研究疾病:
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糖尿病视网膜病变
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研究疾病代码:
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Target disease:
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Diabetic retinopathy
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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探索性研究/预试验
Pilot clinical trial
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研究目的:
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中医学认为早期糖尿病视网膜病变的病机为气阴两虚为本,瘀血阻络为标,二者相互影响;中期糖尿病视网膜病变的病机为淤血阻络为本,兼有湿阻。血瘀是加快病情发展的关键因素,血瘀则血行不畅,与西医学血流变化机理相一致。内皮细胞功能障碍是糖尿病性视网膜病变发生发展的重要环节,研究也显示内皮细胞功能障碍与中医血瘀证有密切联系,活血化瘀中药可显著改善内皮细胞功能障碍。传统中医学认为“久病入络,瘀而血行不畅”,我科眼科名老中医朱炜敏教授多年临床积累经验上,运用“因虚致瘀,因瘀致虚,血溢脉外,发为本病”的中医理论,采用活血化瘀,健脾利水之法加味桃红四物汤,汤药内服来治疗重度非增殖期糖尿病视网膜病变。对于DR的治疗,是一个复杂而系统的治疗过程。重度非增生性DRP患者需要激光联合中药改善视网膜血供,改善视网膜微循环,可有效降低致盲率,提高患者生活质量。因而对于重度非增生性DRP患者采用激光联合中药加味桃红四物汤内服的方法,以发挥中医“未病先防,既病防变”的治疗优势。
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Objectives of Study:
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Traditional Chinese medicine believes that the pathogenesis of early diabetic retinopathy is based on the deficiency of both qi and yin, and blood stasis is the target, and the two influence each other; the pathogenesis of mid-term diabetic retinopathy is based on blood congestion and collateral resistance, combined with wet resistance. Blood stasis is a key factor in accelerating the development of the disease, and blood stasis is not smooth, which is consistent with the mechanism of blood flow changes in Western medicine. Endothelial cell dysfunction is an important link in the occurrence and development of diabetic retinopathy. Studies have also shown that endothelial cell dysfunction is closely related to TCM blood stasis syndrome. Traditional Chinese medicine for promoting blood circulation and removing blood stasis can significantly improve endothelial cell dysfunction. Traditional Chinese medicine believes that "long-term illness enters the collaterals, blood stasis is not smooth". Professor Zhu Weimin, a well-known ophthalmologist in our department, has accumulated many years of clinical experience and used "blood stasis due to deficiency, deficiency due to blood stasis, bleeding outside the vein, The traditional Chinese medicine theory of "this disease" uses the method of promoting blood circulation to remove blood stasis, strengthening the spleen and promoting hydration, adding Taohong Siwu Decoction, and oral decoction to treat severe non-proliferative diabetic retinopathy. The treatment of DR is a complex and systematic treatment process. Patients with severe non-proliferative DRP need laser combined with traditional Chinese medicine to improve retinal blood supply and improve retinal microcirculation, which can effectively reduce blindness and improve the quality of life of patients. Therefore, for patients with severe non-proliferative DRP, the laser combined with traditional Chinese medicine Jiawei Taohong Siwu Decoction is taken orally to give full play to the therapeutic advantages of traditional Chinese medicine of "preventing the disease first, preventing the existing disease".
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药物成份或治疗方案详述:
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Description for medicine or protocol of treatment in detail:
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纳入标准:
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(1)病例均由内分泌科确诊为2型糖尿病患者。育龄妇女进行HCG检测。
(2)性别不限,年龄范围在20~70岁。
(3)眼底改变符合DRP国际临床分型为轻、中、重度非增生性DRP(无DME)。
(4)中医证型属于气阴两虚、血瘀阻络型。
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Inclusion criteria
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(1) All cases were diagnosed as type 2 diabetes patients by the Department of Endocrinology. Women of childbearing age undergo HCG testing.
(2) There is no restriction on gender, and the age range is 20 to 70 years old.
(3) The changes in the fundus accord with the international clinical classification of DRP as mild, moderate and severe non-proliferative DRP (without DME).
(4) The TCM syndrome type belongs to the type of deficiency of both qi and yin and blood stasis blocking the collaterals.
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排除标准:
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(1)高血糖未有效控制者(空腹血糖≥19.0mmol/L)。
(2)合并有青光眼、葡萄膜炎、重度白内障、玻璃体积血、眼底静脉阻塞、视神经炎、视网膜脱离等其他影响视力或效果观察的眼科疾病病例。
(3)合并其他脏器(如心、脑、肝)等严重疾病,或精神病患者。
(4)糖尿病肾病合并发生肾衰(尿毒症期)。
(5)妊娠、准备妊娠或哺乳期妇女。
(6)不合作及中断治疗观察者。
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Exclusion criteria:
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(1) Hyperglycemia is not effectively controlled (fasting blood glucose >= 19.0mmol/L).
(2) Cases of other ophthalmological diseases that affect vision or effect observation, such as glaucoma, uveitis, severe cataract, vitreous hemorrhage, fundus vein occlusion, optic neuritis, retinal detachment, etc.
(3) Patients with serious diseases such as other organs (such as heart, brain, liver), or mental illness.
(4) Diabetic nephropathy and renal failure (uremia stage).
(5) Women who are pregnant, preparing to become pregnant or breastfeeding.
(6) Observers who do not cooperate and interrupt treatment.
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研究实施时间:
Study execute time:
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从From
2021-03-16
至To
2022-03-16
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征募观察对象时间:
Recruiting time:
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从From
2021-03-16
至To
2022-03-16
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