| ObjectivesDiabetic retinopathy is a common fundus lesion of metabolic ischemia and hypoxia,and the clinical manifestations of different course of disease are also different.In the early stage of the disease,it is possible to prevent the disease of the fundus from progressing for several years or decades through reasonable diet or blood sugar control.When a severe non-proliferative phase or pre-proliferative fundus lesion occurs,it should promptly perform total retinal photocoagulation to inhibit the disease.Progress,but there may be problems with reactive macular edema or visual field defects in patients with standardized PRP.Therefore,it is very important to actively and fully communicate with patients about the course characteristics of diabetic retinopathy and the advantages and disadvantages of laser treatment in the course of disease development.And after laser treatment is not once and for all,but more need to actively control the underlying diseases,the use of integrated Chinese and Western medicine intervention,may reduce the complications of laser treatment,so that the fundus benefits more.Therefore,this study combines scientific research and clinical use,and prospective randomized controlled trials were used to evaluate the effect of Mianlutong combined with compound anisodine injection on visual field protection after DR photocoagulation.MethodsPatients with diabetic retinopathy who received standard PRP from the Department of Ophthalmology,Oriental Hospital of Beijing University of Traditional Chinese Medicine,from October 2017 to February 2019,were assigned a random serial number in the order of patient visits(a random serial number was generated by computer and saved by screenshot).),the treatment plan is assigned according to the group corresponding to the random number.DR patients began to intervene the next day after laser photocoagulation treatment:control group A:photocoagulation after calcium hydroxybenzenesulfonate capsules 1 tablet tid+Maizhiling tablets 2 tablets bid,oral.Test group B:Group A treatment+Miaoluotongfang(provided by the Chinese medicine preparation room of our hospital,the original prescription ratio is:raw land 15g,salvia miltiorrhiza 10g,angelica 10g,Chuanxiong 10g,spatholobus 10g,loofah 10g,Lulutong 10g,Pseudostellariae 30g,clam shell 10g,Campanulaceae 10g,Astragalus 30g)+compound anisodine injection(Beijing Zizhu Pharmaceutical)2ml suffering from the injection of the temple injection,once a day.Continuous treatment for 2 weeks,followed up for 2 weeks after stopping the drug.Results1 The main observation index visual fieldVisual field mean defect MD value showed a downward trend in the treatment of both groups,representing the improvement of visual field(P<0.05),statistically significant difference,indicating that either calcium hydroxybenzenesulfonate+The basic treatment of Maizhiling or the treatment of Miaoluotong combined with analgesia in the temple can improve the visual field of patients to some extent.However,no comparison between the experimental group and the control group showed that the experimental group had a higher degree of visual field improvement(P>0.05).In addition,in the comparison of the data of the four observation nodes of the visual field,it was found that the first week of treatment was better than the pre-treatment visual field(P<0.05),and the second week of treatment was further improved than the first week of treatment(P<0.05).There was no further improvement in visual field between the second week after stopping the drug and the second week after treatment(P>0.05),but the visual field was compared with that before treatment,the first week of treatment,and the second week of treatment.It was improved(P<0.05).2.The second observation index visual acuityThe visual acuity did not improve significantly before and after treatment in the experimental group(P>0.05).The visual acuity of the first week of the control group was higher than that before the enrollment(P<0.05),and the visual acuity of the second week was higher than that before the enrollment.(P<0.05),there was no significant increase compared with the first week of treatment(P<0.05),and there was no significant improvement in visual acuity compared with the previous three observation points in the fourth week of treatment(P>0.05).There was no statistically significant difference between the observation group and the control group in the visual acuity measured by the three observation nodes after treatment(P>0.05).3.The second observation index macular edema thicknessThe thickness of macular edema was not significantly improved in the treatment of the two groups(P>0.05).There was no statistically significant difference between the two groups(P>0.05).This is inseparable from the clinically significant diabetic macular edema and the reversal of macular edema caused by PRP before the patient undergoes panretinal photocoagulation.Conclusions and significance1.During the study period,the two groups of treatments have improved the visual field after DR photocoagulation,but the improvement of visual acuity and macular edema is not obvious.2.In the study period,the improvement of visual field in the experimental group was not superior to the control group.Poor patient efficacy may be related to medication time and short observation period,suggesting that diabetes is a lifelong disease requiring long-term monitoring and treatment.This still requires more clinical trials to verify. |
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