目的：探讨人参皂苷Rg1注射剂联合肌苷片和维生素B₁对原发性视网膜色素变性的血清脑源性神经营养因子(BDNF)、垂体腺苷酸环化酶激活多肽(PACAP)影响及临床疗效。

方法：纳入2019-08/2022-03河北北方学院附属第二医院眼科收治的50例100眼原发性视网膜色素变性患者作为研究对象，按随机数字表分为研究组和对照组，各50眼。对照组患者给予肌苷片和维生素B₁治疗，研究组患者给予人参皂苷Rg1注射剂联合肌苷片和维生素B₁治疗。比较治疗前后两组血清BDNF和PACAP表达、视网膜电图、光谱域光学相干断层扫描(SD-OCT)检查黄斑中心凹为圆点直径1mm范围视网膜厚度(RT)、视野平均缺失(MD)及临床疗效及安全性指标。

结果：治疗前，两组MD比较无差异(t=1.670，P=0.098)。治疗后，研究组MD显著低于对照组(t=3.628，P<0.01)； 治疗前，两组黄斑中心凹为圆点直径1mm范围RT比较无差异(t=0.108，P=0.914)。治疗后，研究组黄斑中心凹为圆点直径1mm范围RT显著高于对照组(t=6.125，P<0.01)； 治疗前，两组各项视网膜电图暗适应的结果比较无差异(均P>0.05)。治疗后，研究组各项暗视网膜电图暗适应的结果改善均显著优于对照组(均P<0.01)。治疗前，两组各项视网膜电图明适应的结果比较无差异(均P>0.05)。治疗后，研究组各项视网膜电图明适应的结果改善显著优于对照组(均P<0.01)。治疗前，两组BDNF、PACAP比较无差异(均P>0.05)； 治疗后，研究组BDNF、PACAP高于对照组(均P<0.01)。治疗后，两组均未见任何的不良反应。

结论：原发性视网膜色素变性患者采用人参皂苷治疗可通过调节BDNF和PACAP的表达，改善患者视网膜功能，促进病情转归，且安全性高。

METHODS: A total of 50 patients(100 eyes)with primary retinitis pigmentosa who admitted to the Department of Ophthalmology, the Second Affiliated Hospital of Hebei North University from August 2019 to March 2022 were selected as the research object. They were divided into the study group and the control group according to random number table, with 50 eyes in each group. Patients in the control group were treated with inosine tablets and vitamin B₁, while patients in the study group were treated with ginsenoside Rg1 injection on the basis of the control group. The expression of BDNF and PACAP in serum, electroretinogram and spectral-domain optical coherence tomography(SD-OCT)were compared before and after treatment, and the retinal thickness(RT), mean deviation(MD), clinical efficacy and safety indexes were compared between the two groups.

RESULTS: There were no differences in the MD of the two groups before treatment(t=1.670, P=0.098), while the MD of the study group was significantly lower than that of the control group after treatment(t=3.628, P<0.01). Before treatment, RT with a diameter of 1mm at the circle of macular fovea was compared between the two groups(t=0.108, P=0.914), it was significantly higher than that in the control group after treatment(t=6.125, P<0.01). Before treatment, there was no significant difference in the results of dark adaptation of electroretinogram between the two groups(all P>0.05). After treatment, the results of dark adaptation in the study group were significantly better than those in the control group(all P<0.01). Before treatment, there was no significant difference in the results of electroretinogram adaptation between the two groups(all P>0.05). After treatment, the results of electroretinogram adaptation in the study group were significantly better than those in the control group(all P<0.01). There was no significant difference in BDNF and PACAP between the two groups before treatment(all P>0.05). BDNF and PACAP in the study group were higher than those of the control group after treatment(all P<0.01). After treatment, no adverse reactions were observed in both groups.

CONCLUSION: The treatment of patients with primary retinitis pigmentosa with ginsenoside will improve the retinal function and promote the prognosis of the disease by regulating the expression of BDNF and PACAP, and it is highly safe.