目的 探討長(zhǎng)春胺緩釋膠囊聯(lián)合羥苯磺酸鈣分散片治療非增殖期糖尿病視網(wǎng)膜病變的臨床效果。方法 選取2015年3月—2018年12月遼寧省人民醫(yī)院治療的200例非增殖期糖尿病視網(wǎng)膜病變患者（共383只患眼）作為研究對(duì)象，采用隨機(jī)數(shù)字表法將患者其隨機(jī)分成觀察組（n=100例，195眼）與對(duì)照組（n=100例，188眼）。對(duì)照組患者口服羥苯磺酸鈣分散片，2片/次，3次/d。觀察組在對(duì)照組基礎(chǔ)上口服長(zhǎng)春胺緩釋膠囊，1粒/次，2次/d。兩組均治療3個(gè)月。觀察兩組臨床療效，比較兩組治療前后的最佳矯正中心視力（BCVA）、眼底檢查相關(guān)指標(biāo)、血流變學(xué)指標(biāo)、視網(wǎng)膜中央動(dòng)脈血流動(dòng)力學(xué)參數(shù)及不良反應(yīng)發(fā)生情況。結(jié)果 治療后，觀察組總有效率為94.9%，顯著高于對(duì)照組的87.2%（P<0.05）。兩組治療后BCVA較治療前均顯著提高，黃斑中心凹視網(wǎng)膜厚度（CMT）均顯著減小，微血管瘤數(shù)則均顯著減少，而視網(wǎng)膜血管滲漏（VL）、毛細(xì)血管無(wú)灌注區(qū)（CNP）面積均顯著縮小，視網(wǎng)膜平均循環(huán)時(shí)間（MCT）均顯著縮短（P<0.05）；且觀察組治療后BCVA和眼底檢查相關(guān)參數(shù)的改善效果均更顯著（P<0.05）。與治療前相比，兩組治療后紅細(xì)胞聚集指數(shù)（RCAI）、血漿黏度（PV）均顯著下降，而紅細(xì)胞變形指數(shù)（RDI）均顯著升高（P<0.05）；且治療后，觀察組RCAI、PV均顯著低于對(duì)照組同期，RDI則顯著更高（P<0.05）。兩組治療后患眼視網(wǎng)膜中央動(dòng)脈收縮期峰值（PSV）、舒張末期血流速度（EDV）較治療前均顯著增高，阻力指數(shù)（RI）則均顯著降低（P<0.05）；治療后，觀察組患眼視網(wǎng)膜中央動(dòng)脈各項(xiàng)血流動(dòng)力學(xué)參數(shù)的改善效果均更顯著（P<0.05）。治療期間，觀察組不良反應(yīng)發(fā)生率為5.0%，與對(duì)照組的3.0%比較，差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 長(zhǎng)春胺緩釋膠囊聯(lián)合羥苯磺酸鈣分散片治療非增殖期糖尿病視網(wǎng)膜病變的整體療效良好，有助于提高患者視力，改善眼底病變，糾正體內(nèi)血流變學(xué)異常，改善視網(wǎng)膜血流動(dòng)力學(xué)，且安全可靠，值得臨床推廣應(yīng)用。

Objective To investigate the clinical effect of Vincamine Sustained Release Capsules combined with Calcium Dobesilate Dispersible Tablets in treatment of non-proliferative diabetic retinopathy. Methods A total of 200 patients with non-proliferative diabetic retinopathy (383 eyes) admitted to The People's Hospital of Liaoning Province from March 2015 to December 2018 were selected, and randomly divided into observation group (n=100 cases, 195 eyes) and control group (n=100 cases, 188 eyes) by random number table method. The control group was treated with Calcium Dobesilate Dispersible Tablets, 2 tablets/time, three times daily. Patients in observation group was po administered with Vincamine Sustained Release Capsules on the basis of control group, 1 grains/time, twice daily. All patients were treated for 3 months. After treatment, the clinical effects in two groups were observed, and the BCVA, fundus examination related indexes, hemorheological indexes, PV, central retinal artery hemodynamic parameters, and adverse reaction before and after treatment were compared. Results After treatment, the total effective rate in the observation group was 94.9%, which was significantly higher than 87.2% in the control group (P < 0.05). After treatment, BCVA in two groups were significantly increased, CMT were significantly decreased, the number of microangiomas was significantly decreased, while the VL, CNP area were significantly reduced, and the MCT were significantly shortened (P < 0.05). And the improvement effect of BCVA and fundus examination related parameters in the observation group after treatment was more significant (P < 0.05). Compared with treatment before, RCAI and PV in two groups were decreased significantly, but the RDI were increased (P < 0.05). After treatment, the RCAI and PV in the observation group were significantly lower than those in the control group, while RDI was significantly higher than those in the control group (P < 0.05). After treatment, PSV and EDV of central retinal artery in two groups were significantly higher than those before treatment, while RI were significantly decreased (P < 0.05). After treatment, the improvement effect of various hemodynamic parameters of the central retinal artery in the observation group was more significant (P < 0.05). During the treatment, the adverse reaction rate in the observation group was 5.0%, which was not significantly different between 3.0% in the control group. Conclusion Vincamine Sustained Release Capsules combined with Calcium Dobesilate Dispersible Tablets has a good effect in treatment of non-proliferative diabetic retinopathy, which is conducive to improving patients' vision, improving fundus lesions, correcting hemorheology anomalies in vivo, and retinal hemodynamics. It is safe and reliable, and worthy of clinical promotion and application.

R988.1