目的 探討芪明顆粒聯(lián)合雷珠單抗治療糖尿病性黃斑水腫的臨床療效。方法 選取2015年3月-2016年3月在上海市閔行區(qū)中心醫(yī)院進(jìn)行治療的糖尿病性黃斑水腫患者90例，根據(jù)治療方案的差別分為對照組（45例）和治療組（45例）。對照組患者玻璃體腔內(nèi)注射雷珠單抗注射液，0.5 mg/次，1次/月。治療組在對照組的基礎(chǔ)上口服芪明顆粒，1袋/次，3次/d。兩組患者均連續(xù)治療6個(gè)月。評價(jià)兩組患者臨床療效，比較治療前后兩組患者最佳矯正視力（BCVA）、黃斑中央視網(wǎng)膜厚度（CMT）和玻璃體液中細(xì)胞因子。結(jié)果 治療后，對照組的總有效率為80.00%，顯著低于治療組的95.56%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血管內(nèi)皮生長因子（VEGF）和白細(xì)胞介素-6（IL-6）水平均明顯降低，而色素上皮衍生因子（PEDF）水平顯著升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組上述指標(biāo)水平顯著優(yōu)于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組BCVA顯著升高，CMT顯著降低，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組BCVA和CMT改善更顯著，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 芪明顆粒聯(lián)合雷珠單抗治療糖尿病性黃斑水腫效果顯著，可明顯改善患者視力，促進(jìn)黃斑水腫恢復(fù)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Qiming Granules combined with ranibizumab in treatment of diabetic macular edema. Methods Patients (90 cases) with diabetic macular edema in Central Hospital of Minhang District of Shanghai from March 2015 to March 2016 were divided into control (45 cases) and treatment (45 cases) groups based on different treatments. Patients in the control group were intravitreal injection of Ranibizumab Injections, 0.5 mg/time, once a month. Patients in the treatment group were po administered with Qiming Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, BCVA, CMT, and cytokines of vitreous humor in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.00%, which was significantly lower than 95.56% in the treatment group, with significant difference between two groups (P<0.05). After treatment, the VEGF and IL-6 levels in two groups were significantly decreased, PEDF was significantly increased, and there were differences in the same group (P<0.05). And the indicators levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, BCVA in two groups was significantly increased, CMT was significantly decreased, and the difference was statistically significant in the same group (P<0.05). And BCVA and CMT in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Qiming Granules combined with ranibizumab has significant effect in treatment of diabetic macular edema, can significantly improve the patient's vision and reduce macular edema, which has a certain clinical application value.