CAJ | 학술논문

背景拟胆碱能药物和前列腺素类似物分别用于治疗原发性闭角型青光眼和开角型青光眼的临床效果已被证实,临床上二者常联合用药治疗青光眼,但理论上二者对睫状肌的作用机制是相背离的,因此有必要对二者联合用药的效果和作用机制进行进一步探讨.目的观察联合应用质量分数0.004％曲伏前列腺素和质量分数2％毛果芸香碱的降眼压效果.方法将正常无色素兔30只以随机数字表法随机分为毛果芸香碱组、曲伏前列腺素组和联合用药组3个组,每只兔任意选择一侧眼作为实验眼,分别每日3次点用2％毛果芸香碱滴眼液或每晚1次0.004％曲伏前列腺素滴眼液,联合用药组按上述用法同时点用上述两种药物；对侧眼点用生理盐水为对照眼.各组动物于用药前1d8:00时以Perkins手持式压平眼压计测量双眼眼压作为基线眼压,并分别于用药后第1、2、4、8、14和24天的8:00时测量双眼眼压,以点眼前后眼压的变化作为主要观测指标. 结果毛果芸香碱组、曲伏前列腺素组和联合用药组点眼后1 d的眼压均明显低于基线眼压,而对照眼点眼前后眼压无明显变化；各实验眼治疗后各时间点间眼压无明显变化.毛果芸香碱组、曲伏前列腺素组和联合用药组实验眼眼压在点眼前与对照眼相比无明显差异,但点眼后均明显低于对照眼,差异均有统计学意义(P＜0.05).与各组基线眼压比较,毛果芸香碱组、曲伏前列腺素组和联合用药组的实验眼眼压分别降低了17.5％～ 22.0％、23.8％～26.4％和27.6％～ 32.0％.对正常眼来说,联合用药组降眼压作用最强,其次依次为曲伏前列腺素和毛果芸香碱. 结论联合用药的降眼压效果比单独点用毛果芸香碱和曲伏前列腺素的效果要好,但小于单独滴用毛果芸香碱和曲伏前列腺素的降眼压幅度之和.
배경 의담감능약물화전렬선소유사물분별용우치료원발성폐각형청광안화개각형청광안적림상효과이피증실,림상상이자상연합용약치료청광안,단이론상이자대첩상기적작용궤제시상배리적,인차유필요대이자연합용약적효과화작용궤제진행진일보탐토.목적 관찰연합응용질량분수0.004％곡복전렬선소화질량분수2％모과예향감적강안압효과.방법 장정상무색소토30지이수궤수자표법수궤분위모과예향감조、곡복전렬선소조화연합용약조3개조,매지토임의선택일측안작위실험안,분별매일3차점용2％모과예향감적안액혹매만1차0.004％곡복전렬선소적안액,연합용약조안상술용법동시점용상술량충약물；대측안점용생리염수위대조안.각조동물우용약전1d8:00시이Perkins수지식압평안압계측량쌍안안압작위기선안압,병분별우용약후제1、2、4、8、14화24천적8:00시측량쌍안안압,이점안전후안압적변화작위주요관측지표. 결과 모과예향감조、곡복전렬선소조화연합용약조점안후1 d적안압균명현저우기선안압,이대조안점안전후안압무명현변화；각실험안치료후각시간점간안압무명현변화.모과예향감조、곡복전렬선소조화연합용약조실험안안압재점안전여대조안상비무명현차이,단점안후균명현저우대조안,차이균유통계학의의(P＜0.05).여각조기선안압비교,모과예향감조、곡복전렬선소조화연합용약조적실험안안압분별강저료17.5％～ 22.0％、23.8％～26.4％화27.6％～ 32.0％.대정상안래설,연합용약조강안압작용최강,기차의차위곡복전렬선소화모과예향감. 결론 연합용약적강안압효과비단독점용모과예향감화곡복전렬선소적효과요호,단소우단독적용모과예향감화곡복전렬선소적강안압폭도지화.
Background It has been clarified that topical administration of cholinomimetic drug or prostaglandin analogus can effectively low intraoeular pressure (IOP) in primary angle-closure glaueoma and angleopen glaucoma,respectively.The two eyedrops are often combined clinically to treat glaueomatous eye.But their effect mechanism on ciliary muscle is different.It is neeessarv to prove the clinical efficacy of combination of these two drugs.Objective This study attempted to compare hypotensive effect of individual and combinative use of 2％piloearpine and 0.004％ travoprost in normal rabbit eyes.Methods Thirty normal albino rabbits were randomly divided into three parallel groups.Lateral eye of each rabbit was appointed as the experimental eye and the fellow eye was used as control eye.2％ Pilocarpine eyedrop was instilled three times daily and 0.004％ travoprost eyedrops was used once per night in the pilocarpine and travoprost group.These two drugs were combined in the combination group.The normal saline solution was used in the control eyes IOP was measured bilaterally with Perkins application tonometer at 8:00 am on the day before and 1,2,4,8,14,24 days after the administration of eyedrops.The use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The IOP was significantly lower on 1 day after use of eyedrops than baseline IOP in the experimental eyes in the pilocarpine group,travoprost group and combination group,but no obvious change in IOP before and after use of eyedrops in the control eyes.There was no significant difference in the baseline IOP in both experimental eyes and control eyes,however,signifieant differences were seen in various time points after administration of eyedrops between experimental eyes and control eyes(P＜0.05).Compared with baseline IOP,IOP declined by 17.5％-22.0％ in pilocarpine group,23.8％-26.4％ travoprost group,27.6％-32.0％ in the combination group.For normal eye,piloearpine+travoprost showed a more power lowing IOP effect.Conclusions Hypotensive effect of combinative use of 2％ pilcoarpine and 0.004％ travoprost is strongest in comparison with individual use of pilocarpine or travoprost,but less than the statistical sum of individual use of these two drugs in a 24-day duration in normal eye of albino rabbit.