| Objective: diabetic retinopathy (DR) is a difficult disease ofophthalmology today. It is also a disease that lead.to blinding,bring the patient great suffering. It is necessary for the doctorof ophthalmology to find an ideal way to cure diabetic retinopathy(DR). This researching compare the effects of traditional Chinesemedicine, laser photocoagulation, and the two combined on thetreatment of diabetic retinopathy (DR). Then it will provide the moreefficient basis of theory to cure diabetic retinopathy (DR) for theclinic.Subjects and methods:Subjects: all subjects involved were treated at ophthalmologydepartment of the attached hospital to Liaoning College of TCM fromMatch, 2002 to January, 2003, diabetes mellitus (DM) patient werein accorded with the diagnostic standard of diabetes stipulated byAmerican Diabetes Association. The diagnostic standard of diabeticretinopathy (DR) followed the Third Chinese ophthalmologyconvention.The syndrome differentiation of TCM in according to clinic behaveand the changes of oculi fundus tally with deficiency of both qi andyin double hypostasis. The subjects were divided into Sgroups.25cases (50 eyes) took traditional Chinese medicine according to thesyndrome differentiation, and 31 cases (37 eyes) were treated withphotocoagulation. 36 cases (48eyes) were treated withphotocoagulation combine with Chinese herbs. No difference wasconfirmed by the test of homoscedasticity in age, sex among eachgroup (p>0. 05). by the test of homoscedasticity , no significantdifference was found in clinical course of disease among 3 groups(p>0. 05).Methods:1. laser photocoagulation: we adopted IRIS GL-532 nm midcondiictorlaser photocoagulate made in American, in according to the differentbehave of fundus fluorescein angiography (FFA), we .adopted panretinal photocoagulation, focal photocoagulation and grid pattern photocoagulation. The spot size is 30CT500um. The exposure time isO. 1~ 0. 2 second and the standard of power is gray reaction of retina.2. traditional Chinese medicine: we used the Chinese herbs of supplementing qi and nourishing yin , promoting blood circulation to remove blood stasis.Results: the data were shown by average眘tandard deviation (X± S), and X2 test and t test was then used for groups with homogeneous variables . The results showed: the patients treated with photocoagulation combined with traditional Chinese medicine had much better results on the improvement of visual acuity, rapid dismissal of renal hemorrhage , edema , exudation and neovascularization than that in the other two ways. To improve blo^d lipid and blood rheology, the effect of Chinese medicine and combined both is better than the group of laser photocoagulation. Discussion: many scholars have proved in practice that lfaser photocoagulation is the efficient method to treat diabetic retinopathy. The theory is laser photocoagulation can block the exudation of retinal blood vessel, which can reduce the edema, exudates and renal hemorrhage. It can block the unperfusion of retinal capillary vessel in order to revive hypoxia of retina, reduce and remove the synthesize and release of growth factor of neovascularization. Laser photocoagulation can directly block neovascularization to prevent volume bleeding of reiina, accordingly recover and stabilify the visual function of the patients. Laser photocoagulation is a method of treatment , at the same time it is also a pathologic course, and it can create light injury for retina in order to damage the visual acuity, visual field and dark adaptation. The injury of free redical and the enhance of nonenzymatic plycation of the patients themselves. The light injury can enhance oxygen and bring more free redical. Through the lab researching , the Chinese herbs of supplementing qi and vourishing yin, nourishing kidney to improving acuity of vision and promoting blood circulation to remove blood stasiscan resist the damage of free redical and restrain nonenzymatic plycatio... |
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