中西医结合治疗真菌性角膜溃疡20例疗效观察

Treatment of Fungal Corneal Ulcer by TCM Combined with Western Medicine:A Clinical Observation of 20 Cases

目的:观察中西医结合治疗真菌性角膜溃疡的临床疗效。方法:对20例真菌性角膜溃疡患者在西医常规治疗基础上,予中药内服外熏。内服方药早中期用甘露消毒丹加减(处方:藿香、石菖蒲、白豆蔻、连翘、黄芩、滑石、川木通、射干、川贝母、茵陈、薄荷);后期用消翳汤加减(处方:木贼、密蒙花、羌活、防风、荆芥、蔓荆子、当归、柴胡、赤芍、生地黄)。同时外用中药熏蒸、湿热敷(处方:荆芥、防风、羌活、藿香、金银花、黄芩、蒲公英、川芎)。结果:20例患者的角膜溃疡均在7周内愈合;其中8例有前房积脓者于1周内吸收干尽,1-2周内,溃疡明显好转。全部患者经视力检查,3例患者云翳不显,视力恢复如初,其余17例均有不同程度提高。全部病例均未发生角膜穿孔。随访6月-1年,未见复发。结论:中西医结合治疗真菌性角膜溃疡,疗效显著。

Objective： To observe the curative effect of TCM combined with western medicine（WM） for fungal corneal ulcer （FCU）. Methods： 20 cases of FCU were treated by routine WM and internal use with modified Ganlu Xiaodu Dan （GXD） for early and middle stages of FCU, the GXD composed of Herba Pogostemonis, Rhizoma Acori Tatarinowii, Fructus Amomi Rotundus, Fructus Forsythiae, Radix Scutellariae, Talcum, Caulis Clematidis Armandii, Rhizoma Belamcandae, Bulbus Fritillariae Cirrhosae, Herba Artemisiae Scopariae and Herba Menthae. And modified Xiaoyi Tang （composed of Herba Equiseti Hiemalis, Flos Buddlejae, Rhizoma et Radix Notopterygii, Radix Saposhnikoviae, Herba Schizonepetae, Herba Pogostemonis, Fructus Viticis, Radix Angelicae Sinensis, Radix Bupleuri, Radix Paeoniae Rubra and Radix Rehmanniae） was applied for late stage of FCU. The external fumigation formula （composed of Herba Schizonepetae, Radix Saposhnikoviae, Rhizoma et Radix Notopterygii, Herba Pogostemonis, Flos Lonicerae, Radix Scutellariae, Herba Taraxaci and Rhizoma Chuanxiong） was applied simultaneously. Results： 20 cases of FCU were cured within 7 weeks, among them, 8 cases with hypopyon were absorbed within one week, the ulcer was markedly improved, the vision examination in 20 cases showed that the nepheliums were disappeared and the vision was recovered in 3 cases, and the other 17 cases were improved in different degree. All the cases showed no corneal perforation. A follow - up of 6 months to one year showed no recurrence. Conclusion： TCM combined with WM possesses marked effect for FCU.