圣约翰草提取物对青光眼围手术期眼压的影响

Clinical effect of St. John＇s Wort Extract on intraocular pressure in perioperative period of narrow- angle glaucoma

目的探讨圣约翰草提取物对抗青光眼术前眼压的影响，研究青光眼围手术期眼压波动诱因及应对策略。方法56例原发性闭角性青光眼按照随机表顺序随机进入对照组及治疗组，术前均采用盐酸卡替洛尔滴眼液2Zg／d，布林佐胺滴眼液30：／d滴眼控制眼压，3d后手术。抗青光眼术前连续3d，治疗组口服圣约翰草提取物300mg／d、对照组给予外形相似、频率相同的安慰剂口服。记录所有患者每日眼压及入院日及手术前汉密尔顿焦虑量表（HAMA）得分，进行两组间对比。结果治疗组圣约翰草提取物治疗前后眼压差值（8．91±2．73）mmHg大于对照组（3．66±1．93）mmHg，（t=2．017 P=0．046）。且术后1周眼压平均值治疗组（6．37±2．49）mmHg显著低于对照组（9．25±1．98）mmHg（t=2．009 P=0．041）。手术前对照组焦虑指数（13．35±2．58）显著高于治疗组（8．67±2．32）（t=2．013 P=0．044），且手术前治疗组及对照组焦虑指数与眼压数值均呈正相关（r1=0．397，P1=0．046，r2=415 P2=0．033）。结论圣约翰草提取物对于青光眼围手术期眼压稳定有明确临床意义，其稳定眼压的作用可能与其平复焦虑情绪的药理作用有关。

Objective To research the matching factor about intraocular pressure in perioperative period by studying the influence of St. John＇s Wort Extract to intraocular pressure during this time. Methods The 56 narrow - angle glaucoma patients were charged into St. Johns Wort Extract group or control group randomly and all cases were treated with carteolol hydrochloride eyedrop by 2 times and Brinzolamide 3 times every day for lowering IOP in 3 days before operation, while the St. Johns Wort Extract 300mg was given to the treatment group＇ s cases everyday before operation for 3 day. Control group was charged with placebo. The same score before St. John＇ S Wort Extract and before operation between groups was analysed by t test The lOP Of St. Johns Wort Extract group and cintrol group 7 day. after operation was contrasted by t test and line that the cirrelation coefficient with SPSS 13.0. Results The difference of lOP between before and after the theory of St. Johns Wort Extract were charged by t test （t = 2. 017 P = 0.046）and the treatment group was significanly higher（8.91 ±2.73mmHg） than the control group（3.66 ± 1.93mmHg） ,meanwhile, 1 week after operation, the IOP of treatment group （6.37 ± 2.49mmHg） were significantly lower than control（9.25 ± 1.98）, the differnece were significantly showed by t test （t = 2. 009 P = 0. 001 ）. In operation day, HAMA score of control group （ 13.35 ± 2.58 ） and treatment group （ 8.67 ± 2.32） showed significant difference （ t = 2. 013 P = 0.044） while HAMA score seems positive correlation to IOP in treatment group and control groups cases in operation day （rI = 0. 397 P1 = 0. 046, r2 = 415 P2 = 0. 033 ）. Conclusion St. John＇s Wort Extract seems the effect of lower lOP for glaucoma operation through modifing anxiety of narrow-angle glaucoma patients.