芪明颗粒的应用可改善T2DM患者眼科手术后干眼症
|
摘要
为探讨2型糖尿病(T2DM)患者超声乳化术后干眼并角膜上皮损伤患者应用芪明颗粒治疗的临床效果,本研究选取了80例病例患者(100眼)(2014年8月至2016年5月)进行研究,其中40例(50眼)采用普拉洛芬、玻璃酸钠滴眼液治疗(对照组)、40例患者在对照组基础上加用芪明颗粒治疗(观察组),对比两组效果。研究发现,治疗前,两组患者的泪膜破裂时间、5 min Schirmer值差异无统计学意义(p>0.05);治疗后,观察组患者的泪膜破裂时间、5 min Schirmer值均显著的大于对照组(p<0.05);治疗前,两组患者的角膜荧光素染色评分、结膜充血症状评分差异无统计学意义(p>0.05);治疗后,观察组患者的角膜荧光素染色评分、结膜充血症状评分均显著的低于对照组(p<0.05);治疗后,观察组患者的治愈58.00%、显效36.00%、有效6.00%,对照组治愈40.00%、显效38.00%、有效18.00%、无效4.00%,两组比较差异具有统计学意义(p<0.05)。研究表明,T2DM患者超声乳化术后干眼并角膜上皮损伤患者应用芪明颗粒治疗能够进一步提升临床治疗效果,具备临床进一步推广应用的价值。
To investigate the clinical effect of Qiming granule in the treatment of dry eye and corneal epithelial wound in patients with type 2 diabetes mellitus(T2 DM) after phacoemulsification, 80 patients with this disease(100 eyes)(August 2014 to May 2016) were selected in this study. 40 patients(50 eyes) were treated with pranoprofen and hyaluronic acid sodium eye drops(control group), and Qiming granule were added in the treatment of other 40 patients on the basis of the control group(observation group), and the effects were compared. It was found that theere was no significant difference in tear film breakup time and 5 min Schirmer value between the two groups before treatment(p>0.05). After treatment, the tear film breakup time and 5 min Schirmer value of the observation group were significantly higher than those of the control group(p<0.05). There was no significant difference in corneal fluorescein staining scores and conjunctival hyperemia scores between the two groups before treatment(p>0.05). After treatment, the corneal fluorescein staining scores and conjunctival hyperemia scores were significantly lower than those of the control group(p<0.05). After treatment, the patients in the observation group were cured 58.00%,markedly effective 36.00%, effective 6.00%, while the control group was cured 40.00%, markedly effective38.00%, effective 18.00%, ineffective 4.00%. The difference was statistically significant(p<0.05). It indicated that the application of Qiming granule could further enhance clinical therapeutic effect for dry eye and corneal epithelial wound in patients with type 2 diabetes mellitus(T2DM) after phacoemulsification, which might have further value in clinical application.
To investigate the clinical effect of Qiming granule in the treatment of dry eye and corneal epithelial wound in patients with type 2 diabetes mellitus(T2 DM) after phacoemulsification, 80 patients with this disease(100 eyes)(August 2014 to May 2016) were selected in this study. 40 patients(50 eyes) were treated with pranoprofen and hyaluronic acid sodium eye drops(control group), and Qiming granule were added in the treatment of other 40 patients on the basis of the control group(observation group), and the effects were compared. It was found that theere was no significant difference in tear film breakup time and 5 min Schirmer value between the two groups before treatment(p>0.05). After treatment, the tear film breakup time and 5 min Schirmer value of the observation group were significantly higher than those of the control group(p<0.05). There was no significant difference in corneal fluorescein staining scores and conjunctival hyperemia scores between the two groups before treatment(p>0.05). After treatment, the corneal fluorescein staining scores and conjunctival hyperemia scores were significantly lower than those of the control group(p<0.05). After treatment, the patients in the observation group were cured 58.00%,markedly effective 36.00%, effective 6.00%, while the control group was cured 40.00%, markedly effective38.00%, effective 18.00%, ineffective 4.00%. The difference was statistically significant(p<0.05). It indicated that the application of Qiming granule could further enhance clinical therapeutic effect for dry eye and corneal epithelial wound in patients with type 2 diabetes mellitus(T2DM) after phacoemulsification, which might have further value in clinical application.
