中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2014年
11期
1374-1377
,共4页
李彬%陈小虎%赵媛%陈向晖%白煜%赖凤鸣
李彬%陳小虎%趙媛%陳嚮暉%白煜%賴鳳鳴
리빈%진소호%조원%진향휘%백욱%뢰봉명
糖皮质激素%四环素类%抗炎%干眼
糖皮質激素%四環素類%抗炎%榦眼
당피질격소%사배소류%항염%간안
Glucocorticoid%Tetracyclinefamily%Anti-inflammatory%Dry eye
目的 观察局部使用人工泪液、糖皮质激素眼液,口服四环素类(多西环素)抗炎药治疗中、重度蒸发过强性干眼的疗效.方法 对2012年5月至2013年4月在绵阳市中心医院眼科门诊,按照国际干眼研究组(DEWS)标准分级为2及3级干眼、SⅠt正常患者46例(92只眼),按级分层后分为两组,实验组24例(48只眼),其中2级11例(22只眼);对照组22例(44只眼),其中2级10例(20只眼).实验组以局部滴用0.2％卡波姆眼用凝胶、0.5％氯替泼诺滴眼液联合口服四环素类抗炎药(多西环素)治疗;对照组仅局部滴用0.2％卡波姆眼用凝胶、0.5％氯替泼诺滴眼液治疗.在治疗前及治疗后2、4、6、8周询问患者自觉症状、裂隙灯显微镜检查、角膜荧光染色(FL),泪膜破裂时间(BUT)、Schirmer Ⅰ试验(S Ⅰ t)及眼压.各项指标采用x2检验和t检验.结果 治疗8周后,治疗前眼表炎症分在10分以上者,治疗组与对照组的症状体征综合评分均降低,分别为(15.2±2.5)、(21.0±5.1)分,BUT均较治疗前延长(9.5±2.8)、(6.5±2.2)s,FL较治疗前减低(3.6±1.3)、(5.5±2.3)分,治疗前后两者比较差异均有统计学意义(P＜0.05);而治疗前眼表炎症分在10分以下者,治疗组与对照组的疗效症状评分均降低,分别为(11.7±2.2)、(12.2±3.2)分,BUT均较治疗前延长(10.2±2.6)、(10.4±2.7)s,FL较治疗前减低(2.8±1.5)、(2.5±1.2)分,治疗前后两者比较差异均无统计学意义(P＞0.05).结论 对眼表有明显炎症患者(眼表炎症分在10分以上者)局部点用0.2％卡波姆眼用凝胶、0.5％氯替泼诺滴眼液联合口服四环素类抗炎药(多西环素)治疗较未使用四环素类抗炎药效果更好.而对眼表炎症较轻患者(眼表炎症分在10分以下者)可不口服四环素类抗炎药.
目的 觀察跼部使用人工淚液、糖皮質激素眼液,口服四環素類(多西環素)抗炎藥治療中、重度蒸髮過彊性榦眼的療效.方法 對2012年5月至2013年4月在綿暘市中心醫院眼科門診,按照國際榦眼研究組(DEWS)標準分級為2及3級榦眼、SⅠt正常患者46例(92隻眼),按級分層後分為兩組,實驗組24例(48隻眼),其中2級11例(22隻眼);對照組22例(44隻眼),其中2級10例(20隻眼).實驗組以跼部滴用0.2％卡波姆眼用凝膠、0.5％氯替潑諾滴眼液聯閤口服四環素類抗炎藥(多西環素)治療;對照組僅跼部滴用0.2％卡波姆眼用凝膠、0.5％氯替潑諾滴眼液治療.在治療前及治療後2、4、6、8週詢問患者自覺癥狀、裂隙燈顯微鏡檢查、角膜熒光染色(FL),淚膜破裂時間(BUT)、Schirmer Ⅰ試驗(S Ⅰ t)及眼壓.各項指標採用x2檢驗和t檢驗.結果 治療8週後,治療前眼錶炎癥分在10分以上者,治療組與對照組的癥狀體徵綜閤評分均降低,分彆為(15.2±2.5)、(21.0±5.1)分,BUT均較治療前延長(9.5±2.8)、(6.5±2.2)s,FL較治療前減低(3.6±1.3)、(5.5±2.3)分,治療前後兩者比較差異均有統計學意義(P＜0.05);而治療前眼錶炎癥分在10分以下者,治療組與對照組的療效癥狀評分均降低,分彆為(11.7±2.2)、(12.2±3.2)分,BUT均較治療前延長(10.2±2.6)、(10.4±2.7)s,FL較治療前減低(2.8±1.5)、(2.5±1.2)分,治療前後兩者比較差異均無統計學意義(P＞0.05).結論 對眼錶有明顯炎癥患者(眼錶炎癥分在10分以上者)跼部點用0.2％卡波姆眼用凝膠、0.5％氯替潑諾滴眼液聯閤口服四環素類抗炎藥(多西環素)治療較未使用四環素類抗炎藥效果更好.而對眼錶炎癥較輕患者(眼錶炎癥分在10分以下者)可不口服四環素類抗炎藥.
