益脉康分散片联合甲钴胺治疗原发性开角型青光眼的疗效观察
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摘要
目的探讨益脉康分散片联合甲钴胺片治疗原发性开角型青光眼的临床疗效。方法选取2015年9月—2017年8月西安市第一医院收治的原发性开角型青光眼患者共80例(136眼)为研究对象,将所有患者随机分为对照组和治疗组,每组各40例(68眼)。对照组患者口服甲钴胺片,1片/次,3次/d;治疗组在对照组的基础上口服益脉康分散片,2片/次,3次/d。两组患者均治疗3个月。观察两组的临床疗效,比较两组的眼压、视野平均光敏度、视野平均缺损、网膜中央动脉(CRA)血流动力学指标和睫状后短动脉(PCA)血流动力学指标。结果治疗后,对照组和治疗组的总有效率分别为70.59%、91.18%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者眼压均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗组视野平均光敏度显著提高,视野平均缺损显著降低,治疗前后比较差异有统计学意义(P<0.05);且治疗后治疗组的眼压、视野平均光敏度、视野平均缺损明显优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组CRA和PCA血流动力学指标中收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)显著升高,阻力系数(RI)显著下降,治疗前后比较差异有统计学意义(P<0.05);且治疗后,治疗组的CRA和PCA血流动力学指标中PSV、EDV和RI显著优于对照组,两组比较差异有统计学意义(P<0.05)。结论益脉康分散片联合甲钴胺片治疗原发性开角型青光眼具有较好的临床疗效,能够改善患者的眼压、视敏度和血流动力学,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of Yimaikang Dispersible Tablets combined with Mecobalamin Tablets in treatment of primary open-angle glaucoma. Methods Patients(80 cases, 136 eyes) with primary open-angle glaucoma in Xi'an First Hospital from September 2015 to August 2017 were randomly divided into control and treatment groups, and each group had 40 cases(68 eyes). Patients in the control group were po administered with Mecobalamin Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Yimaikang Dispersible Tablets on the basis of the control group, 2 tablets/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and intraocular pressure,visual field average photosensitivity, visual field average defect, and hemodynamic indexes of CRA and PCA in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 70.59% and 91.18%, respectively,and there was difference between two groups(P < 0.05). After treatment, the intraocular pressure in two groups were significantly decreased, but the visual field average photosensitivity in the treatment group was significantly increased, and the visual field average defect in the treatment group was significantly decreased, and the difference was statistically significant in the same group(P < 0.05).And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the PSV and EDV of CRA and PCA in two groups were significantly increased, but the RI of CRA and PCA in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group,with significant difference between two groups(P < 0.05). Conclusion Yimaikang Dispersible Tablets combined with mecobalamin has clinical curative effect in treatment of primary open-angle glaucoma, can improve the intraocular pressure, visual acuity and hemodynamics of patients, which has a certain clinical application.
Objective To investigate the clinical efficacy of Yimaikang Dispersible Tablets combined with Mecobalamin Tablets in treatment of primary open-angle glaucoma. Methods Patients(80 cases, 136 eyes) with primary open-angle glaucoma in Xi'an First Hospital from September 2015 to August 2017 were randomly divided into control and treatment groups, and each group had 40 cases(68 eyes). Patients in the control group were po administered with Mecobalamin Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Yimaikang Dispersible Tablets on the basis of the control group, 2 tablets/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and intraocular pressure,visual field average photosensitivity, visual field average defect, and hemodynamic indexes of CRA and PCA in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 70.59% and 91.18%, respectively,and there was difference between two groups(P < 0.05). After treatment, the intraocular pressure in two groups were significantly decreased, but the visual field average photosensitivity in the treatment group was significantly increased, and the visual field average defect in the treatment group was significantly decreased, and the difference was statistically significant in the same group(P < 0.05).And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the PSV and EDV of CRA and PCA in two groups were significantly increased, but the RI of CRA and PCA in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group,with significant difference between two groups(P < 0.05). Conclusion Yimaikang Dispersible Tablets combined with mecobalamin has clinical curative effect in treatment of primary open-angle glaucoma, can improve the intraocular pressure, visual acuity and hemodynamics of patients, which has a certain clinical application.
引文
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[3]马大卉,黄丽娜,成洪波,等.年龄和眼内压不对称性对诊断原发性闭角型青光眼的价值[J].江苏医药,2016,42(9):1015-1017.
[4]王雪琼,李军,黎卫平.原发性开角型青光眼的治疗现状[J].临床眼科杂志,2017,25(2):183-187.
