目的 探讨杞菊地黄丸联合银杏叶提取物注射液治疗非增殖期糖尿病视网膜病变患者的临床疗效。方法 选取2018年1月—2019年6月开封市中医院收治的非增殖期糖尿病视网膜病变患者126例，随机分为对照组和治疗组，每组各63例。对照组患者iv银杏叶提取物注射液，70 mg加入250 mL生理盐水中，1次/d。治疗组在对照组的基础上口服杞菊地黄丸，8丸/次，3次/d。2周为1个疗程，每个疗程间隔2 d，两组均治疗2个疗程。观察两组临床疗效，同时比较治疗前后两组视网膜中央动脉收缩期峰值流速（PSV）、舒张末期血流速度（EDV）、平均血流速度（V_m）、肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）、可溶性细胞间黏附分子-1（sICAM-1）、谷胱甘肽过氧化物酶（GSH-Px）、总抗氧化能力（TAOC）、晚期氧化蛋白产物（AOPP）、血管内皮生长因子（VEGF）和色素上皮细胞衍生因子（PEDF）水平。结果 治疗后，对照组临床有效率79.36%，显著低于治疗组的93.65%，两组比较差异有统计学意义（P<0.05）。治疗后，两组CRV、RI、PI、TNF-α、sICAM-1、IL-6、OPP和EGF明显降低（P<0.05），而PSV、EDV、V_m、SH-Px、TAOC和EDF较治疗前明显升高（P<0.05），且治疗后治疗组这些指标水平明显优于对照组（P<0.05）。结论 杞菊地黄丸联合银杏叶提取物注射液治疗糖尿病视网膜病变患者具有良好的临床疗效，可抑制炎症反应、氧化应激反应、血管新生，具有一定的临床推广应用价值。

Objective To explore the clinical effect of Qiju Dihuang Pills combined with extract of Extract of Ginkgo Biloba Leaves Injection in treatment of nonproliferative diabetic retinopathy. Methods Patients (126 cases) with nonproliferative diabetic retinopathy in Kaifeng Hospital of TCM from January 2018 to June 2019 were randomly divided into control and treatment groups, and each group had 63 cases. Patients in the control group were iv administered with Extract of Ginkgo Biloba Leaves Injection, 70 mg added into normal saline 250 mL, once daily. Patients in the treatment group were po administered with Qiju Dihuang Pills on the basis of the control group, 8 pills/time, three times daily. 2 weeks for a course of treatment, each course interval of 2 d, and patients in two groups were treated for 2 courses of treatment. After treatment, the clinical efficacy was evaluated, and the levels of PSV, EDV, V_m, TNF-α, sICAM-1, IL-6, GSH-Px, TAOC AOPP and PEDF in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 79.36%, which was significantly lower than 93.65% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the levels of CRV, RI PI, TNF-α, sICAM-1, IL-6, OPP and EGF in two groups were significantly decreased (P<0.05), but the levels of PSV, EDV, V_m, SH-Px, TAOC and EDF were significantly increased (P<0.05), and these indexes levels in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Qiju Dihuang Pills combined with Extract of Ginkgo Biloba Leaves Injection in treatment of nonproliferative diabetic retinopathy has a good clinical effect,can inhibit inflammatory reaction, oxidative stress reaction, angiogenesis, which has a certain clinical application value.

R977