CAJ | 학술논문

目的观察非诺贝特治疗非增生期糖尿病视网膜病变的临床疗效.方法前瞻性随机对照研究.对2010年7月至2011年12月在江西省中医院眼科就诊的40例(80只眼)2型糖尿病并发非增生期糖尿病性视网膜病变患者,按就诊顺序的随机数字分为A、B两组,在严格控制血糖及血压基础上A组(20例,40只眼)口服非诺贝特胶囊0.2 g,3次/d;B组(20例,40只眼)口服安慰剂Vit C片0.1 g,3次/d,饭前0.5 h口服;两组均常规口服复方血栓通胶囊0.5 g,3次/d,连续用28天.比较观察患者治疗前后视力、眼底镜检查、眼底荧光血管造影及眼底照相的变化.结果两组患者一般情况比较差异均无统计学意义(x2性别=0.464,P ＞0.05; t年龄=0.437,tDM病程=0.484,tDR病程=0.962,t血糖=0.886,t血肌酐=0.768,tBMI=0.812,tTG=0.924,tLDL=0.834,tSBp=0.956,tDBp=0.647,tGh=0.726,t视力=0.864,P均＞0.05).治疗21 d后,视力提高56只眼,其中A组32只眼(占57.1％),B组24只眼(占42.9％),两组视力较治疗前比较差异有统计学意义(x2=5.605,P＜0.05);其中38只眼治疗后矫正视力＞0.05,其中A组26只眼(68.4％),B组12只眼(31.6％),两组比较差异有统计学意义(x2=9.264,P＜0.05).治疗28 d后,A组眼底病变治疗有效率为30.0％ (12/40),总有效率85.0％ (34/40),B组显效率15.0％(6/40),总有效率55.0％ (22/40),结果显示A组疗效优于B组,两组有效率比较差异有统计学意义(x2=8.571,P＜0.05).单因素及多因素分析提示NPDR临床疗效与年龄、病程、严重程度呈负相关.结论非诺贝特可提高非增生期DR患者视力,有效改善非增生期DR症状,治疗的临床疗效与年龄、病程、严重程度存在一定关系.
목적 관찰비낙패특치료비증생기당뇨병시망막병변적림상료효.방법 전첨성수궤대조연구.대2010년7월지2011년12월재강서성중의원안과취진적40례(80지안)2형당뇨병병발비증생기당뇨병성시망막병변환자,안취진순서적수궤수자분위A、B량조,재엄격공제혈당급혈압기출상A조(20례,40지안)구복비낙패특효낭0.2 g,3차/d;B조(20례,40지안)구복안위제Vit C편0.1 g,3차/d,반전0.5 h구복;량조균상규구복복방혈전통효낭0.5 g,3차/d,련속용28천.비교관찰환자치료전후시력、안저경검사、안저형광혈관조영급안저조상적변화.결과 량조환자일반정황비교차이균무통계학의의(x2성별=0.464,P ＞0.05; t년령=0.437,tDM병정=0.484,tDR병정=0.962,t혈당=0.886,t혈기항=0.768,tBMI=0.812,tTG=0.924,tLDL=0.834,tSBp=0.956,tDBp=0.647,tGh=0.726,t시력=0.864,P균＞0.05).치료21 d후,시력제고56지안,기중A조32지안(점57.1％),B조24지안(점42.9％),량조시력교치료전비교차이유통계학의의(x2=5.605,P＜0.05);기중38지안치료후교정시력＞0.05,기중A조26지안(68.4％),B조12지안(31.6％),량조비교차이유통계학의의(x2=9.264,P＜0.05).치료28 d후,A조안저병변치료유효솔위30.0％ (12/40),총유효솔85.0％ (34/40),B조현효솔15.0％(6/40),총유효솔55.0％ (22/40),결과 현시A조료효우우B조,량조유효솔비교차이유통계학의의(x2=8.571,P＜0.05).단인소급다인소분석제시NPDR림상료효여년령、병정、엄중정도정부상관.결론 비낙패특가제고비증생기DR환자시력,유효개선비증생기DR증상,치료적림상료효여년령、병정、엄중정도존재일정관계.
Objective To observe the effect of Fenofibrate treating Non-proliferation diabetic retinopathy (NPDR).Methods A prospective random controlled study.Totally forty patients (80 eyes) with NPDR were randomized into two groups:Fenofibrate (group A,15g,qd),placebo Vitamin C (group B,0.1g,tid),and all groups were added with Xueshuangtong capsule.They were taken half an hour before meals.The change of ocular fundus,vision,funduscopy,FFA and fundus photography were observed after 28 days.Results There were no significant difference for the items of patients between two groups pre-therapy (x2sex=0.464,P ＞0.05; tage=0.437,tDM condition=0.549,tDR history=0.962,tDM history=0.484,tFbg=0.886,tSc=0.768,tBMI=0.812,tTG=0.924,tLDL=0.834,tsBp=0.956,tDBp=0.647,tGh=0.726,tvision=0.864,P ＞0.05); the visual acuity of total 52 eyes was increased,including 32 eyes (57.1％) of group A,24 eyes (42.9％) of group B.There were statistically significance for visual acuity at the post-therapy day 21 in both groups compared with pre-therapy (x2=5.605,P ＜0.05),and the number of eyes (BCVA＞0.05) was in 38 eyes,including 26 eyes (68.4％) of group A,12 eyes (31.6％) of group B,There were statistically significance between group A and group B (x2=9.264,P ＜0.05).After treatment,the effective rate of fundus lesions of group A was 30.0％,total effective rate 85.0％,while the effective rate of group B was 15.0％,total effective rate was 55.0％; and the results showed that the curative effect of group A was better than that of group B.There were significant difference for the effective rate between groups (x2=8.571,P ＜0.05).Logistic analysis results showed NPDR clinical therapeutic effect and traditional Chinese medicine symptom were negative correlated with age,history and severity (P ＜0.05).Conclusions Fenofibrate can improve the vision of patients with NPDR,the fundus lesions and the traditional Chinese medicine symptoms.The clinical therapeutic effect of NPDR is possibly correlated to age,history and severity.