[5]Li F,Huang W,Zhang X.Efficacy and safety of different regimens for primary open-angle glaucoma or ocular hypertension:a systematic review and network metaanalysis[J].Acta Ophthalmol,2017,96(3):e277-e284.
[6]王彩萍,赵军梅.小梁切除术联合甲钴胺片治疗青光眼[J].山西医药杂志,2015,44(3):325-326.
[7]赵勇,季敏,秦文燕.益脉康分散片联合胰激肽原酶治疗糖尿病视网膜病变的疗效观察[J].现代药物与临床,2016,31(9):1434-1438.
[8]中华医学会眼科学分会青光眼学组.我国原发性青光眼诊断和治疗专家共识(2014年)[J].中华眼科杂志,2014,50(5):382-383.
[9]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:318-319.
[10]Siesky B,Harris A,Carr J,et al.Reductions in retrobulbar and retinal capillary blood flow strongly correlate with changes in optic nerve head and retinal morphology over 4 years in open-angle glaucoma patients of african descent compared with patients of European descent[J].J Glaucoma,2016,25(9):750-757.
[11]Tobe L A,Harris A,Hussain R M,et al.The role of retrobulbar and retinal circulation on optic nerve head and retinal nerve fibre layer structure in patients with openangle glaucoma over an 18-month period[J].Br JOphthalmol,2015,99(5):609-612.
[12]Burgansky-Eliash Z,Bartov E,Barak A,et al.Blood-flow velocity in glaucoma patients measured with the retinal function imager[J].Curr Eye Res,2016,41(7):965-970.
[13]王旭辉,徐静,盛迅伦.彩色多普勒超声技术对糖尿病视网膜病变患者视网膜血流动力学的分析研究[J].国际眼科杂志,2018,18(1):112-114.
[14]李亚珂,娄迎阁,时贵阁,等.彩色多普勒成像在糖尿病视网膜病变患者中的应用价值[J].国际眼科杂志,2018,18(2):360-362.
[2]Liu Y,Allingham R R.Major review:Molecular genetics of primary open-angle glaucoma[J].Exp Eye Res,2017,160:62-84.
[3]马大卉,黄丽娜,成洪波,等.年龄和眼内压不对称性对诊断原发性闭角型青光眼的价值[J].江苏医药,2016,42(9):1015-1017.
[4]王雪琼,李军,黎卫平.原发性开角型青光眼的治疗现状[J].临床眼科杂志,2017,25(2):183-187.
[5]Li F,Huang W,Zhang X.Efficacy and safety of different regimens for primary open-angle glaucoma or ocular hypertension:a systematic review and network metaanalysis[J].Acta Ophthalmol,2017,96(3):e277-e284.
[6]王彩萍,赵军梅.小梁切除术联合甲钴胺片治疗青光眼[J].山西医药杂志,2015,44(3):325-326.
[7]赵勇,季敏,秦文燕.益脉康分散片联合胰激肽原酶治疗糖尿病视网膜病变的疗效观察[J].现代药物与临床,2016,31(9):1434-1438.
[8]中华医学会眼科学分会青光眼学组.我国原发性青光眼诊断和治疗专家共识(2014年)[J].中华眼科杂志,2014,50(5):382-383.
[9]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:318-319.
[10]Siesky B,Harris A,Carr J,et al.Reductions in retrobulbar and retinal capillary blood flow strongly correlate with changes in optic nerve head and retinal morphology over 4 years in open-angle glaucoma patients of african descent compared with patients of European descent[J].J Glaucoma,2016,25(9):750-757.
[11]Tobe L A,Harris A,Hussain R M,et al.The role of retrobulbar and retinal circulation on optic nerve head and retinal nerve fibre layer structure in patients with openangle glaucoma over an 18-month period[J].Br JOphthalmol,2015,99(5):609-612.
[12]Burgansky-Eliash Z,Bartov E,Barak A,et al.Blood-flow velocity in glaucoma patients measured with the retinal function imager[J].Curr Eye Res,2016,41(7):965-970.
[13]王旭辉,徐静,盛迅伦.彩色多普勒超声技术对糖尿病视网膜病变患者视网膜血流动力学的分析研究[J].国际眼科杂志,2018,18(1):112-114.
[14]李亚珂,娄迎阁,时贵阁,等.彩色多普勒成像在糖尿病视网膜病变患者中的应用价值[J].国际眼科杂志,2018,18(2):360-362.