目的 探討復(fù)方丹參滴丸聯(lián)合硫辛酸治療糖尿病視網(wǎng)膜病變的臨床療效。方法 選取2021年11月—2022年7月蘇州科技城醫(yī)院門診收治的116例糖尿病視網(wǎng)膜病變患者，按隨機(jī)數(shù)字表法將所有患者分為對照組和治療組，每組各58例。對照組口服硫辛酸膠囊，0.2 g/次，3次/d。治療組在對照組基礎(chǔ)上口服復(fù)方丹參滴丸，20丸/次，3次/d。兩組療程均為3個月。觀察兩組的臨床療效，比較兩組面色晦暗、視物昏花的消失率。比較治療前后兩組最小分辨角對數(shù)（logMAR）、眼底改變指標(biāo)（微血管瘤和出血灶數(shù)）、眼底熒光血管造影檢查相關(guān)指標(biāo)[臂-視網(wǎng)膜循環(huán)時間（A-Rct）和視網(wǎng)膜毛細(xì)血管無灌注區(qū)（NPA）面積、血管滲漏（VL）面積]及黃斑水腫相關(guān)指標(biāo)[黃斑中心凹厚度（CMT）、視網(wǎng)膜體積（TMV）]。結(jié)果 治療后，治療組總有效率是91.38%，顯著高于對照組的77.59%（P＜0.05）。治療后，治療組面色晦暗消失率62.07%和視物昏花消失率50.00%均顯著高于對照組的43.10%、31.03%（P＜0.05）。治療后，兩組患者logMAR、微血管瘤數(shù)和出血灶數(shù)均顯著減少（P＜0.05）；且治療后治療組logMAR、微血管瘤數(shù)和出血灶數(shù)低于對照組（P＜0.05）。治療后，兩組A-Rct均顯著縮短，視網(wǎng)膜毛細(xì)血管NPA面積和VL面積均顯著縮小（P＜0.05）；治療后，治療組A-Rct、視網(wǎng)膜毛細(xì)血管NPA面積和VL面積均小于對照組（P＜0.05）。治療后，兩組CMT、TMV均較治療前顯著減?。?i>P＜0.05），均以治療組降低更顯著（P＜0.05）。結(jié)論 復(fù)方丹參滴丸聯(lián)合硫辛酸治療糖尿病視網(wǎng)膜病變具有確切療效，能安全有效地減輕患者視力損傷，緩解臨床癥狀，改善眼底病理改變及視網(wǎng)膜血流狀況。

Objective To investigate the clinical efficacy of Compound Danshen Dropping Pills combined with thioctic acid in treatment of diabetic retinopathy. Methods A total of 116 patients with diabetic retinopathy admitted to the outpatient department of Suzhou Science and Technology City Hospital from November 2021 to July 2022 were selected and divided into control group and treatment group according to random number table method, with 58 patients in each group. Patients in the control group were po administered with Thioctic Acid Capsules, 0.2 g/time, three times daily. Patients in the treatment group were po administered with Compound Danshen Dripping Pills on the basis of the control group, 20 pills/time, three times daily. The treatment course of both groups was 3 months. The clinical efficacy of the two groups was observed, and the disappearance rate of dull complexion and dim vision was compared. The logarithm of minimum resolution Angle (logMAR), fundus change index (number of microhemangioma and bleeding foci), fundus fluorescence angiography related index [arm-retinal circulation time (A-Rct), retinal capillary non-perfusion area (NPA), vascular leakage (VL) area] and macular edema related index [Macular fovea thickness (CMT) and retinal volume (TMV)] were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 91.38%, significantly higher than that of the control group (77.59%) (P < 0.05). After treatment, the disappearance rate of complexion dull 62.07% and visual faintness 50.00% in the treatment group were significantly higher than those in the control group (43.10% and 31.03%, P < 0.05). After treatment, logMAR, the number of microhemangioma and the number of bleeding foci were significantly decreased in 2 groups (P < 0.05). The number of logMAR, microhemangioma and bleeding focus in the treatment group were lower than those in the control group after treatment (P < 0.05). After treatment, A-Rct was significantly shortened, and retinal capillary NPA area and VL area were significantly reduced in both groups (P < 0.05). After treatment, A-Rct, retinal capillary NPA area and VL area in the treatment group were smaller than those in the control group (P < 0.05). After treatment, CMT and TMV in 2 groups were significantly decreased compared with before treatment (P < 0.05), and the decrease was more significant in the treatment group (P < 0.05). Conclusion Compound Danshen Dropping Pills combined with thioctic acid has definite curative effect in treatment of diabetic retinopathy, and can safely and effectively reduce visual impairment of patients, relieve clinical symptoms, which can improve fundus pathological changes and retinal blood flow.

R977;R988.1

吳階平醫(yī)學(xué)基金會臨床科研專項資助基金（320.6750.18528）