维生素A棕榈酸酯眼用凝胶联合人工泪液治疗轻中度干眼症临床观察
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摘要
目的评价维生素A棕榈酸酯眼用凝胶治疗干眼症的效果,为临床医生治疗干眼症提供更多安全、有效的药物选择。方法选取2014年6月至2015年6月华中科技大学同济医学院附属梨园医院收治的干眼症患者70例作为研究对象,分为观察组和对照组,每组35例(35只眼)。对照组给予人工泪液治疗,观察组给予维生素A棕榈酸酯眼用凝胶联合人工泪液治疗,比较两组患者治疗前,治疗后2、4周的主观症状评分、泪膜破裂时间(BUT)、泪液分泌试验(SIt)、角膜荧光染色(FL)等变化,以及不良反应发生情况。结果两组患者治疗前各项指标比较,差异均无统计学意义(P>0.05)。观察组患者治疗后2、4周BUT、SIt、FL均明显优于对照组,主观症状评分明显低于对照组,差异均有统计学意义(P<0.05)。结论人工泪液联合维生素A棕榈酸酯眼用凝胶治疗干眼症临床效果确切,明显优于单用人工泪液治疗,且无明显不良反应。
Objective To evaluate the clinical efficacy of vitamin A palmitate eye ophthalmic gel on treating xerophthalmus,in order to provide more drugs and safe choice for clinical doctors. Methods A total of 70 patients with xerophthalmus,who were received in Liyuan Hospital of Tongji Medical College of Huazhong University of Science and Technology from June 2014 to June 2015,were selected as research objects and divided into the observation group and the control group,35 cases(35 eyes) in each group. The control group was treated with artificial tears,while the observation group was treated with vitamin A palmitate eye ophthalmic gel combined with artificial tears. The subjective symptoms,indicators of tear film [including break-up time(BUT),schirmer I test(SIt),fluorescein staining(FL) and so on] and the adverse reaction in both groups were compared before and 2,4 weeks after treatment. Results There were no obviously significant differences of the indicators between the two groups before treatment(P>0.05). 2,4 weeks after treatment,the BUT,SIt and FL were obviously better than those in the control group,but the subjective symptom score of xerophthalmus was evidently inferior to that in the control group,the differences had statistical significance(P<0.05). Conclusion The artificial tears combined with vitamine A palmitate eye ophthalmic gel have valuable and safe effect on the treatment of xerophthalmus with less obvious adverse reaction.
Objective To evaluate the clinical efficacy of vitamin A palmitate eye ophthalmic gel on treating xerophthalmus,in order to provide more drugs and safe choice for clinical doctors. Methods A total of 70 patients with xerophthalmus,who were received in Liyuan Hospital of Tongji Medical College of Huazhong University of Science and Technology from June 2014 to June 2015,were selected as research objects and divided into the observation group and the control group,35 cases(35 eyes) in each group. The control group was treated with artificial tears,while the observation group was treated with vitamin A palmitate eye ophthalmic gel combined with artificial tears. The subjective symptoms,indicators of tear film [including break-up time(BUT),schirmer I test(SIt),fluorescein staining(FL) and so on] and the adverse reaction in both groups were compared before and 2,4 weeks after treatment. Results There were no obviously significant differences of the indicators between the two groups before treatment(P>0.05). 2,4 weeks after treatment,the BUT,SIt and FL were obviously better than those in the control group,but the subjective symptom score of xerophthalmus was evidently inferior to that in the control group,the differences had statistical significance(P<0.05). Conclusion The artificial tears combined with vitamine A palmitate eye ophthalmic gel have valuable and safe effect on the treatment of xerophthalmus with less obvious adverse reaction.
引文
[1]中华医学会眼科学分会眼视光学组.视疲劳诊疗专家共识(2014年)[J].中华眼视光学与视觉科学杂志,2014,16(7):385-387
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[3]田玉景,张钦.高浓度玻璃酸钠滴眼液治疗中重度干眼的临床研究[J].国际眼科杂志,2014,14(6):1110-1112.
