| Aim: The aim of this study was to investigate the protective effects of Ginkgo biloba tablet(GBT) and L-carnitine(LC) in combination on patients with diabetic retinopathy who experienced panretinal photocoagulation(PRP), focusing on the blood viscosity,blood lipid profile, fasting blood sugar(FBS), Hb Alc, vision and fundus fluorescein angiography(FFA).Methods: 79 diabetic retinopathy patients(stage III-IV) were enrolled according to the diagnosis and staging standard established on 1984 Third CCOS with age ranging from49-68 and a diabetic history of 8-25 year. No patients received GBT or LC prior to the study. Prior to PRP, patients were randomly assigned to combo-treatment group(N=40)or GBT only group(N=39). Mydriasis was induced in both groups with tropicamide before PRP procedure. The vertical range of PRP was 1.5-2 DD of optic disc, temporal range was 1-2 DD of macula lutea, resulting in class III light spot. The total PRP procedure was consist of four treatments, with seven day intervals between two treatments. Patients in both groups received diet control, exercise therapy and hypoglycemic medication. Patients in GBT only group received GBT 19.2 mg, t.i.d, while patients in combo-treatment group received identical GBT doses along with additional LC oral solution 1 g, b.i.d. Rotary viscosity measurement, biochemical enzymatic methods,5m standard logarithmic visual acuity chart method and FFA method were utilized to assess blood viscosity, blood lipid profile, FBS, Hb Alc, vision and FFA changes in both groups of patients, respectively. Statistics were performed with SPSS 16.0.Results: The gender ratio(25/15, 23/16), age(54.4±9.5 year for GBT group,55.2±8.9year for combo group), disease course(16.3±4.7 year for GBT group,15.7±5.1 year for combo group) were not statistically different between the two groups(P>0.05).Additionally, no statistical differences were found in blood viscosity, blood lipid profile(total cholesterol, triacylglycerol, LDL), FBS, Hb Alc, vision and FFA prior to treatments(P>0.05). After three-month treatment, the blood total cholesterol, triacylglycerol, LDL,FBS and Hb Alc levels were significantly decreased(P<0.05). Moreover, patients in combo-treatment group presented with more profound improvement in these above parameters relative to those in GBT only group: triacylglycerol(1.54±0.32 mmol/L vs1.71±0.43 mmol/L); total cholesterol(4.64±1.92 mmol/L vs 5.97±2.31 mmol/L); LDL(3.13±0.37 mmol/L vs 3.45±0.39 mmol/L); FBS(6.42±2.62mmol/L vs 7.42±2.54mmol/L); Hb Alc(7.7±2.2% vs 8.9±2.6%)(P<0.05). Additionally, the HDL level inpatients of both groups was remarkably increased, and the combo-treatment group exhibited further increase(1.65±0.32 mmol/L vs 1.54±0.21 mmol/L)(P<0.05). Vision in both groups were significantly improved following the three-month treatment, with the improvement rate of 95% in combo-treatment group and 76.9% in GBT only group(P<0.05). FFA demonstrated significant improvement in both groups, with the total improvement rate of 92.5% in combo-treatment group and 77% in GBT only group(P<0.05). Lower blood viscosity was observed in both groups of patients, with no statistical difference observed(P>0.05). Our results suggest that GBT could effectively improve vision of the diabetic retinopathy patients underwent PRP and blood lipid profile while decrease the incidence of fundus complications as well as the levels of blood sugar and Hb Alc,. Combination treatment of GBT and L-carnitine further enhanced such improvements.Conclusion: Oral administration of GBT 19.2 mg, t.i.d along with L-carnitine oral solution 1 g, b.i.d. for three months could protect diabetic retinopathy patients underwent PRP, which was associated with blood lipid modulation as well as blood sugar and viscosity improvement. |
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