益气解毒冲剂联合西药治疗单纯疱疹病毒性角膜炎107例临床研究  

Clinical Study on Yiqi Jiedu Granules Combined With Western Medicine for 107 Cases of Herpes Simplex Keratitis

作　　者：王玉中[1] 徐艳[2] 王利群[3] 辛云芳 杨小生[2] 顾光霞[2] 

机构地区：[1]漯河医学高等专科学校,河南省漯河市462002 [2]河南省洛阳市疾病预防控制中心 [3]河南省洛阳市中心医院

出　　处：《中医杂志》2014年第2期133-136,共4页Journal of Traditional Chinese Medicine

摘　　要：目的评价益气解毒冲剂治疗单纯疱疹病毒性角膜炎(HSK)的临床疗效,并探讨其可能作用机制。方法将213例(217眼)HSK患者随机分为对照组106例(108眼)和治疗组107例(109眼)。对照组用0.15%更昔洛韦滴眼液点眼,并对症处理;治疗组在对照组治疗的基础上,同时加服院内制剂益气解毒冲剂,每次20g,每日2次。治疗4周后评价临床疗效,观察两组治疗前后症状体征、角膜知觉、角膜病损面积变化及外周血CD4、CD8水平,记录治愈患者1年内复发情况。结果治疗组临床疗效治愈率、显效率和有效率分别为53.21%、26.61%和20.18%,对照组分别为28.70%、38.89%和32.41%,两组比较差异均有统计学意义(P=0.001)。两组治疗后角膜知觉敏感、迟钝、消失眼数均较治疗前明显减少(P<0.05);治疗组角膜知觉改善明显优于对照组(P<0.01)。治疗后治疗组角膜病损面愈合指数优于对照组(P<0.01)。治疗组治疗后CD4、CD8和CD4/CD8与对照组比较差异均有统计学意义(P<0.01)。治疗组1年累计复发率为20.50%,对照组为38.00%,两组比较差异有统计学意义(P<0.01)。结论益气解毒冲剂联合西药治疗HSK较单纯西药干预可以更好地缓解患者临床症状体征和减少复发,提高CD4、降低CD8 T淋巴细胞亚群表达、调节免疫功能可能是其作用机制之一。Objective To evaluate the therapeutic effect and research the possible mechanism of Yiqi Jiedu Granules （ qi-boosting toxin-resolving granules） combined with western medicine for herpes simplex keratitis （HSK）. Methods Totally 213 cases （217 eyes） of HSK were randomized into the control group of 106 cases （108 eyes） and treatment group of 107 cases （109 eyes）. The control group was given 0. 15% gancielovir eye drops and symptomatic treatment. The treatment group was added with 20 g Yiqi Jiedu Granules twice daily. The therapeutic effect was evalu- ated after 4-week treatment. The symptoms, signs, corneal sensitivity, corneal lesion and recurrence within l year were observed in both groups. The levels of CD4 and CD8 were detected. Results The cure rate, significant effi- ciency and effectiveness were 53.21% , 26.61% and 20. 18% in the treatment group and 28.70% , 38.89% and 32.41% in the control group, with significant difference between groups （P = 0. 001 ）. The eyes of sensitivity, retar- dation and disappearance of corneal sensation in both groups were significantly decreased after treatment （ P 〈 0.05 ）, especially in the treatment group （P 〈 0.05 ）. The healing index of corneal lesion in the treatment group was superior to that in the control group after treatment （ P 〈 0.01 ）. There were significant differences between groups in the levels of CD4, CD8 and CD4/CD8 after treatment （P 〈 0. 01 ）. The 1-year cumulative recurrence rate in the treatment group and control group was 20.5% and 38.00% respectively, with a significant difference between groups （ P 〈 0. 01 ）. Conclusion The combo therapy of Yiqi Jiedu Granules and western medicine can obviously relieve the symptoms and signs, reduce recurrence, increase CD4 expression and decrease CD8 expression as compared with sin- gle western medicine therapy and the regulation of immune function may be one of its mechanisms.

关 键 词：单纯疱疹病毒性角膜炎 益气解毒冲剂 T淋巴细胞 

分 类 号：R772.2[医药卫生—眼科]