引文
Cao Z.,and Xiao X.P.,2000,A study of factors and related to the incidence of cataract in patients with non-insul-dependent diabetes mellitus,Linchuang Yanke Zazhi(Journal of Clinical Ophthalmology),10(4):211-212(曹征,夏小平,2000,糖尿病性白内障发病的有关因素研究,临床眼科杂志,10(4):211-212)
Chung S.H,Lim S.A.,and Tchach H.,2016,Efficacy and safety of carbomer based lipid containing artificial tear for mulations in patients with dry eye syndrome,Cornea,35(2):181-186
Guo X.,Su S.,and Liu P.,2015,Proteomic analysis of type 1 and type 2 diabetic cataracts and normal lens,Haerbin Yike Daxue Xuebao(Journal of Harbin Medical University),49(4):313-316(郭鑫,苏胜,刘平,2015,1型和2型糖尿病性白内障和正常晶状体的蛋白质组学分析,哈尔滨医科大学学报,49(4):313-316)
Hang W.Q.,Ren M.,Li X.J.,and Deng Y.P.,2015,This paper reports a case of Qi Ming granule combined with sodium hyaluronate eye drops treatment of serious dry eye syndrome,Zhongyi Yanerbihou Zazhi(Journal of Chinese Oph thalmology and Otorhinolaryngology)5(2):110-111(杭伟奇,任敏,李秀娟,邓亚平,2015,芪明颗粒联合玻璃酸钠滴眼液治疗重度干眼症病案报道1例,中医眼耳鼻喉杂志,5(2):110-111)
Li H.C.,and Xu Y.Y.,2014,Clinical efficacy review and economic evaluation of Qiming granule for diabetic retinopathy,Yaowu Yu Linchuang(Drugs and Clinic),11(2):378-396(李洪超,许扬扬,2014,芪明颗粒治疗糖尿病视网膜病变的疗效及经济性评价,药物与临床,11(2):378-396)
Lienert J.P.,Tarko L.,Uchino M.,Christen W.G.,and Schaumberg D.A.,2016,Long-term natural history of dry eye disease from the patient's perspective,Ophthalmology,123(2):425-433
Liu A.Q.,Liao P.Z.,Zheng Y.L.,and Duan J.G.,2003,Effect of qiming granule on antioxidatizing reaction in the retinal tissue of diabetic rats,Zhongguo Zhongyi Yanke Zazhi(Journal of Traditional Chinese Ophthalmology),13(3):128-130(刘爱琴,廖品正,郑燕林,段俊国,2003,芪明颗粒在糖尿病大鼠视网膜抗氧化反应中的作用,中国中医眼科杂志,13(3):128-130)
Liu Y.B.,Wu Z.H.,Guo J.E.,Ren Z.F.,Duan H.,and Sun X.,2016,Efficacy of recombinant bovine basic fibroblast growth factor in treatment of dry eye following phacoemulsification with IOL implantation,Zhonghua Shiyan Yanke Zazhi(Chinese Journal of Experimental Ophthalmology),34(2):175-180(刘院斌,武忠华,郭俊儿,任志凤,段惠,孙霞,2016,重组牛碱性成纤维细胞生长因子对白内障超声乳化联合IOL植入术后干眼的治疗,中华实验眼科杂志,34(2):175-180)
Liu Z.G.,Luo L.H.,Zhang Z.P.,Cheng B.,Zheng D.Y.,Chen W.R.,Lin Z.D.,Yang W.H.,Liu Y.Z.,Zhang M.,Xiao Q.G.,and Chen J.Q.,2002,Tear film changes after phacoemulsification,Zhonghua Yanke Zazhi(Chinese Journal of Ophthalmology),38(5):274-277(刘祖国,罗丽辉,张振平,程冰,郑丹莹,陈伟蓉,林振德,杨文辉,刘奕志,张梅,肖启国,陈家祺,2002,超声乳化白内障吸除术后泪膜的变化,中华眼科杂志,38(5):274-277)
Lv F.,and Qu J.,2002,Diagnosis of dry eye,Zhongguo Shiyong Yaken Zazhi(Chinese Journal of Practical Ophthalmology),20(7):514-517(吕帆,瞿佳,2002,干眼症的临床诊断研究,中国实用眼科杂志,20(7):514-517)
Napoli P.E.,Satta G.M.,Coronella F.,and Fossarello M.,2014,Spectral domain optical coherence tomography study on dynamic changes of human tears after instillation of artificial tears,Invest.Ophthalmol.Vis.Sci.,55(7):4533-4540
Wang H.Q.,Wang G.Y.,and Jiang L.Z.,2012,The clinical analysis of cataracts in patients with type 2 diabetes mellitus,Zhongguo Tangniaobing Zazhi(Chinese Journal of Diabetes),20(3):180-181(王慧卿,王桂英,蒋绿芝,2012,2型糖尿病并发白内障的临床分析,中国糖尿病杂志,20(3):180-181)
