目的 探究復(fù)方血栓通膠囊聯(lián)合前列地爾對糖尿病視網(wǎng)膜病變及對患者血清活性多肽（Apelin）和富含半胱氨酸酸性分泌蛋白（SPARC）水平的影響。方法 選取2019年6月-2020年3月間在陜西省中醫(yī)醫(yī)院接受治療的糖尿病視網(wǎng)膜病變患者80例為研究對象，按照雙盲抽簽法將患者分為對照組和觀察組，每組各40例。對照組患者緩慢靜注前列地爾注射液，10 μg溶于5%葡萄糖注射液100 mL中，1次/d。觀察組在對照組的基礎(chǔ)上口服復(fù)方血栓通膠囊，0.5 g/次，3次/d。兩組治療1個月。觀察兩組患者的臨床療效，同時比較兩組治療前后的血管瘤數(shù)量、視野灰度值、出血斑面積；超氧化物歧化酶（SOD）、總抗氧化能力（TAC）、丙二醛（MDA）、白細胞介素-2（IL-2）、腫瘤壞死因子-α（TNF-α）、白細胞介素-10（IL-10）、Apelin和富含半胱氨酸酸性分泌蛋白（SPARC）水平。結(jié)果 治療后，對照組和觀察組總有效率分別為80.0%、95.0%，兩組總有效率比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者血管瘤數(shù)量、視野灰度值以及出血斑面積均明顯下降（P<0.05）；且觀察組血管瘤數(shù)量、視野灰度值以及出血斑面積均顯著小于對照組（P<0.05）。治療后，兩組患者SOD、TAC水平均明顯升高，MDA水平明顯降低（P<0.05）；且觀察組患者的SOD及TAC水平顯著高于于對照組患者，MDA水平顯著低于對照組患者（P<0.05）。治療后，兩組患者TNF-α和IL-2水平均顯著降低，IL-10水平顯著升高（P<0.05）；且觀察組患者TNF-α和IL-2水平顯著低于對照組，IL-10水平顯著高于對照組患者（P<0.05）。治療后，兩組血清Apelin和SPARC水平均下降（P<0.05），且觀察組患者血清Apelin和SPARC水平顯著低于對照組患者（P<0.05）。結(jié)論 復(fù)方血栓通膠囊聯(lián)合前列地爾治療糖尿病視網(wǎng)膜病變可有效的降低患者的視野灰度值、血管瘤數(shù)量、出血斑面積，同時調(diào)節(jié)患者體內(nèi)應(yīng)激指標、炎性指標以及血清Apelin和SPARC水平來緩解臨床癥狀，并且相對于單一用藥，聯(lián)合用藥的療效更優(yōu)。

Objective To investigate the effects of Compound Xueshuantong Capsules combined with alprostanil on serum Apelin and SPARC levels in patients with diabetic retinopathy. Methods Eighty patients with diabetic retinopathy who received treatment in Shaanxi Hospital of Traditional Chinese Medicine from June 2019 to March 2020 were selected as the research subjects, and the patients were divided into control group and observation group according to the double-blind lottery method, with 40 cases in each group. Patients in the control group were iv administered with Alprostadil Injection, 10 μg dissolved in 5% 100 mL Glucose injection, once daily. Patients in the observation group were po administered with Compound Xueshuantong Capsules on the basis of control group, 0.5 g/time, three times daily. The two groups were treated for 1 month. The clinical efficacy of two groups was observed, and the number of hemangioma, visual field gray value, bleeding plaque area, and the levels of SOD, TAC, MDA, IL-2, TNF-α, IL-10, Apelin, and SPARC before and after treatment were compared. Results After treatment, the total effective rate of the control group and the observation group was 80.0% and 95.0%, respectively, and the difference of total effective rate between two groups was statistically significant (P<0.05). After treatment, the number of hemangioma, gray value of visual field, and area of bleeding plaques in two groups were significantly decreased (P<0.05), and the number of hemangioma, gray value of field, and area of bleeding plaque in the observation group were significantly lower than those in the control group (P<0.05). After treatment, SOD and TAC levels in two groups were significantly increased, while MDA level was significantly decreased (P<0.05), the levels of SOD and TAC in observation group were significantly higher than those in control group, and the level of MDA in observation group was significantly lower than that in control group (P<0.05). After treatment, the levels of TNF-α and IL-2 in two groups were significantly decreased, while the level of IL-10 was significantly increased (P<0.05), and the levels of TNFα and IL-2 in observation group were significantly lower than those in control group, and the level of IL-10 in observation group was significantly higher than that in control group (P<0.05). After treatment, the serum Apelin and SPARC levels in two groups were decreased (P < 0.05), and the serum Apelin and SPARC levels in observation group were significantly lower than those in control group (P<0.05). Conclusion Compound Xueshuantong Capsules combined with alprostanil in treatment of diabetic retinopathy can effectively reduce the patient's vision of grey value, number of hemangioma, plaque area, at the same time adjust the body stress index and inflammatory index, and serum levels of Apelin and SPARC to relieve the clinical symptoms, and relative to the single drug, the curative effect of combination of better.

R913