目的 探討復方血栓通膠囊聯(lián)合康柏西普眼用注射液治療糖尿病視網膜病變的臨床療效。方法 選取2019年7月—2021年10月湖北省中西醫(yī)結合醫(yī)院收治的72例糖尿病視網膜病變患者，共130只患眼。將72例患者按隨機數(shù)字表法分為對照組和治療組，每組各36例。對照組玻璃體內注射康柏西普眼用注射液，0.5 mg/眼，1次/月。治療組在對照組基礎上口服復方血栓通膠囊，1.5 g/次，3次/d。兩組患者連續(xù)治療3個月。觀察兩組的臨床療效，比較兩組的眼部體征、最佳矯正視力、血流動力學、血清指標。結果 治療后，治療組總有效率為94.44%，比對照組總有效率77.78%高，組間比較差異有顯著性（P＜0.05）。治療后，兩組的視野灰度值、出血斑面積、中心凹視網膜厚度（CMT）低于治療前，最佳矯正視力高于治療前（P＜0.05）；治療組的視野灰度值、出血斑面積、CMT比對照組低，最佳矯正視力比對照組高（P＜0.05）。治療后，兩組視網膜中央動脈的平均血流速度、峰值血流速度比治療前高，搏動指數(shù)比治療前低（P＜0.05）；治療組視網膜中央動脈的平均血流速度、峰值血流速度高于對照組，搏動指數(shù)低于對照組（P＜0.05）。治療后，兩組的血清中細胞間黏附分子-1（ICAM-1）、色素上皮衍生因子（PEDF）、血管內皮生長因子（VEGF）水平低于治療前（P＜0.05）；治療組的血清ICAM-1、PEDF、VEGF水平比對照組低，差異有統(tǒng)計學意義（P＜0.05）。結論 復方血栓通膠囊聯(lián)合康柏西普眼用注射液治療糖尿病視網膜病變的療效確切，能減輕眼底癥狀，改善視力和血流動力學指標，調節(jié)ICAM-1、PEDF、VEGF的分泌，并且安全性良好。

Objective To investigate the clinical effect of Compound Xueshuantong Capsules combined with Conbercept Ophthalmic Injection in treatment of diabetic retinopathy.Methods Patients (72 cases, 130 affected eyes) with diabetic retinopathy in Hubei Provincial Hospital of Integrated Chinese Western Medicine from July 2019 to October 2021 were randomly divided into control and treatment groups, and each group had 36 cases. Patients in the control group were intravitreal injection with Conbercept Ophthalmic Injection, 0.5 mg/eye, once monthly. Patients in the treatment group were po administered with Compound Xueshuantong Capsules on the basis of the control group, 1.5 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and the eye signs, best corrected visual acuity, hemodynamics, and serum indexes in two groups were compared. Results After treatment, the total effective rate of the treatment group was 94.44%, which was higher than 77.78% of the control group, and there was a significant difference between two groups (P < 0.05). After treatment, the visual field gray value, bleeding spot area, and CMT of two groups were lower than those before treatment, but the best corrected visual acuity of two groups was higher than that before treatment (P < 0.05). The gray value of visual field, bleeding spot area, and CMT in the treatment group were lower than those in the control group, but the best corrected visual acuity in the treatment group was higher than that in the control group (P < 0.05). After treatment, the average blood flow velocity and peak blood flow velocity of central retinal artery in two groups were higher than those before treatment, but the pulsatility index of central retinal artery in two groups was lower than that before treatment (P < 0.05). The average blood flow velocity and peak blood flow velocity of central retinal artery in the treatment group were lower than those in the control group, but the pulsatility index of central retinal artery in two groups was lower than that in the control group (P < 0.05). After treatment, the serum levels of ICAM-1, PEDF, and VEGF in two groups were lower than those before treatment (P < 0.05). The serum levels of ICAM-1, PEDF, and VEGF in the treatment group were lower than those in the control group (P < 0.05). Conclusion Compound Xueshuantong Capsules combined with Conbercept Ophthalmic Injection has clinical curative effect in treatment of diabetic retinopathy, can reduce fundus symptoms, improve visual acuity and hemodynamic indexes, regulate the secretion of ICAM-1, PEDF and VEGF, with good safety.

R977

湖北省教育廳科學研究計劃項目(B2020095)