Wang Y.F.,and Long L.H.,2014,Efficacy and economic evaluation of two schemes for long-term xerophthalmia in elder patients,Zhongguo Yiyuan Yongyaopingjia Yu Fenxi(Evaluation and Analysis of Drug-Use in Hospitals of China),14(11):988-990(王寅飞,龙璐晗,2014,2种方案治疗老年长期干眼症的疗效观察与药物经济学评价,中国医院用药评价与分析,14(11):988-990)
Xu X.Y.,and Lin M.G.,2015,Effects analysis of pranoprofen and sodium hyaluronate eye drops combined with traditional Chinese medicines on elderly patients with phacoemulsification sequela,Guoji Yanke Zazhi(International Eye Science),15(12):2174-2176(许幸燕,林鸣国,2015,普拉洛芬和玻璃酸钠联合中药治疗老年糖尿病超乳术后遗症效果分析,国际眼科杂志,15(12):2174-2176)
Yang F.,and Yan H.,2014,Pathogenesis and pharmic treatment of diabetic cataract,Disi Junyi Daxue Xuebao(Journal of The Fourth Military Medical University),25(18):1717-1720(杨方,严宏,2004,糖尿病性白内障发病机制和药物治疗,第四军医大学学报,25(18):1717-1720)
Yu J.H.,and Wang H.J.,2012,Risk factor analysis of type 2 diabetes mellitus complicated with cataract,Zhongguo Dangdai Yiyao(China Modern Medicine),19(22):68-69(于江红,王慧君,2012,2型糖尿病并发白内障的危险因素分析,中国当代医药,19(22):68-69)
Zhang B.,Li W.,and He W.,2016,Therapeutic efficiency of sodium hyaluronate eye drops on dry eye in juvenile with my opia wearing rigid gas permeable contact lens,Guoji Yanke Zazhi(International Eye Science),16(3):511-513(张斌,李威,何伟,2016,玻璃酸钠滴眼液治疗青少年近视患者配戴硬性透气性角膜接触镜相关性干眼,国际眼科杂志,16(3):511-513)
Zhao J.Y.,Lu B.,Sun Q.,Wang Y.D.,and Zhang J.S.,2010,Clinical evaluation of pranoprofen eye drops for controlling ocular inflammation in dry eye syndrome,Guoji Yanke Zazhi(International Journal of Ophthalmology),10(3):492-494(赵江月,陆博,孙琦,王又冬,张劲松,2010,普拉洛芬滴眼液治疗干眼症眼表炎症的临床评价,10(3):492-494)
Chung S.H,Lim S.A.,and Tchach H.,2016,Efficacy and safety of carbomer based lipid containing artificial tear for mulations in patients with dry eye syndrome,Cornea,35(2):181-186
Guo X.,Su S.,and Liu P.,2015,Proteomic analysis of type 1 and type 2 diabetic cataracts and normal lens,Haerbin Yike Daxue Xuebao(Journal of Harbin Medical University),49(4):313-316(郭鑫,苏胜,刘平,2015,1型和2型糖尿病性白内障和正常晶状体的蛋白质组学分析,哈尔滨医科大学学报,49(4):313-316)
Hang W.Q.,Ren M.,Li X.J.,and Deng Y.P.,2015,This paper reports a case of Qi Ming granule combined with sodium hyaluronate eye drops treatment of serious dry eye syndrome,Zhongyi Yanerbihou Zazhi(Journal of Chinese Oph thalmology and Otorhinolaryngology)5(2):110-111(杭伟奇,任敏,李秀娟,邓亚平,2015,芪明颗粒联合玻璃酸钠滴眼液治疗重度干眼症病案报道1例,中医眼耳鼻喉杂志,5(2):110-111)
Li H.C.,and Xu Y.Y.,2014,Clinical efficacy review and economic evaluation of Qiming granule for diabetic retinopathy,Yaowu Yu Linchuang(Drugs and Clinic),11(2):378-396(李洪超,许扬扬,2014,芪明颗粒治疗糖尿病视网膜病变的疗效及经济性评价,药物与临床,11(2):378-396)
Lienert J.P.,Tarko L.,Uchino M.,Christen W.G.,and Schaumberg D.A.,2016,Long-term natural history of dry eye disease from the patient's perspective,Ophthalmology,123(2):425-433
Liu A.Q.,Liao P.Z.,Zheng Y.L.,and Duan J.G.,2003,Effect of qiming granule on antioxidatizing reaction in the retinal tissue of diabetic rats,Zhongguo Zhongyi Yanke Zazhi(Journal of Traditional Chinese Ophthalmology),13(3):128-130(刘爱琴,廖品正,郑燕林,段俊国,2003,芪明颗粒在糖尿病大鼠视网膜抗氧化反应中的作用,中国中医眼科杂志,13(3):128-130)
