活血通络汤联合西药治疗糖尿病视网膜神经病变的临床观察

目的 观察活血通络汤联合羟苯磺酸钙治疗糖尿病视网膜神经病变（diabetic retinopathy，DR）的临床疗效及对视力的影响。方法 将82例DR患者按照随机数字表法分为观察组和对照组，每组41例。对照组采用常规治疗加以羟苯磺酸钙分散片治疗，观察组在对照组的基础上联合活血通络汤治疗。1个月为1个疗程，连续治疗3个疗程。观察比较两组患者临床疗效、治疗前后视力变化、视野缺损积分、视敏度情况及一氧化氮、丙二醛、超氧化物歧化酶水平。结果 观察组临床总有效率92.68%，显著高于对照组73.17%（P<0.05）。治疗后观察组的视力、30°视敏度、30°~60°视敏度显著高于对照组（P<0.05），视野缺损积分显著低于对照组（P<0.05）；观察组一氧化氮、丙二醛水平显著低于对照组（P<0.05），超氧化物歧化酶水平显著高于对照组（P<0.05）。所有患者在治疗期间未出现不良反应。结论 活血通络汤联合羟苯磺酸钙治疗DR，能有效改善患者临床症状，临床疗效良好，安全性较高。

Clinical Effect of Huoxue Tongluo Decoction Combined with Western Medicine in Treatment of Diabetic Retinopathy

Objective To observe the clinical efficacy of Huoxue Tongluo Decoction combined with calcium dobesilate in the treatment of diabetic retinopathy (DR) and its effect on the vision. Methods A total of 82 patients with DR were randomly divided into observation group and control group according to a random number table, with 41 patients in each group. The control group was treated with routine regimen plus calcium dobesilate dispersible tablets, and the observation group was treated with Huoxue Tongluo Decoction in addition to the treatment for the control group. Both groups were treated for three courses (one month per course). The two groups were compared for the clinical outcome, changes in vision after treatment, visual field defect score, visual acuity, and the levels of nitric oxide (NO), malondialdehyde (MDA), and superoxide dismutase (SOD). Results The overall response rate of the observation group was significantly higher than that of the control group after treatment (92.68% vs 73.17%, P<0.05). Compared with the control group, the observation group had significantly increased vision, 30° visual acuity, and 30°-60° visual acuity (P<0.05) as well as SOD level (P<0.05), but significantly reduced visual field defect score (P<0.05) and levels of NO and MDA (P<0.05) after treatment. None of the patients showed any adverse reactions during the treatment.Conclusion Huoxue Tongluo Decoction combined with calcium dobesilate can effectively improve the clinical symptoms of patients with favorable efficacy and safety profiles in the treatment of DR.