目的 探讨复方血栓通胶囊联合康柏西普眼用注射液治疗糖尿病视网膜病变的临床疗效。方法 选取2019年7月—2021年10月湖北省中西医结合医院收治的72例糖尿病视网膜病变患者，共130只患眼。将72例患者按随机数字表法分为对照组和治疗组，每组各36例。对照组玻璃体内注射康柏西普眼用注射液，0.5 mg/眼，1次/月。治疗组在对照组基础上口服复方血栓通胶囊，1.5 g/次，3次/d。两组患者连续治疗3个月。观察两组的临床疗效，比较两组的眼部体征、最佳矫正视力、血流动力学、血清指标。结果 治疗后，治疗组总有效率为94.44%，比对照组总有效率77.78%高，组间比较差异有显著性（P＜0.05）。治疗后，两组的视野灰度值、出血斑面积、中心凹视网膜厚度（CMT）低于治疗前，最佳矫正视力高于治疗前（P＜0.05）；治疗组的视野灰度值、出血斑面积、CMT比对照组低，最佳矫正视力比对照组高（P＜0.05）。治疗后，两组视网膜中央动脉的平均血流速度、峰值血流速度比治疗前高，搏动指数比治疗前低（P＜0.05）；治疗组视网膜中央动脉的平均血流速度、峰值血流速度高于对照组，搏动指数低于对照组（P＜0.05）。治疗后，两组的血清中细胞间黏附分子-1（ICAM-1）、色素上皮衍生因子（PEDF）、血管内皮生长因子（VEGF）水平低于治疗前（P＜0.05）；治疗组的血清ICAM-1、PEDF、VEGF水平比对照组低，差异有统计学意义（P＜0.05）。结论 复方血栓通胶囊联合康柏西普眼用注射液治疗糖尿病视网膜病变的疗效确切，能减轻眼底症状，改善视力和血流动力学指标，调节ICAM-1、PEDF、VEGF的分泌，并且安全性良好。

Objective To investigate the clinical effect of Compound Xueshuantong Capsules combined with Conbercept Ophthalmic Injection in treatment of diabetic retinopathy.Methods Patients (72 cases, 130 affected eyes) with diabetic retinopathy in Hubei Provincial Hospital of Integrated Chinese Western Medicine from July 2019 to October 2021 were randomly divided into control and treatment groups, and each group had 36 cases. Patients in the control group were intravitreal injection with Conbercept Ophthalmic Injection, 0.5 mg/eye, once monthly. Patients in the treatment group were po administered with Compound Xueshuantong Capsules on the basis of the control group, 1.5 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and the eye signs, best corrected visual acuity, hemodynamics, and serum indexes in two groups were compared. Results After treatment, the total effective rate of the treatment group was 94.44%, which was higher than 77.78% of the control group, and there was a significant difference between two groups (P < 0.05). After treatment, the visual field gray value, bleeding spot area, and CMT of two groups were lower than those before treatment, but the best corrected visual acuity of two groups was higher than that before treatment (P < 0.05). The gray value of visual field, bleeding spot area, and CMT in the treatment group were lower than those in the control group, but the best corrected visual acuity in the treatment group was higher than that in the control group (P < 0.05). After treatment, the average blood flow velocity and peak blood flow velocity of central retinal artery in two groups were higher than those before treatment, but the pulsatility index of central retinal artery in two groups was lower than that before treatment (P < 0.05). The average blood flow velocity and peak blood flow velocity of central retinal artery in the treatment group were lower than those in the control group, but the pulsatility index of central retinal artery in two groups was lower than that in the control group (P < 0.05). After treatment, the serum levels of ICAM-1, PEDF, and VEGF in two groups were lower than those before treatment (P < 0.05). The serum levels of ICAM-1, PEDF, and VEGF in the treatment group were lower than those in the control group (P < 0.05). Conclusion Compound Xueshuantong Capsules combined with Conbercept Ophthalmic Injection has clinical curative effect in treatment of diabetic retinopathy, can reduce fundus symptoms, improve visual acuity and hemodynamic indexes, regulate the secretion of ICAM-1, PEDF and VEGF, with good safety.

R977

湖北省教育厅科学研究计划项目(B2020095)