目的 探討益脈康分散片聯(lián)合胰激肽原酶治療糖尿病視網(wǎng)膜病變的臨床療效。方法 選取2014年1月-2016年1月上海市楊浦區(qū)五角場鎮(zhèn)社區(qū)衛(wèi)生服務(wù)中心收治的糖尿病視網(wǎng)膜病變患者88例，根據(jù)治療方法不同分成對照組和治療組，每組各44例。對照組口服胰激肽原酶腸溶片，2片/次，3次/d。治療組在對照組基礎(chǔ)上口服益脈康分散片，2片/次，3次/d。兩組患者均治療3個月。觀察兩組的臨床療效，比較兩組的血液流變學(xué)、血糖、血脂及眼部血流動力學(xué)情況。結(jié)果 治療后，對照組和治療組的總有效率分別為81.82%、95.45%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組血細(xì)胞比容（HCT）、纖維蛋白原（FIB）、紅細(xì)胞聚集指數(shù)（RF）、全血高切黏度（HS）均顯著下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的降低程度明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組三酰甘油和總膽固醇均顯著下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的降低程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組眼動脈（OA）、視網(wǎng)膜中央動脈（CRA）、睫狀后動脈（PCA）的收縮期峰值流速（PSV）和舒張末期流速（EDV）均顯著升高，而阻力指數(shù)（RI）均降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 益脈康分散片聯(lián)合胰激肽原酶治療糖尿病視網(wǎng)膜病變具有較好的臨床療效，可改善血液流變學(xué)和眼部血流動力學(xué)，降低血脂水平，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Yimaikang Dispersible Tablets combined with pancreatic kininogenase in treatment of diabetic retinopathy. Methods Patients (88 cases) with diabetic retinopathy in Shanghai Yangpu District Wujiaochang Town Community Health Service Center from January 2014 to January 2016 were enrolled in this study. According to the different treatment plan, patients were divided into the control and treatment groups, and each group had 44 cases. Patients in the control group were po administered with Pancreatic Kininogenase Enteric-coated Tablets, 2 tablets/time, three times daily. Patients in the treatment group were po administered with Yimaikang Dispersible Tablets on the basis of the control group, 2 tablets/time, three times daily. After treatment, the clinical efficacies were evaluated, blood rheology, blood glucose, blood lipid, and hemodynamic parameters in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.82% and 95.45%, respectively, and there was difference between two groups (P<0.05). After treatment, HCT, FIB, RF, and HS in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, triglyceride and total cholesterol in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, PSV and EDV of OA, CRA, and PCA in two groups were significantly increased, but the RI of OA, CRA, and PCA in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Yimaikang Dispersible Tablets combined with pancreatic kininogenase has clinical curative effect in treatment of diabetic retinopathy, and can improve blood rheology and ocular hemodynamics, reduce blood lipid level, which has a certain clinical application value.