目的 观察和血明目片联合前列地尔治疗糖尿病视网膜病变的临床疗效。方法 选择天津市宁河区医院2018年6月—2020年8月收治的97例糖尿病视网膜病变患者，采用信封抽签法将患者分为对照组（48例）和治疗组（49例）。对照组静脉滴注注射用前列地尔，10 μg加入100 mL生理盐水中，1次/d。治疗组在对照组的基础上口服和血明目片，5片/次，3次/d。两组患者均治疗3个月。观察两组患者临床疗效，比较治疗前后两组患者炎症因子白细胞介素-2（IL-2）、肿瘤坏死因子-α（TNF-α）和IL-10水平，及眼动脉血流动力学、血管瘤数量、视野灰度值和出血斑面积。结果 治疗后，治疗组患者总有效率明显高于对照组（91.84%vs 70.83%，P＜0.05）。治疗后，两组IL-2、TNF-α水平明显降低，而IL-10明显升高（P＜0.05），且治疗组明显好于对照组（P＜0.05）。治疗后，两组阻力指数（RI）、搏动指数（PI）明显降低，而动脉舒张末期容积（Edv）、收缩期峰值血流速度（Psv）明显升高（P＜0.05），且治疗组眼动脉血流动力学指标明显好于对照组（P＜0.05）。治疗后，两组血管瘤数量、视野灰度值和出血斑面积明显小于治疗前（P＜0.05），且治疗组患者明显小于对照组（P＜0.05）。结论 和血明目片联合前列地尔治疗糖尿病视网膜病变，可维持视网膜血流稳定，降低炎症因子水平，改善视网膜微循环，减轻眼底病变，安全有效。

Objective To observe the clinical efficacy of Hexue Mingmu Tablets combined with alprostadil in treatment of diabetic retinopathy.Methods Patients (97 cases) with diabetic retinopathy in Tianjin Ninghe District Hospital from June 2018 to August 2020 were divided into control (48 cases) and treatment (49 cases) group based on envelope drawing method. Patients in the control group were iv administered with Alprostadil for injection, 10 μg added into normal saline 100 mL, once daily. Patients in the treatment group were po administered with Hexue Mingmu Tablets on the basis of the control group, 5 tablets/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical evaluation was evaluated, the levels of inflammatory factor IL-2, TNF-α and IL-10, the ophthalmic artery hemodynamic indexes, number of hemangioma, the gray value of visual field and the area of bleeding spot in two groups before and after treatment were compared.Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (91.84% vs 70.83%, P < 0.05). After treatment, the levels of IL-2 and TNF-α in two groups were significantly decreased, while IL-10 were significantly increased (P < 0.05), and the levels of inflammatory factor in the treatment group were significantly better than those of the control group (P < 0.05). After treatment, the RI and PI were significantly decreased, while the Edv and Psv were significantly increased in two groups (P < 0.05), and he ophthalmic artery hemodynamic indexes in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the number of hemangioma, the gray value of visual field and the area of bleeding spot in two groups were significantly smaller than those before treatment (P < 0.05), and the indexes in the treatment group were significantly smaller than those in the control group (P < 0.05).Conclusion Hexue Mingmu Tablets combined with alprostadil in treatment of diabetic retinopathy can maintain the stability of retinal blood flow, reduce the level of inflammatory factors, improve retinal microcirculation, and reduce fundus lesions with safety and efficacy.

R988.1

天津市科技计划项目(17ZXHLSY00040)