目的 觀察和血明目片聯(lián)合前列地爾治療糖尿病視網(wǎng)膜病變的臨床療效。方法 選擇天津市寧河區(qū)醫(yī)院2018年6月—2020年8月收治的97例糖尿病視網(wǎng)膜病變患者，采用信封抽簽法將患者分為對(duì)照組（48例）和治療組（49例）。對(duì)照組靜脈滴注注射用前列地爾，10 μg加入100 mL生理鹽水中，1次/d。治療組在對(duì)照組的基礎(chǔ)上口服和血明目片，5片/次，3次/d。兩組患者均治療3個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者炎癥因子白細(xì)胞介素-2（IL-2）、腫瘤壞死因子-α（TNF-α）和IL-10水平，及眼動(dòng)脈血流動(dòng)力學(xué)、血管瘤數(shù)量、視野灰度值和出血斑面積。結(jié)果 治療后，治療組患者總有效率明顯高于對(duì)照組（91.84%vs 70.83%，P＜0.05）。治療后，兩組IL-2、TNF-α水平明顯降低，而IL-10明顯升高（P＜0.05），且治療組明顯好于對(duì)照組（P＜0.05）。治療后，兩組阻力指數(shù)（RI）、搏動(dòng)指數(shù)（PI）明顯降低，而動(dòng)脈舒張末期容積（Edv）、收縮期峰值血流速度（Psv）明顯升高（P＜0.05），且治療組眼動(dòng)脈血流動(dòng)力學(xué)指標(biāo)明顯好于對(duì)照組（P＜0.05）。治療后，兩組血管瘤數(shù)量、視野灰度值和出血斑面積明顯小于治療前（P＜0.05），且治療組患者明顯小于對(duì)照組（P＜0.05）。結(jié)論 和血明目片聯(lián)合前列地爾治療糖尿病視網(wǎng)膜病變，可維持視網(wǎng)膜血流穩(wěn)定，降低炎癥因子水平，改善視網(wǎng)膜微循環(huán)，減輕眼底病變，安全有效。

Objective To observe the clinical efficacy of Hexue Mingmu Tablets combined with alprostadil in treatment of diabetic retinopathy.Methods Patients (97 cases) with diabetic retinopathy in Tianjin Ninghe District Hospital from June 2018 to August 2020 were divided into control (48 cases) and treatment (49 cases) group based on envelope drawing method. Patients in the control group were iv administered with Alprostadil for injection, 10 μg added into normal saline 100 mL, once daily. Patients in the treatment group were po administered with Hexue Mingmu Tablets on the basis of the control group, 5 tablets/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical evaluation was evaluated, the levels of inflammatory factor IL-2, TNF-α and IL-10, the ophthalmic artery hemodynamic indexes, number of hemangioma, the gray value of visual field and the area of bleeding spot in two groups before and after treatment were compared.Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (91.84% vs 70.83%, P < 0.05). After treatment, the levels of IL-2 and TNF-α in two groups were significantly decreased, while IL-10 were significantly increased (P < 0.05), and the levels of inflammatory factor in the treatment group were significantly better than those of the control group (P < 0.05). After treatment, the RI and PI were significantly decreased, while the Edv and Psv were significantly increased in two groups (P < 0.05), and he ophthalmic artery hemodynamic indexes in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the number of hemangioma, the gray value of visual field and the area of bleeding spot in two groups were significantly smaller than those before treatment (P < 0.05), and the indexes in the treatment group were significantly smaller than those in the control group (P < 0.05).Conclusion Hexue Mingmu Tablets combined with alprostadil in treatment of diabetic retinopathy can maintain the stability of retinal blood flow, reduce the level of inflammatory factors, improve retinal microcirculation, and reduce fundus lesions with safety and efficacy.

R988.1

天津市科技計(jì)劃項(xiàng)目(17ZXHLSY00040)