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目的观察全视网膜激光光凝术联合密蒙花方治疗重度非增殖性糖尿病视网膜病变(NPDR)的临床疗效。方法将71例(134眼)重度NPDR患者随机分为2组,治疗组37例(68眼)在全视网膜激光光凝术基础上应用密蒙花方治疗,对照组34例(66眼)单纯应用全视网膜激光光凝术治疗。大约分4次完成全视网膜激光光凝术,分次光凝时间间隔1周,连续口服密蒙花方2个月。比较2组治疗1、2个月后视力、新生血管消退情况,及治疗前后黄斑水肿厚度变化。结果治疗组治疗1个月后视力提高率41.2%,对照组25.8%;治疗组治疗2个月后视力提高率54.4%,对照组36.4%。治疗组治疗1、2个月后视力提高率均高于对照组(P<0.05,P<0.01)。治疗组治疗1个月后新生血管消退总有效率89.7%,对照组75.7%;治疗组治疗2个月后新生血管消退总有效率95.6%,对照组84.8%。2组治疗1、2个月后总有效率比较差异均有统计学意义(P<0.05,P<0.01),治疗组新生血管消退疗效优于对照组。2组治疗前后黄斑水肿厚度比较差异有统计学意义(P<0.05),治疗后降低,且治疗组治疗后低于对照组(P<0.05)。结论全视网膜激光光凝术联合密蒙花方治疗重度NPDR,较单纯应用全视网膜激光光凝术能更快速有效地改善患者视力,减轻黄斑水肿,促进新生血管消退。
Objective To observe the clinical effect of panretinal laser photocoagulation combined with Manmuhuifang in the treatment of severe non-proliferative diabetic retinopathy (NPDR). Methods Seventy-one patients (134 eyes) with severe NPDR were randomly divided into 2 groups. 37 cases (68 eyes) in the treatment group were treated with the capsule of Budragume by laser photocoagulation. 34 cases (66 eyes) in the control group were simple Application of retinal laser photocoagulation treatment. About 4 times to complete the whole retina laser photocoagulation, fractional photocoagulation interval of 1 week, continuous oral administration of Budweiser for 2 months. The visual acuity and neovascularization of the two groups after treatment for 1 and 2 months were compared, and the thickness of macular edema before and after treatment were also compared. Results After 1 month of treatment, the visual acuity improvement rate was 41.2% in the treatment group and 25.8% in the control group. After 2 months of treatment, the visual acuity improvement rate was 54.4% in the treatment group and 36.4% in the control group. The improvement rate of visual acuity after treatment for 1 and 2 months in treatment group was higher than that in control group (P <0.05, P <0.01). At 1 month after treatment, the total effective rate of neovascularization was 89.7% in the treatment group and 75.7% in the control group. After 2 months of treatment, the total effective rate of neovascularization was 95.6% in the treatment group and 84.8% in the control group. The total effective rate of the two groups after treatment for 1 and 2 months were significantly different (P <0.05, P <0.01). The therapeutic effect of neovascularization in the treatment group was better than that in the control group. The thickness of the macular edema in the two groups before and after treatment had significant difference (P <0.05), decreased after treatment, and the treatment group was lower than the control group after treatment (P <0.05). Conclusions Total retinal laser photocoagulation combined with Mumeng Huayu for the treatment of severe NPDR can improve visual acuity, reduce macular edema and promote neovascularization more quickly and effectively than pure retinal photocoagulation.