目的：研究芪明颗粒联合格栅样激光光凝治疗糖尿病视网膜病变(diabetic retinopathy，DR)合并黄斑水肿(diabetic macular edema，DME)的临床疗效。

方法：本研究对象为2014-03/2017-03于我院治疗的50例98眼DR合并DME患者，按照治疗方式不同分为两组，对照组患者25例48眼采用格栅样激光光凝治疗，观察组患者25例50眼在此基础上联合芪明颗粒治疗。光学相干断层扫描(optical coherence tomography，OCT)及眼底血管造影(fundus fluorescein angiography，FFA)评价两组患者DME消退情况并比较治疗前、治疗7d，1、3mo黄斑中心凹厚度(central macular thickness，CMT)和最佳矫正视力(best corrected visual acuity，BCVA)。

结果：观察组总有效47眼，总有效率为94%，对照组治疗总有效40眼，总有效率为83%，观察组总有效率显著高于对照组，差异具有统计学意义(P<0.05)。两组治疗后BCVA均显著改善，观察组治疗7d，1、3mo均显著优于对照组，差异均有统计学意义(P<0.05)。两组治疗后CMT均显著降低，观察组治疗7d，1、3mo均显著低于对照组，差异均有统计学意义(P<0.05)。观察组和对照组分别出现高眼压2例2眼和1例1眼，给予降眼压药物后迅速缓解，其余无明显不良反应出现。

结论：芪明颗粒联合格栅样激光光凝治疗能显著改善DR合并DME症状，降低CMT，改善视力。

METHODS: The clinical data of 50 patients(98 eyes)with DME treated in our hospital from March 2014 to March 2017 were retrospectively analyzed. Patients were randomly divided into two group, 25 patients(48 eyes)treated with macular grid laser photocoagulation were included into the control group. On the basis of this, 25 patients(50 eyes)treated with Qi Ming granule were included into observation group. The central macular thickness(CMT)and best corrected visual acuity(BCVA)between two groups were evaluated and compared after detected by optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)at 7d, 1 and 3mo post-treatment.

RESULTS: The total effective rate was 94% in the observation group with 47 effective eyes, which was was significantly higher than 83% in the control group with 40 effective eyes(P<0.05). The BCVA was significantly improved in the two groups after treatment; the BCVA of the observation group was significantly higher than that of the control group after 7d, 1 and 3mo treatment, the difference was statistically significant(P<0.05). CMT in the two groups after treatment decreased significantly; the CMT of the observation group was significantly lower than that of the control group after 7d, 1 and 3mo treatment, with statistical significance(P<0.05). The intraocular hypertension occurred in observation group(2 eyes)and the control group(1 eyes), and relieved quickly after receiving medication, without any other obvious adverse reactions.

CONCLUSION: The clinical efficacy of Qi Ming granule combined with macular grid laser photocoagulation in the treatment of diabetic retinopathy with macular edema is effective, which can reduce CMT, improve eyesight.