理伤祛风汤治疗白内障术后重度角膜水肿的疗效观察及机制探究  

Clinical Observation and Mechanism Exploration of Lishangqufeng Decoction in Treating Severe Corneal Edema after Cataract Surgery

作　　者：杨富华 李利侠 韩子嫚 张立炜 YANG Fuhua;LI Lixia;HAN Ziyan(Department of Ophthalmology,Bozhou Hospital of Traditional Chinese Medicine,Bozhou Anhui236800,China)

机构地区：[1]亳州市中医院眼科,安徽亳州236800

出　　处：《四川中医》2024年第8期169-172,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：安徽中医药大学科研基金项目(编号:2021LCBZ10);第七批全国老中医药专家学术经验继承工作(国中医药人教教育便函[2023]127号)。

摘　　要：目的:通过观察超声乳化白内障术后重度角膜水肿患者应用中药理伤祛风汤治疗后的眼部症状及炎症相关指标的变化,分析理伤祛风汤的治疗效果,并揭示其治疗本病可能的作用机制。方法:按照随机抽样法将2022年3月~2023年9月于亳州市中医院眼科收治的术后重度角膜水肿的60例患者分为对照组(n=30,常规治疗)和观察组(n=30,对照组基础上给予理伤祛风汤治疗),所有患者均接受超声乳化白内障手术治疗;观察对比两组患者临床治疗效果、角膜水肿消失时间,比较两组患者治疗前、治疗1个月后视力、角膜厚度、角膜内皮细胞变异数及血清炎性因子[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]。结果:与对照组比,观察组临床治疗总有效率较高(P<0.05)。观察组水肿消失时间为5.5(4.75~8.00)天;对照组水肿消失时间为10.5(5~15)天;观察组短于对照组,差异有统计学意义(Z=-2.632,P=0.008)。观察组治疗前视力1.4(0.8~3.0),治疗后视力0.55(0.300~0.925);对照组治疗前视力0.9(0.6~2.0),术后视力0.4(0.3~0.7);两组患者治疗前、后视力无显著差异(P>0.05)。治疗后1个月,两组角膜厚度比较,观察组低于对照组(P<0.05),两组角膜内皮细胞变异数比较,观察组低于对照组(P<0.05)。治疗后1月,观察组IL-6、IL-8水平均低于对照组(P<0.05),两组间IL-1β无统计学意义(P>0.05)。结论:理伤祛风汤可显著提高临床治疗效果,通过降低机体炎症反应提高治疗后视力及角膜内皮细胞变异数。Objective To observe the changes of ocular symptoms and inflammation-related indicators in patients with severe corneal edema after phacoemulsification cataract surgery treated with Lishang Qufeng Decoction,analyze the therapeutic effect of Lishang Qufeng Decoction,and reveal the possible mechanism of its treatment of this disease.Methods According to random sampling method,60patients with severe corneal edema after surgery admitted to Department of Ophthalmology of Bozhou City of Traditional Chinese Medicine from March 2022to September 2023were divided into control group and control group(n=30,conventional treatment)and observation group(n=30,the control group was treated with Lishang Qufeng Decoction on the basis of treatment),and all patients received phacoemulsification cataract surgery;the clinical therapeutic effect and disappearance time of corneal edema of the two groups were observed and compared,and the visual acuity,corneal thickness,corneal endothelial cell variation and serum inflammatory factors[interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-8(IL-8)]of the two groups were compared before treatment and 1month after treatment.Results Compared with the control group,the total effective rate in the observation group was higher(P<0.05).Edema disappearance time was 5.5(4.75~8.00)days in observation group and 10.5(5-15)days in control group,and the observation group was shorter than the control group,with statistical significance(Z=-2.632,P=0.008).The visual acuity of observation group was 1.4(0.8~3.0)before treatment and 0.55(0.300~0.925)after treatment;the visual acuity of control group was 0.9(0.6~2.0)before treatment and 0.4(0.3~0.7)after treatment;there was no significant difference in visual acuity between the two groups before and after treatment(P>0.05).One month after treatment,the corneal thickness of the observation group was lower than that of the control group(P<0.05),and the variation of corneal endothelial cells of the observation group was lower than that of the control group(P<0.0

关 键 词：超声乳化白内障术 重度角膜水肿 理伤祛风汤 视力 角膜内皮厚度 炎症因子 

分 类 号：R772.2[医药卫生—眼科]