目的 探讨芪明颗粒联合雷珠单抗治疗糖尿病性黄斑水肿的临床疗效。方法 选取2015年3月-2016年3月在上海市闵行区中心医院进行治疗的糖尿病性黄斑水肿患者90例，根据治疗方案的差别分为对照组（45例）和治疗组（45例）。对照组患者玻璃体腔内注射雷珠单抗注射液，0.5 mg/次，1次/月。治疗组在对照组的基础上口服芪明颗粒，1袋/次，3次/d。两组患者均连续治疗6个月。评价两组患者临床疗效，比较治疗前后两组患者最佳矫正视力（BCVA）、黄斑中央视网膜厚度（CMT）和玻璃体液中细胞因子。结果 治疗后，对照组的总有效率为80.00%，显著低于治疗组的95.56%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血管内皮生长因子（VEGF）和白细胞介素-6（IL-6）水平均明显降低，而色素上皮衍生因子（PEDF）水平显著升高，同组比较差异具有统计学意义（P<0.05）；且治疗后治疗组上述指标水平显著优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组BCVA显著升高，CMT显著降低，同组比较差异具有统计学意义（P<0.05）；且治疗后治疗组BCVA和CMT改善更显著，两组比较差异具有统计学意义（P<0.05）。结论 芪明颗粒联合雷珠单抗治疗糖尿病性黄斑水肿效果显著，可明显改善患者视力，促进黄斑水肿恢复，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Qiming Granules combined with ranibizumab in treatment of diabetic macular edema. Methods Patients (90 cases) with diabetic macular edema in Central Hospital of Minhang District of Shanghai from March 2015 to March 2016 were divided into control (45 cases) and treatment (45 cases) groups based on different treatments. Patients in the control group were intravitreal injection of Ranibizumab Injections, 0.5 mg/time, once a month. Patients in the treatment group were po administered with Qiming Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, BCVA, CMT, and cytokines of vitreous humor in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.00%, which was significantly lower than 95.56% in the treatment group, with significant difference between two groups (P<0.05). After treatment, the VEGF and IL-6 levels in two groups were significantly decreased, PEDF was significantly increased, and there were differences in the same group (P<0.05). And the indicators levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, BCVA in two groups was significantly increased, CMT was significantly decreased, and the difference was statistically significant in the same group (P<0.05). And BCVA and CMT in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Qiming Granules combined with ranibizumab has significant effect in treatment of diabetic macular edema, can significantly improve the patient's vision and reduce macular edema, which has a certain clinical application value.