秦皮汤治疗初发性单纯疱疹病毒性角膜炎的疗效观察  

Therapeutic effects of Qinpi decoction on primary herpes simplex keratitis

作　　者：江丹[1] 刘新泉[1] 张殷建[1] JIANG Dan,LIU Xinquan, ZHANG Yinjian.(Longhua Hosptial, Shanghai University of Traditional ChinaeseMedicine, Shanghai 200032, China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《中国中医眼科杂志》2018年第2期92-96,共5页China Journal of Chinese Ophthalmology

基　　金：国家自然基金项目(NO.81574028);上海中医药大学附属龙华医院国家中医临床研究基地龙医学者项目(LYTD-50);上海中医药大学预算内项目(1485)

摘　　要：目的明确秦皮汤治疗初发性单纯疱疹病毒性角膜炎的临床疗效。方法选取初发性单纯疱疹病毒性角膜炎患者90例,根据随机原则分成治疗组和对照组;对照组仅予0.1%更昔洛韦眼药水、0.5%更昔洛韦眼用凝胶等局部对症治疗。治疗组是在对照组治疗方法的基础上加秦皮汤中药汤剂口服,两组治疗共4周。观察治疗前、治疗后2周、4周患者自觉症状评分、角膜荧光素染色(FL)评分、角膜知觉、中央角膜厚度(CCT)、疗效及中医症候评分,监测服用秦皮汤的安全性、随访并计算治疗一年内的复发率。结果共纳入病例90例中脱失9例,最终纳入疗效评价的治疗组42例,对照组39例,治疗前两组患者的自觉症状评分、FL评分、角膜知觉、CCT、中医症候评分均无明显差异(P>0.05),治疗后2周、4周两组均观察到自觉症状、FL、中医症候评分、CCT降低、角膜知觉值增加,与治疗前比较,P<0.05;治疗后2周、4周治疗组患者的自觉症状、CCT、中医症候改善程度分别优于对照组,P<0.05,而两组间FL评分及角膜知觉无统计学差异,P>0.05;治疗组总有效率(95.2%)高于对照组(74.4%)。所有患者服用秦皮汤后均未出现明显副作用;治疗组复发率(11.9%)与对照组复发率(20.5%),无显著性差异(P>0.05)。结论秦皮汤可有效改善初发性单纯疱疹病毒性角膜炎的临床症状与体征,且具有良好的安全性。OBJECTIVE To evaluate the therapeutic effects of Qinpi decoction on primary herpes simplex keratitis（HSK）. METHODS Ninety patients with primary HSK were randomly divided into two groups. Patients in therapy group were treated with 0.1% Ganciclovir eye drops every 2 hours, 0.5% Ganciclovir gel before sleep and Qinpi decoction by oral administration for 4 weeks. Meanwhile, patients in control group were only treated with the same concentration of Gan-ciclovir eye drops and gel. Subjective symptom scores, fluorescence（FL） scores, corneal sensitivity,central cornea thickness（CCT）, therapeutic efficiency and traditional Chinese medicine（TCM）syndrome scores were observed before therapy and 2 weeks, 4 weeks after therapy. Safety evalua-tion and recurrence rate in one year after therapy were also analyzed. RESULTS Eighty-one patients（42 patients in therapy group and 39 patients in control group） finished the trial and 9 pa-tients dropped out. There were no significant difference in subjective symptom scores, FL scores,cornea sensitivity, CCT, TCM syndrome scores between groups before therapy（P〈0.05）. The subjective symptom scores, FL scores, TCM syndrome scores and CCT decreased and cornea sensitivity values of two groups increased 2 weeks and 4 weeks after intervention（P〈0.05）,improvements of subjective symptom scores, CCT and TCM syndrome scores were superior in the therapy group（P〈0.05）. However, no significant difference of FL scores and cornea sensitivity was showed in two groups after therapy（P〈0.05）. Totally therapeutic efficiency of therapy group（95.2%） was much more higher than that in control group（74.4%）. There was no obvious side effect in all patients after taking Qinpi decoction. The recurrence rate was 11.9% in therapy group and 20.5% in control group respectively, which meant no significant difference（P〈0.05）. CONCLUSIONS Qinpi decoction was effective in improving the clinical symptoms and objective signs of primary HSK patients with favorable safe

关 键 词：秦皮汤 单纯疱疹病毒性角膜炎 疗效 

分 类 号：R772.21[医药卫生—眼科]