Effects of Zhixue Sanyu Mingmu Decoction Combined with Panretinal Photocoagulation on Visual Acuity,Macular Thickness and Serum Adiponectin Level in Patients with Diabetic Retinopathy
Objective To investigate the effect of Zhixue Sanyu Mingmu Decoction(composed of Astragali Radix,Moutan Cortex,Dioscoreae Rhizoma,Anemarrhenae Rhizoma,Phellodendri Chinensis Cortex,Rehmanniae Radix,etc.)combined with panretinal photocoagulation(PRP)on visual acuity,macular thickness and serum adiponectin level in patients with diabetic retinopathy(DR).Methods A retrospective analysis was carried out for the clinical data of 98 patients with DR of qi-yin deficiency complicated with blood stasis and qi stagnation in vessels and collaterals type admitted from February 2020 to May 2022.According to the treatment methods,the patients were divided into PRP group(48 cases)and combined group(50 cases).The PRP group was treated with PRP alone,and the combined group was given Zhixue Sanyu Mingmu Decoction orally together with PRP.The course of treatment for the two groups lasted for 3 months.Before treatment and 3 months after treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,visual acuity,macular thickness,blood flow related parameters of central retinal vein(CRV)such as end diastolic velocity(EDV)and peak systolic velocity(PSV),blood lipid indicators and serum adiponectin level.Results(1)After 3 months of treatment,TCM syndrome scores and macular thickness in the two groups were significantly lower than those before treatment(P＜0.05),and the visual acuity was significantly higher than that before treatment(P＜0.05).The TCM syndrome scores and macular thickness in the combined group were significantly lower than those in the PRP group,and the visual acuity was significantly higher than that in the PRP group,the differences being statistically significant(P＜0.01).(2)After 3 months of treatment,the CRV blood flow related parameters of EDV and PSV in the two groups were significantly increased compared with those before treatment(P＜0.05),and the EDV and PSV in the combined group were significantly higher than those in the PRP group,the differences being statistically significant(P＜0.01).(3)After 3 months of treatment,the levels of total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)in the combined group were decreased compared with those before treatment(P＜0.05),while there were no obvious changes in the levels of TC and LDL-C of the PRP group(P＞0.05).After treatment,the levels of TC and LDL-C in the combined group were significantly lower than those in the PRP group,and the differences were statistically significant(P＜0.01).(4)After 3 months of treatment,the serum adiponectin level in the two groups was significantly increased compared with that before treatment(P＜0.01),and the level in the combined group was significantly higher than that in the PRP group,the difference being statistically significant(P＜0.01).Conclusion For the treatment of DR patients with qi-yin deficiency complicated with blood stasis and qi stagnation in vessels and collaterals type,the oral administration of Zhixue Sanyu Mingmu Decoction based on PRP can effectively up-regulate serum adiponectin level,significantly reduce the macular thickness,and markedly improve blood lipid indicators,CRV blood flow related parameters and the visual acuity of the patients.
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