目的 探讨银杏叶片联合羟苯磺酸钙治疗糖尿病视网膜病变的临床疗效。方法 纳入2023年1月—2024年10月南京大学医学院附属苏州医院（苏州科技城医院）收治的116例糖尿病视网膜病变患者，按照随机数字表法分为对照组和治疗组，每组各58例。对照组饭后服用羟苯磺酸钙胶囊，0.5 g/次，3次/d。治疗组在对照组基础上饭后服用银杏叶片，2片/次，3次/d。两组疗程12周。比较两组临床疗效，治疗前后视野平均缺损（MD）、最佳矫正视力（BCVA）、眼底彩色照相指标、眼底荧光血管造影（FFA）指标、黄斑中心凹厚度（CMT）及症状自评量表（SCL-90）和视功能相关生存质量量表-25（NEI-VFQ-25）评分。结果 治疗后，治疗组总有效率是93.10%，较对照组（79.31%更高（P＜0.05）。治疗后，两组视野MD较同组治疗前显著降低，BCVA增加（P＜0.05）；治疗后，治疗组视野与视力均优于对照组（P＜0.05）。治疗后，两组眼底出血面积及硬性渗出面积均缩小，微血管瘤数量减少（P＜0.05）；治疗组患者眼底出血面积、硬性渗出面积、微血管瘤数量均低于对照组（P＜0.05）。治疗后，两组患者视网膜毛细血管无灌注区面积（RNPA）、视网膜新生血管荧光素渗漏面积（RNFLA）缩小（P＜0.05），臂-视网膜循环时间（A-Rct）缩短（P＜0.05）；治疗组均优于对照组（P＜0.05）。治疗后，两组CMT及SCL-90评分均降低，NEI-VFQ-25评分增加（P＜0.05）；治疗后，治疗组CMT及SCL-90评分、NEI-VFQ-25评分改善均优于对照组（P＜0.05）。结论 糖尿病视网膜病变采用银杏叶片联合羟苯磺酸钙治疗不仅能更显著提升患者视力、改善视野缺损，还能有效减轻眼底出血、渗出及黄斑水肿，优化视网膜微循环功能，同时在缓解患者心理症状、提升视功能相关生存质量方面表现更优。

Objective To investigate the clinical efficacy of Yinxingye Tablets combined with calcium dobesilate in treatment of diabetes retinopathy. Methods A total of 116 patients with diabetic retinopathy who were admitted to Suzhou Hospital Affiliated to Nanjing University Medical School (Suzhou Science and Technology Town Hospital) from January 2023 to October 2024 were included. They were divided into control group and treatment group according to random number table method, 58 cases in each group. Patients in control group were po administered with Calcium Dobesilate Capsules, 0.5 g/time, three times daily. Patients in treatment group were po administered with Yinxingye Tablets on the basis of control group, 2 tablets/time, three times daily. The two groups received treatment for 12 weeks. The clinical efficacy of two groups was compared. The average visual field defect (MD), best corrected visual acuity (BCVA), fundus color photography indicators, fundus fluorescein angiography (FFA) indicators, macular foveal thickness (CMT), symptom self-rating scale (SCL-90), and visual function-related quality of life scale-25 (NEI-VFQ-25) scores were evaluated before and after treatment. Results After treatment, the total effective rate of treatment group was 93.10%, which was higher than that of control group (79.31%) (P < 0.05). After treatment, the MD of visual field in both groups decreased significantly compared to that before treatment in the same group, and BCVA increased (P < 0.05). After treatment, the visual field and vision of the treatment group were better than those of control group (P < 0.05). After treatment, the areas of fundus hemorrhage and hard exudates in both groups decreased, and the number of microaneurysms reduced (P < 0.05). The areas of fundus hemorrhage, hard exudates, and the number of microaneurysms in treatment group were all lower than those in control group (P < 0.05). After treatment, the areas of retinal capillary non-perfusion zone (RNPA) and retinal neovascular fluorescein leakage area (RNFLA) in both groups decreased (P < 0.05), and the arm-retinal circulation time (A-Rct) shortened (P < 0.05). The treatment group was better than control group in all aspects (P < 0.05). After treatment, the CMT and SCL-90 scores of both groups decreased, and the NEI-VFQ-25 score increased (P < 0.05). After treatment, the CMT and SCL-90 scores, NEI-VFQ-25 scores of treatment group improved better than those of control group (P < 0.05). Conclusion The treatment of diabetic retinopathy with Yinxingye Tablets combined with calcium dobesilate not only significantly improves patients’ vision and alleviates visual impairment, but also effectively reduces fundus hemorrhage, exudation and macular edema, optimizes retinal microcirculation function, and performs better in alleviating patients’ psychological symptoms and improving the quality of life related to visual function.

R977

苏州市科技发展计划项目（SKJYD2021056）