氯替泼诺联合玻璃酸钠治疗中重度干眼病患者的临床疗效与安全性

Clinical efficacy and safety of clindolide combined with sodium hyaluronate in the treatment of moderate to severe dry eye

目的探讨氯替泼诺联合玻璃酸钠治疗中重度干眼病患者的临床疗效及安全性。方法选取2013年8月至2016年9月收治的112例(224眼)中重度干眼病患者作为研究对象,按随机数字表法分为观察组与对照组,每组各56例(112眼)。对照组采用玻璃酸钠滴眼液,每次1滴,每日3次;观察组在对照组的基础上联合应用氯替泼诺滴眼液,每次1滴,每日3次,2周为1个疗程,两组患者均治疗4个疗程。观察两组患者治疗前后的角膜荧光素染色评分(FL)、泪膜破裂时间(BUT)、干眼症状评分、泪液分泌情况试验(SchirmerⅠ)结果。结果观察组与对照组进行治疗前及治疗1、2、3、4个疗程后干眼症状评分、BUT、FL评分的比较。治疗前,观察组与对照组对比无明显差异(P>0.05);治疗1、2、3、4个疗程后,观察组比治疗前显著改善(P<0.05),且与对照组对比有明显差异(P<0.05)。治疗前,观察组与对照组进行Schirmer对比无明显差异(P>0.05);治疗1、2个疗程后,观察组与治疗前无明显改善(P>0.05);治疗3、4个疗程后,观察组较治疗前显著改善(P<0.05),且与对照组相比差异无统计学意义(P>0.05)。观察组总有效率高于对照组(P<0.05)。两组患者不良反应发生率无明显差异(P>0.05)。结论氯替泼诺联合玻璃酸钠治疗中重度干眼病临床疗效更佳,可明显改善患者临床症状,缩短治疗疗程,提高治疗安全性,有利于患者病情快速恢复。

Objective To investigate the clinical efficacy and safety of cyproterone combined with sodium hyalur- onate in the treatment of moderate to severe dry eye. Methods 112 patients （224 eyes） underwent moderate to severe dry eye disease were selected as subjects admitted to our hospital from August 2013 to September 2016. The patients were divided into observation group and control group according to the random number table method, each group of 56 cases （112 eyes）. The control group was treated with sodium hyaluronate eye drops, each time 1 drop, 3 times a day. The observation group was combined with clopidogreI eye drops on the basis of the control group, each time 1 drop, 3 times a day. Two groups of patients were treated for 4 courses, 2 weeks for a course of treatment. The clinical data of the selected patients were retrospectively analyzed. The corneal fluorescein staining score （FL）, tear film rupture time （BUT）, dry eye symptom score and tear secretion test （Schirmer I ） were observed before and after treatment in two groups. Its clinical efficacy and safety were analyzed. Results No significant difference of dry eye symptom score, BUT and FL score was detected between the observation group and the control group before and after treatment （P〈0. 05）. The dry eye symptom score, BUT and FL score of observation group before treatment were significantly improved com- pared with that after treatment for 1, 2, 3 and 4 courses （P〈0.05）. The difference of dry eye symptom score, BUT and FL score after treatment between observation group and control group was statistically significant （P〈0.05）. The re- sults of Sehirmer I of observation group and the control group before treatment had no significant difference （P〈0.05）. No significant difference of Schirmer I was detected between the observation group and the control group after 1, 2 cour- ses of treatment （P〉0.05） ; After 3, 4 courses of treatment, the observation group was significantly improved compared with before treatment, the difference of Schirmer I was statistically significant （P（0.05）. The total effective rate of observation group and control group were 98.21% and 83. 93%. The difference of clinical efficacy of the two groups was statistically significant （P〈20.05）. The incidence of adverse reactions in the observation group and the control group were 5.36% and 7.14%. No significant difference was detected in the incidence of adverse reactions between the two groups （P〉0.05）. Conclusion Clopidopine combined with sodium hyaluronate has a better clinical effect in the treat- ment of moderate to severe dry eye disease. It can significantly improve the clinical symptoms, reduce the incidence of ad- verse reactions, shorten the course of treatment, improve the safety of treatment, and help the patients recover rapidly.