목적 관찰국부사용인공루액、당피질격소안액,구복사배소류(다서배소)항염약치료중、중도증발과강성간안적료효.방법 대2012년5월지2013년4월재면양시중심의원안과문진,안조국제간안연구조(DEWS)표준분급위2급3급간안、SⅠt정상환자46례(92지안),안급분층후분위량조,실험조24례(48지안),기중2급11례(22지안);대조조22례(44지안),기중2급10례(20지안).실험조이국부적용0.2％잡파모안용응효、0.5％록체발낙적안액연합구복사배소류항염약(다서배소)치료;대조조부국부적용0.2％잡파모안용응효、0.5％록체발낙적안액치료.재치료전급치료후2、4、6、8주순문환자자각증상、렬극등현미경검사、각막형광염색(FL),루막파렬시간(BUT)、Schirmer Ⅰ시험(S Ⅰ t)급안압.각항지표채용x2검험화t검험.결과 치료8주후,치료전안표염증분재10분이상자,치료조여대조조적증상체정종합평분균강저,분별위(15.2±2.5)、(21.0±5.1)분,BUT균교치료전연장(9.5±2.8)、(6.5±2.2)s,FL교치료전감저(3.6±1.3)、(5.5±2.3)분,치료전후량자비교차이균유통계학의의(P＜0.05);이치료전안표염증분재10분이하자,치료조여대조조적료효증상평분균강저,분별위(11.7±2.2)、(12.2±3.2)분,BUT균교치료전연장(10.2±2.6)、(10.4±2.7)s,FL교치료전감저(2.8±1.5)、(2.5±1.2)분,치료전후량자비교차이균무통계학의의(P＞0.05).결론 대안표유명현염증환자(안표염증분재10분이상자)국부점용0.2％잡파모안용응효、0.5％록체발낙적안액연합구복사배소류항염약(다서배소)치료교미사용사배소류항염약효과경호.이대안표염증교경환자(안표염증분재10분이하자)가불구복사배소류항염약.
Objective To observe the effect of the use of artificial tears,glucocorticoid eyedrops,anti-inflammatory drugs of oral tetracycline family (doxycycline) to treat medium and severe evaporative dry eye.Methods According to the DEWS standard,the 46 patients (92 eyes) were divided into level 2 and level 3 dry eyes,Schirmer Ⅰ test (S Ⅰ t) from May 2012 to April 2013.After that,these patients were divided into experimental group and control group randomly.There were 24 cases (48 eyes) in experimental group,in which there 11 cases (22 eyes) of the level 2 while there were 22 cases (44 eyes) in control group,in which there 10 cases (20 eyes) of the level 2.The experimental group were treated with topical drops 0.2％ Carbomer Eye Drops and 0.5％ Loteprednol Etabonate Ophthalmic Suspension,eye drops combined oral tetracycline family anti-inflammatory drugs (doxycycline).The control group were treated with topical drops 0.2％ Carbomer Eye Drops and 0.5％ Loteprednol Etabonate Ophthalmic Suspension.The patients were asked about their subjective symptom,examined with slit-lamp microscopic,corneal fluorescein staining,break-up time (BUT),S Ⅰ t and intraocular pressure before the treatment and the 2nd,4th,6th and 8th week after the treatment.All the indexes were conducted by X-ray test and t test.Results At the 8th week after treatment to those whose symptom scores of ocular surface were below 10 before the treatment,their comprehensive scores of signs and symptoms of the treatment group and control group decreased respectively (15.2±2.5,21.0±5.1),BUT extended (9.5±2.8,6.5±2.2)s,FL decreased (3.6±1.3,5.5± 2.3),than before,with significant difference (P ＜0.05).To those whose symptom scores of ocular surface were below 10 before the treatment,the curative effect of treatment group and control group symptom scores were lower than before,respectively (11.7±2.2,12.2±3.2),BUT extended (10.2±2.6,10.4±2.7)s,FL decreased than before (2.8±1.5,2.5±1.2),without significant difference (P ＞0.05).Conclusions To those with severe ocular surface inflammation (ocular surface inflammation's scores above 10 points),treated with local point for chloride with 0.2％ Carbomer Eye Drops,0.5％ Loteprednol Etabonate Ophthalmic Suspension,eye drops combined oral tetracycline class anti-inflammatory drugs (doxycycline) therapy is better.This effect is better than that without anti-inflammatory drugs.To those with mild ocular surface inflammation (ocular surface inflammation's scores below 10 points),it's no need to use anti-inflammatory drugs of tetracycline family.
