every evaluating indicator of severe NPDR who received the treatment of photocoagulation in the experiment (P>0.05).② Oral Tanglin and glycemic control were statistical significance on main effects of visual acuity improvement (P<0.001).③Oral Tanglin and glycemic control stated above were statistical difference for main effect of patients’ EPG-Ops (P<0.05).④ Oral Tanglin was statistically significant for the dominant effect of patients’ CRA peak systolic (PSV), end diastolic velocity (EDV) and resistance index (RI) (P<0.05). Comparing the general curative effect for severe NPDR in the treatment of joint adoption of glycemic control and oral Tanglin:in the phase of treatment at the end of 4 and 1.2 weeks, experimental group’s efficiency was much higher than Tanglin control group, blood glycemic control group and the complete control group, the difference was statistically significant (P<0.001).Conclusion:The vision, FFA, ERG-Ops and the blood flow mechanics of CRA of severe NPDR treated by photocoagulation were improve significantly after taking ARIs; ARIs combined photocoagulation can improve the prognosis of severe NPDR, prevent or delay the further occurrence and development of DR; ARIs combined photocoagulation may become a new method on the treatment of severe NPDR. |
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