赤丹地黄汤联合糖皮质激素治疗急性期VKH的临床研究  

Clinical study on the treatment of Vogt-Koyanagi-Harada syndrome at acute stage with Chidan Dihuang Decoction and glucocorticoid

作　　者：张艳蕊 李厚刚[1] 赵桂霞[1] 刘金凤 王春梅[1] 刘静娜 赵旭峥 ZHANG Yanrui;LI Hougang;ZHAO Guixia;LIU Jinfeng;WANG Chunmei;LIU Jingna;ZHAO Xuzheng(Tangshan Eye Hospital,Tang-shan Eye Research Institute,Tangshan 063016,China)

机构地区：[1]唐山市眼科医院,唐山市眼科研究所,唐山063016

出　　处：《中国中医眼科杂志》2023年第4期327-331,共5页China Journal of Chinese Ophthalmology

基　　金：河北省中医药管理局科研计划课题(2022564)。

摘　　要：目的观察赤丹地黄汤联合糖皮质激素治疗急性期小柳原田综合征(VKH)的临床疗效。方法纳入2018年1月—2021年5月唐山市眼科医院诊治的急性期VKH患者80例(160只眼),随机分为治疗组和对照组,每组各40例(80只眼)。对照组予醋酸泼尼松片晨起顿服。治疗组在对照组基础上联合赤丹地黄汤口服。2组均观察6个月。分别于治疗前、治疗后14 d和治疗后6个月检测受试者的最佳矫正视力(BCVA)和中医证候评分,记录数据并做统计分析。结果(1)BCVA:治疗前后比较,2组治疗后14 d BCVA均较治疗前提高,差异均有统计学意义(t治疗组=6.811,t_(对照组)=5.943,均P=0.000),2组治疗后6个月BCVA均较治疗前提高,差异均有统计学意义(t治疗组=8.500,t_(对照组)=8.005,均P=0.000)。治疗后2组间比较,治疗组治疗后14 d和6个月BCVA均较对照组提高,差异均有统计学意义(t14 d=4.103,t6个月=5.137,P=0.000)。(2)中医证候评分:治疗前后比较,2组治疗后14 d中医证候积分均降低,差异均有统计学意义(t治疗组=15.914,t_(对照组)=17.249,均P=0.000),2组治疗后6个月中医证候积分均较治疗前降低,差异均有统计学意义(t治疗组=24.962,t_(对照组)=23.256,均P=0.000)。治疗后2组间比较,治疗组治疗后14 d和6个月中医证候积分均较对照组均降低,差异均有统计学意义(t14 d=2.466,P=0.016;t6个月=2.602,P=0.011)。(3)临床疗效:2组的总有效率均为100%。治疗组显效率为97.50%,对照组显效率为80.00%,治疗组优于对照组,差异有统计学意义(χ^(2)=6.135,P=0.013)。(4)不良反应率:治疗组药物不良反应率为70.00%,对照组药物不良反应率为90.00%,治疗组低于对照组,差异有统计学意义(χ^(2)=5.000,P=0.025)。结论赤丹地黄汤联合糖皮质激素对急性期VKH的治疗优于单纯糖皮质激素,对于改善患者视力、中医症候积分具有重要意义,值得广泛应用。OBJECTIVE To observe the clinical efficacy of Chidan Dihuang Decoction and glucocorticoids in the treatment of Vogt-Koyanagi-Harada syndrome(VKH)at acute stage.METHODS A total of 80 patients(160 eyes)who were diagnosed and treated by Tangshan Eye Hospital from January 2018 to May 2021 were randomly divided into treatment group and control group,with 40 patients(80 eyes)in each group.The control group was given prednisone acetate tablets orally every morning,while the treatment group was given Chidan Dihuang Decoction orally on the basis of the control group.Both groups were observed for six months.The best corrected visual acuity(BCVA),and Traditional Chinese Medicine(TCM)symptoms scores were measured before,14 days after,and six months after treatment,respectively.The data were recorded and statistically analyzed.RESULTS(1)BCVA:The BCVA of both groups increased at 14 days after treatment when compared to that before treatment respectively,with a statistically significant difference(t_(TG)=6.811,tCG=5.943,both P=0.000).The BCVA of both groups increased at six months after treatment when compared to that before treatment respectively,with statistically significant difference(t_(TG)=8.500,tCG=8.005,both P=0.000).When compared between the two groups after treatment,the BCVA in the treatment group was significantly higher than that in the control group at 14 days and six months after treatment(t14 d=4.103,t6 months=5.137,both P=0.000).(2)TCM symptom scores:The TCM symptom scores of both groups decreased at 14 days after treatment when compared to those before treatment respectively,with a statistically significant difference(t_(TG)=15.914,tCG=17.249,both P=0.000).The TCM symptom scores of both groups decreased at six months after treatment when compared to those before treatment respectively,with a statistically significant difference(t_(TG)=24.962,tCG=23.256,both P=0.000).When compared between the two groups after treatment,the TCM symptom scores in the treatment group were significantly lower than those in the cont

关 键 词：赤丹地黄汤 糖皮质激素 小柳原田综合征 中西医结合疗法 

分 类 号：R276.7[医药卫生—中医五官科学]