抗炎治疗干眼的疗效观察  

Clinical observation of anti-inflammation cure to dry eye

作　　者：李彬[1] 陈小虎[1] 赵媛[1] 陈向晖[1] 白煜[1] 赖凤鸣 

机构地区：[1]四川省绵阳市中心医院,621000

出　　处：《中国实用眼科杂志》2014年第11期1374-1377,共4页Chinese Journal of Practical Ophthalmology

摘　　要：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.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）

关 键 词：糖皮质激素 四环素类 抗炎 干眼 

分 类 号：R562.25[医药卫生—呼吸系统]