Liu Y.B.,Wu Z.H.,Guo J.E.,Ren Z.F.,Duan H.,and Sun X.,2016,Efficacy of recombinant bovine basic fibroblast growth factor in treatment of dry eye following phacoemulsification with IOL implantation,Zhonghua Shiyan Yanke Zazhi(Chinese Journal of Experimental Ophthalmology),34(2):175-180(刘院斌,武忠华,郭俊儿,任志凤,段惠,孙霞,2016,重组牛碱性成纤维细胞生长因子对白内障超声乳化联合IOL植入术后干眼的治疗,中华实验眼科杂志,34(2):175-180)
Liu Z.G.,Luo L.H.,Zhang Z.P.,Cheng B.,Zheng D.Y.,Chen W.R.,Lin Z.D.,Yang W.H.,Liu Y.Z.,Zhang M.,Xiao Q.G.,and Chen J.Q.,2002,Tear film changes after phacoemulsification,Zhonghua Yanke Zazhi(Chinese Journal of Ophthalmology),38(5):274-277(刘祖国,罗丽辉,张振平,程冰,郑丹莹,陈伟蓉,林振德,杨文辉,刘奕志,张梅,肖启国,陈家祺,2002,超声乳化白内障吸除术后泪膜的变化,中华眼科杂志,38(5):274-277)
Lv F.,and Qu J.,2002,Diagnosis of dry eye,Zhongguo Shiyong Yaken Zazhi(Chinese Journal of Practical Ophthalmology),20(7):514-517(吕帆,瞿佳,2002,干眼症的临床诊断研究,中国实用眼科杂志,20(7):514-517)
Napoli P.E.,Satta G.M.,Coronella F.,and Fossarello M.,2014,Spectral domain optical coherence tomography study on dynamic changes of human tears after instillation of artificial tears,Invest.Ophthalmol.Vis.Sci.,55(7):4533-4540
Wang H.Q.,Wang G.Y.,and Jiang L.Z.,2012,The clinical analysis of cataracts in patients with type 2 diabetes mellitus,Zhongguo Tangniaobing Zazhi(Chinese Journal of Diabetes),20(3):180-181(王慧卿,王桂英,蒋绿芝,2012,2型糖尿病并发白内障的临床分析,中国糖尿病杂志,20(3):180-181)
Wang Y.F.,and Long L.H.,2014,Efficacy and economic evaluation of two schemes for long-term xerophthalmia in elder patients,Zhongguo Yiyuan Yongyaopingjia Yu Fenxi(Evaluation and Analysis of Drug-Use in Hospitals of China),14(11):988-990(王寅飞,龙璐晗,2014,2种方案治疗老年长期干眼症的疗效观察与药物经济学评价,中国医院用药评价与分析,14(11):988-990)
Xu X.Y.,and Lin M.G.,2015,Effects analysis of pranoprofen and sodium hyaluronate eye drops combined with traditional Chinese medicines on elderly patients with phacoemulsification sequela,Guoji Yanke Zazhi(International Eye Science),15(12):2174-2176(许幸燕,林鸣国,2015,普拉洛芬和玻璃酸钠联合中药治疗老年糖尿病超乳术后遗症效果分析,国际眼科杂志,15(12):2174-2176)
Yang F.,and Yan H.,2014,Pathogenesis and pharmic treatment of diabetic cataract,Disi Junyi Daxue Xuebao(Journal of The Fourth Military Medical University),25(18):1717-1720(杨方,严宏,2004,糖尿病性白内障发病机制和药物治疗,第四军医大学学报,25(18):1717-1720)
Yu J.H.,and Wang H.J.,2012,Risk factor analysis of type 2 diabetes mellitus complicated with cataract,Zhongguo Dangdai Yiyao(China Modern Medicine),19(22):68-69(于江红,王慧君,2012,2型糖尿病并发白内障的危险因素分析,中国当代医药,19(22):68-69)
Zhang B.,Li W.,and He W.,2016,Therapeutic efficiency of sodium hyaluronate eye drops on dry eye in juvenile with my opia wearing rigid gas permeable contact lens,Guoji Yanke Zazhi(International Eye Science),16(3):511-513(张斌,李威,何伟,2016,玻璃酸钠滴眼液治疗青少年近视患者配戴硬性透气性角膜接触镜相关性干眼,国际眼科杂志,16(3):511-513)
Zhao J.Y.,Lu B.,Sun Q.,Wang Y.D.,and Zhang J.S.,2010,Clinical evaluation of pranoprofen eye drops for controlling ocular inflammation in dry eye syndrome,Guoji Yanke Zazhi(International Journal of Ophthalmology),10(3):492-494(赵江月,陆博,孙琦,王又冬,张劲松,2010,普拉洛芬滴眼液治疗干眼症眼表炎症的临床评价,10(3):492-494)