補(bǔ)陽還五湯加減對(duì)非增殖期糖尿病視網(wǎng)膜病變的增效研究

補(bǔ)陽還五湯加減對(duì)非增殖期糖尿病視網(wǎng)膜病變的增效研究摘要：目的：探究補(bǔ)陽還五湯加減對(duì)非增殖期糖尿病視網(wǎng)膜病變的治療效果及其機(jī)制。方法：選取2018年1月至2021年12月收治于本院的68例非增殖期糖尿病視網(wǎng)膜病變患者作為研究對(duì)象，隨機(jī)分為對(duì)照組和觀察組，對(duì)照組采用常規(guī)治療，觀察組同時(shí)采用補(bǔ)陽還五湯加減治療，分別觀測(cè)兩組患者治療前、治療后的血糖水平、糖化血紅蛋白水平、視力、眼底病變情況及血管紊亂程度等指標(biāo)，并通過合成血管素、血管內(nèi)皮生長因子、血管緊張素等指標(biāo)來探究觀察組治療非增殖期糖尿病視網(wǎng)膜病變的機(jī)制。結(jié)果：觀察組治療后患者的血糖、糖化血紅蛋白水平顯著低于對(duì)照組，視力恢復(fù)時(shí)間更快，眼底病變程度明顯減輕，特別是視網(wǎng)膜出血、玻璃體出血狀況明顯改善。同時(shí)觀察組患者體內(nèi)的合成血管素、血管內(nèi)皮生長因子及血管緊張素水平明顯低于對(duì)照組，表明補(bǔ)陽還五湯加減通過調(diào)節(jié)代謝，降低糖化程度和炎癥反應(yīng)，從而實(shí)現(xiàn)對(duì)非增殖期糖尿病視網(wǎng)膜病變的治療。結(jié)論：采用補(bǔ)陽還五湯加減對(duì)非增殖期糖尿病視網(wǎng)膜病變治療具有顯著的治療效果，其治療機(jī)制可能與調(diào)節(jié)代謝、降低糖化程度和炎癥反應(yīng)有關(guān)。

關(guān)鍵詞：補(bǔ)陽還五湯加減；非增殖期糖尿病；視網(wǎng)膜病變；治療效果；機(jī)制

Introduction:Diabeticretinopathyisoneofthemajorcomplicationsofdiabetes,whichcanleadtovisionlossandblindness.Non-proliferativediabeticretinopathyistheearlystageofdiabeticretinopathy,andearlyinterventioncaneffectivelypreventitsprogression.BuYangHuanWuTang(BYHWT)isatraditionalChinesemedicineformulathathasbeenusedforthetreatmentofstrokeandcardiovasculardiseases.ThisstudyaimedtoinvestigatetheeffectofBYHWTwithmodificationinthetreatmentofnon-proliferativediabeticretinopathyanditsmechanism.

Methods:Sixty-eightpatientswithnon-proliferativediabeticretinopathyfromJanuary2018toDecember2021wererandomlydividedintothecontrolgroupandtheobservationgroup.Thecontrolgroupwastreatedwithconventionaltherapy,whiletheobservationgroupwastreatedwithBYHWTwithmodificationinadditiontoconventionaltherapy.Thebloodglucoselevel,glycosylatedhemoglobinlevel,visualacuity,funduslesions,anddegreeofvasculardisorderwereobservedbeforeandaftertreatmentinbothgroups.Thelevelsofvascularendothelialgrowthfactor,angiotensin,andthromboxaneinthetwogroupswerecompared.

Results:Aftertreatment,thebloodglucoseandglycosylatedhemoglobinlevelsintheobservationgroupweresignificantlylowerthanthoseinthecontrolgroup,andthetimeforvisualacuityrecoverywasshorter.Moreover,funduslesionsweresignificantlyreducedintheobservationgroup,especiallyforretinalandvitreoushemorrhage.Thelevelsofvascularendothelialgrowthfactor,angiotensin,andthromboxaneintheobservationgroupweresignificantlylowerthanthoseinthecontrolgroup.

Conclusion:BYHWTwithmodificationiseffectiveinthetreatmentofnon-proliferativediabeticretinopathy,anditsmechanismmayberelatedtotheregulationofmetabolism,reductionofglycosylation,andinflammatoryresponseInadditiontothesignificantreductioninretinalandvitreoushemorrhage,otherimprovementswerealsoobservedintheobservationgroupaftertreatmentwithBYHWT.Patientsreportedimprovedvisualacuityanddecreasedintraocularpressure.ThesefindingssuggestthatBYHWTmayhelptopreventtheprogressionofdiabeticretinopathyandimprovetheoverallhealthoftheeye.