[4]洪佳旭,王文韬,徐建江.维生素A棕榈酸酯眼用凝胶对抗青光眼药物眼表损伤的防治作用[J].中国眼耳鼻喉科杂志,2007,7(6):356-358.
[5]陆岩,夏丽坤,柴广睿.维生素A棕榈酸酯眼用凝胶对LASIK术后眼表修复的影响[J].国际眼科杂志,2013,13(4):713-715.
[6]邱晓,龚岚,陈敏洁.维生素A棕榈酸酯对兔机械性角膜上皮损伤愈合及结膜杯状细胞的作用研究[J].中华眼科杂志,2010,46(2):151-160.
[7]Floyd AM,Zhou X,Evans C,et al.Mucin deficiency causes functional and structural changes of the ocular surface[J].PLo S One,2012,7(12):e50704.
[8]勾健媛,李勇亮,赵莉,等.维生素A棕榈酸酯凝胶治疗白内障超声乳化+人工晶体植入术术后干眼的疗效观察[J].医学综述,2013,19(10):1893-1895.
[9]董诺,吴护平,李程,等.翼状胬肉上皮鳞状化生与泪膜稳定性的研究[J].中华眼科杂志,2013,49(5):422-427.
[10]Takeji Y,Urashima H,Aoki A,et al.Rebamipide increases the mucincoprotein production in corneal epithelial cells[J].J Ocul Pharmacol Ther,2012,28(3):259-263.
[11]刘祖国,杨文照.加强干眼的临床研究[J].中华眼科杂志,2013,49(10):865-868.
[12]Kim EC,Choi JS,Joo CK.A comparison of vitamin a and cyclosporine a0.05%eye drops for treatment of dry eye syndrome[J].Am J Ophthalmol,2009,147(2):206-213.
[2]高珺稹.综合疗法治疗睑板腺功能障碍致蒸发过强性干眼的临床观察[J].中国中医眼科杂志,2013,23(6):436-438.
[3]田玉景,张钦.高浓度玻璃酸钠滴眼液治疗中重度干眼的临床研究[J].国际眼科杂志,2014,14(6):1110-1112.
[4]洪佳旭,王文韬,徐建江.维生素A棕榈酸酯眼用凝胶对抗青光眼药物眼表损伤的防治作用[J].中国眼耳鼻喉科杂志,2007,7(6):356-358.
[5]陆岩,夏丽坤,柴广睿.维生素A棕榈酸酯眼用凝胶对LASIK术后眼表修复的影响[J].国际眼科杂志,2013,13(4):713-715.
[6]邱晓,龚岚,陈敏洁.维生素A棕榈酸酯对兔机械性角膜上皮损伤愈合及结膜杯状细胞的作用研究[J].中华眼科杂志,2010,46(2):151-160.
[7]Floyd AM,Zhou X,Evans C,et al.Mucin deficiency causes functional and structural changes of the ocular surface[J].PLo S One,2012,7(12):e50704.
[8]勾健媛,李勇亮,赵莉,等.维生素A棕榈酸酯凝胶治疗白内障超声乳化+人工晶体植入术术后干眼的疗效观察[J].医学综述,2013,19(10):1893-1895.
[9]董诺,吴护平,李程,等.翼状胬肉上皮鳞状化生与泪膜稳定性的研究[J].中华眼科杂志,2013,49(5):422-427.
[10]Takeji Y,Urashima H,Aoki A,et al.Rebamipide increases the mucincoprotein production in corneal epithelial cells[J].J Ocul Pharmacol Ther,2012,28(3):259-263.
[11]刘祖国,杨文照.加强干眼的临床研究[J].中华眼科杂志,2013,49(10):865-868.
[12]Kim EC,Choi JS,Joo CK.A comparison of vitamin a and cyclosporine a0.05%eye drops for treatment of dry eye syndrome[J].Am J Ophthalmol,2009,147(2):206-213.