联合中药熏眼治疗角膜移植排斥反应的临床观察  

Experimental Study on the Therapeutic Effect of Combined Eye Herbal Fumigation in the Treatment of Corneal Allograft Rejection

作　　者：张丽娟[1] 陈婷[1] 刘礼婷 卢珊[1] 

机构地区：[1]哈尔滨医科大学附属第一医院,眼科医院,哈尔滨150001

出　　处：《中国中医眼科杂志》2017年第5期311-314,共4页China Journal of Chinese Ophthalmology

基　　金：黑龙江省中医药管理局中医药科研项目(ZHY12-Z182);黑龙江省教育厅科研项目(12521262);黑龙江省卫生厅科研项目(2011-031)

摘　　要：目的观察常规西药治疗联合中药熏眼对角膜移植术后排斥反应的作用。方法前瞻性临床研究。穿透性角膜移植术后发生免疫排斥者150例(150只眼),随机分为2组。试验组予常规西药联合中药熏眼治疗,对照组予常规西药治疗。以症状及体征评分、治愈者治愈时间以及临床疗效为指标,比较两组差异。结果 1.基本情况:至观察结束时,试验组脱落4例,完成随访75例,对照组脱落4例,完成随访67例,两组性别及分型构成等差异无统计学意义(P>0.05)。2.临床疗效:试验组治愈49例,好转23例,无效3例,有效率96%;对照组治愈29例,好转29例,无效9例,有效率87%。试验组有效率高于对照组(χ~2=4.070,P=0.040),其中对上皮型的疗效优于其他分型。3.治愈时间:试验组治愈眼的治愈时间(19.1±5.3)d,对照组治愈时间(21.2±5.4)d。Kaplan-Meier生存分析结果提示试验组的治愈时间更短(log rank检验χ~2=17.1,P<0.001)。4.症状与体征评分:治疗前两组各项评分水平相当(P>0.05),治疗后试验组角膜混浊度、角膜水肿程度以及眼部刺激症状评分明显低于对照组(P<0.05),角膜新生血管评分与对照组无明显差异(P>0.05)。结论常规西药联合中药熏眼治疗角膜移植后排斥反应有较好疗效,相对常规西药治疗,在缩短治愈时间,减轻角膜水肿、混浊及刺激症状方面有优势,且对上皮型的疗效更好。OBJECTIVE To observe the difference between regular western medicine combined with eye herbal fumigation and regular western medicine treatment on the therapeutic effect of corneal allograft rejection.METHODS 150 of cases（150 eye） with corneal allograft rejection from July, 2007 to November, 2013 in Eye Hospital of the First Affiliated Hospital of Harbin Medical University was studied, then randomly divided into experimental group： regular western medicine combined with eye herbal fumigation group and control group： regular western medicine treatment group. Recovery time and therapeutic effects was observed and studied. RESULTS Finally,data from 75 cases in experimental group and 67 cases in control group were obtained and statistically analyzed. In experimental group, 49 cases were cured, 23 cases became better, 3 cases showed no therapy effect, and the effective rate was 96%. In control group, 29 cases were cured, 29 cases became better, 9 cases showed no therapy effect, and the effective rate was 87%. The effective rate in experimental group is significantly higher than that in control group（χ~2=4.07, P =0.04）. The period of therapy in experimental group were 19.1 ±5.3 days, which are significantly lower than that in control group 21.2±5.4 days（log rank test χ~2= 17.1, P〈0.001）. After therapy, the scores of corneal turbidity, corneal edema degree and eye irritation in experimental group were significantly lower than that in control group（all P〈0.05）, and there was no difference on the score of corneal neovascularization between two groups, although the four scores in the two groups were identical before therapy. CONCLUSIONS Regular western medicine combined with eye herbal fumigation treatment can modify and improve the survival of corneal allografts by inhibiting graft rejection.

关 键 词：中药 熏眼 角膜移植排斥反应 

分 类 号：R779.65[医药卫生—眼科]