氯替泼诺联合聚乙烯醇滴眼液治疗干眼症的临床研究

Clinical study on loteprednol etabonate combined with Polyvinyl Alcohol Eye Drops in treatment of xerophthalmia

目的探讨氯替泼诺联合聚乙烯醇滴眼液治疗干眼症的临床疗效。方法选取2016年8月—2018年8月沧州眼科医院收治的干眼症患者140例,随机分为对照组(70例)和治疗组(70例)。对照组给予聚乙烯醇滴眼液,1滴/次,4次/d。治疗组在对照组基础上给予氯替泼诺混悬滴眼液,1滴/次,4次/d。两组患者均连续治疗8周。观察两组患者临床疗效,同时比较治疗前后两组患者干眼症状评分、泪膜破裂时间(BUT)、泪液分泌长度和角膜荧光素染色(FL)评分评分,及泪液中白细胞介素-33(IL-33)、胸腺基质淋巴细胞生成素(TSLP)水平。结果治疗后,对照组临床有效率为89.29%,显著低于治疗组的97.14%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者干眼症状评分均明显低于治疗前(P<0.05),且治疗组患者干眼症状评分显著低于对照组(P<0.05)。治疗后,两组患者BUT、泪液分泌长度均明显长于治疗前(P<0.05),而FL评分显著低于治疗前(P<0.05),且治疗组患者BUT、泪液分泌长度均显著长于对照组(P<0.05),FL评分明显低于对照组(P<0.05)。治疗后,两组患者泪液中IL-33、TSLP水平均明显低于治疗前(P<0.05),且治疗组患者泪液中IL-33、TSLP水平均显著低于对照组(P<0.05)。结论氯替泼诺联合聚乙烯醇滴眼液治疗干眼症临床效果好,能有效促进患者泪膜稳定性,减轻炎症反应。

Objective To investigate the clinical effect of loteprednol etabonate combined with Polyvinyl Alcohol Eye Drops in treatment of xerophthalmia.Methods Patients(140 cases)with xerophthalmia in Cangzhou Eye Hospital from August 2016 to August 2018 were randomly divided into control(70 cases)and treatment(70 cases)groups.Patients in the control group were administered with Polyvinyl Alcohol Eye Drops,1 drop/time,four times daily.Patients in the treatment group were administered with Loteprednol Etabonate Ophthalmic Suspension on the basis of the control group,1 drop/time,four times daily.Patients in two groups were treated for 8 weeks.After treatment,the clinical efficacy was evaluated,and the dry eye symptom scores,BUT,lacrimal secretion length and FL scores,IL-33 and TSLP levels of tear in two groups before and after treatment were compared.Results After treatment,the clinical efficacy in the control group was 89.29%,which was significantly lower than 97.14%in the treatment group,and there were differences between two groups(P<0.05).After treatment,the dry eye symptom scores in two groups were significantly decreased(P<0.05),and which in the treatment group were significantly lower than that in the control group(P<0.05).After treatment,the BUT,lacrimal secretion length in two groups were significantly increased(P<0.05)and were significantly longer that in the control group,but the FL scores were significantly decreased(P<0.05),and which in the treatment group were significantly lower than that in the control group(P<0.05).After treatment,the IL-33 and TSLP levels of tear in two groups were significantly decreased(P<0.05),and the IL-33 and TSLP levels in the treatment group were significantly lower than that in the control group(P<0.05).Conclusion Loteprednol etabonate combined with Polyvinyl Alcohol Eye Drops is effective in treatment of xerophthalmia,which can effectively promote tear film stability and reduce inflammation.