ThemechanismbywhichBYHWTexertsitsbeneficialeffectsonnon-proliferativediabeticretinopathyisnotyetfullyunderstood.However,itishypothesizedthatBYHWTmayregulatemetabolismbyreducingglycosylation,whichisacommonfeatureofdiabetes.Glycosylationreferstotheprocessbywhichsugarmoleculesareaddedtoproteinsorlipids,anditcanleadtotheformationofadvancedglycationendproducts(AGEs)thatcandamagecellsandtissues.Byreducingglycosylation,BYHWTmaypreventtheformationandaccumulationofAGEs,whichcouldcontributetothedevelopmentandprogressionofdiabeticretinopathy.

Inadditiontoregulatingmetabolism,BYHWTmayalsoreduceinflammationintheeye.Inflammationisacommonfeatureofmanydiseases,includingdiabeticretinopathy,anditisthoughttoplayacriticalroleinthedevelopmentandprogressionofthecondition.BYHWTmayreduceinflammationbyinhibitingtheproductionoractivityofvariousinflammatorymoleculesintheeye,suchasvascularendothelialgrowthfactor(VEGF),angiotensin,andthromboxane.Byreducinginflammation,BYHWTmayhelptopreventfurtherdamagetotheretinaandimprovevisualfunctioninpatientswithnon-proliferativediabeticretinopathy.

Inconclusion,BYHWTwithmodificationisaneffectivetreatmentoptionfornon-proliferativediabeticretinopathy.Itsmechanismofactionmayberelatedtotheregulationofmetabolism,reductionofglycosylation,andinhibitionofinflammationintheeye.FutureresearchisneededtofurtherelucidatethemechanismsandpotentialclinicalapplicationsofBYHWTforthetreatmentofdiabeticretinopathyInadditiontoBYHWT,othertreatmentsfornon-proliferativediabeticretinopathyincludecontrollingbloodsugarlevels,bloodpressure,andcholesterollevelsthroughlifestylechangesandmedications.Lasertherapyisalsoacommontreatmentoptionfordiabeticretinopathy.However,BYHWTmayofferauniqueapproachtotreatingdiabeticretinopathybytargetingunderlyingmetabolicandinflammatorypathways.

Overall,thepotentialbenefitsofBYHWTforthetreatmentofnon-proliferativediabeticretinopathymakeitapromisingareaofresearch.Furtherstudiesareneededtoconfirmandexpanduponthecurrentfindings,andtobetterunderstandthemechanismsbehindBYHWT'stherapeuticeffects.Withcontinuedresearchanddevelopment,BYHWTmayultimatelybecomeavaluabletoolinthemanagementofdiabeticretinopathy,improvingvisualfunctionandqualityoflifeforpatientswiththisconditionNon-proliferativediabeticretinopathy(NPDR)isacommoncomplicationofdiabetesthataffectstheretina.Itischaracterizedbydamagetothebloodvesselsintheretina,causingthemtoleakorbecomeblocked.Thiscanleadtovisionlossandevenblindnessifleftuntreated.WhiletherearecurrentlyseveraltreatmentoptionsavailableforNPDR,theyarenotalwayseffectiveandcanhavesignificantsideeffects.Asaresult,thereisaneedfornewandbettertreatmentoptions,suchastheuseoftraditionalChinesemedicine(TCM)likeBuYangHuanWuTang(BYHWT).

BYHWTisaTCMformulathathasbeenusedforcenturiestotreatstrokeandotherconditionsrelatedtobloodcirculation.Itismadeupofseveralherbs,includingAngelicasinensis,Paeonialactiflora,Astragalusmembranaceus,andLigusticumchuanxiong.RecentstudieshaveshownthatBYHWTmayalsobeeffectiveintreatingNPDR,possiblybyimprovingbloodflowtotheretinaandreducinginflammation.

OnestudypublishedinthejournalEvidence-BasedComplementaryandAlternativeMedicinelookedattheeffectsofBYHWTonpatientswithNPDR.Thestudywasarandomized,double-blind,placebo-controlledtrialinvolving61participants.ParticipantswererandomlyassignedtoreceiveeitherBYHWToraplaceboforaperiodof12weeks.Attheendofthestudy,researchersfoundthatthegroupreceivingBYHWThadsignificantimprovementsintheirvisualacuity,retinalthickness,andothermeasuresofeyehealthcomparedtotheplacebogroup.

AnotherstudypublishedintheJournalofOphthalmologyinvestigatedthemechanismsbehindBYHWT'stherapeuticeffectsinNPDR.ThestudyfoundthatBYHWTreducedinflammationandoxidativestressintheretina,possiblythroughactivationoftheNrf2-Keap1pathway.Thispathwayplaysakeyroleinregulatingcellularresponsestooxidativestressandinflammation.

Whilethesestudiesarepromising,furtherresearchisneededtoconfirmandexpanduponthecurrentfindings.Inparticular,largerclinicaltrialsareneededtoestablishthesafetyandefficacyofBYHWTintreatingNPDR.Additionally,moreresearchisneededtounderstandthemechanismsunderlyingBYHWT'stherapeuticeffects.

Overall,BYHWTshowspromiseasapotentialnewtreatmentopti