色甘酸钠联合双氯芬酸钠滴眼液治疗过敏性结膜炎的疗效

Effect of cromolyn sodium combined with diclofenac sodium eye drops on allergic conjunctivitis

目的探讨色甘酸钠联合双氯芬酸钠滴眼液在过敏性结膜炎(AC)中的应用及对泪膜功能、白介素-10(IL-10)、白介素-17(IL-17)、免疫球蛋白E(IgE)的影响。方法将2018年4月至2020年5月武警辽宁省总队医院收集的78例AC患者按照随机数字表法分为对照组和观察组(各39例)。对照组给予色甘酸钠滴眼液,观察组给予色甘酸钠联合双氯芬酸钠滴眼液。比较两组疗效、临床症状、体征变化、泪膜功能[泪膜破裂时间(BUT)、Schirmer I试验(SIt)]、泪液炎症指标[白介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)、IL-10、IL-17]、泪液过敏介质[嗜酸性细胞阳离子蛋白(ECP)、透明质酸(HA)、IgE]及安全性。结果观察组总有效率为100.00%,高于对照组(84.62%),差异有统计学意义(P<0.05);治疗后两组眼痒、流泪、畏光、眼分泌物、结膜充血、结膜水肿、睑结膜乳头滤泡增生评分较治疗前显著降低,且观察组低于对照组,差异有统计学意义(均P<0.05);观察组治疗后BUT高于对照组,差异有统计学意义(P<0.05);观察组治疗后泪液IL-4、TNF-α、IL-10、IL-17水平低于对照组,差异有统计学意义(均P<0.05);观察组治疗后泪液ECP、HA、IgE低于对照组,差异有统计学意义(均P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论色甘酸钠联合双氯芬酸钠滴眼液治疗AC效果显著,可有效改善其临床症状体征,促进泪膜功能平稳,缓解局部变态及炎症反应,且安全性良好。

Objective To investigate the application of cromolyn sodium combined with diclofenac sodium eye drops in allergic conjunctivitis(AC)and its effect on tear film function,interleukin-10(IL-10),interleukin-17(IL-17)and immunoglobulin E(IgE).Methods From April 2018 to May 2020,78 patients with AC collected in Liaoning Armed Police Crops Hospital were divided into control group and observation group according to the random number table method(39 cases in each group).The control group was given cromolyn sodium eye drops,and the observation group was given cromolyn sodium combined with diclofenac sodium eye drops.The efficacy,clinical symptoms,changes of signs,tear film function[tear film rupture time(BUT),Schirmer I test(SIt)],tear inflammation indicators[interleukin-4(IL-4),tumor necrosis factor-α(TNF-α),IL-10,IL-17],tear allergy mediators[eosinophil cationic protein(ECP),hyaluronic acid(HA),IgE]and safety.Results The total effective rate of observation group was 100.00%,which was higher than that of control group(84.62%),with statistically significant difference(P<0.05).After treatment,the scores of eye itching,tearing,photophobia,eye secretion,conjunctival hyperemia,conjunctival edema and blepharoconjunctival papillary follicular hyperplasia in the two groups were significantly lower than those before treatment,and the observation group was lower than the control group,with statistically significant difference(all P<0.05).The BUT in the observation group was higher than that in the control group after treatment,with statistically significant difference(P<0.05).After treatment,the tear levels of IL-4,TNF-α,IL-10 and IL-17 in the observation group were lower than those in the control group,with statistically significant difference(all P<0.05).After treatment,the tear ECP,HA and IgE level in the observation group were lower than those in the control group,with statistically significant difference(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Cromolyn sodium combined with diclofenac sodium eye drops is effective in the treatment of AC,which can effectively improve the clinical symptoms and signs,promote stable tear film function,alleviate local metamorphosis and inflammation,and has good safety.