益气解毒中药对复发性单纯疱疹病毒性角膜炎HSV-1再活化抑制作用的研究

Research about traditional Chinese medicine of Yiqi detoxification inhibit HSV-1DNA reactivation of herpes simplex keratitis

目的检测黄芪桂枝口服液治疗复发性单纯疱疹病毒性角膜炎（HSK）患者治疗前后泪液中HSV-1（Herpessim plex virus typeI，HSV-I）DNA的变化情况，进一步阐明该药联合更昔洛韦眼用凝胶抗HSK复发的作用机制。方法临床病例对照研究。对2010年3月至2011年11月在青海省人民医院眼科就诊的HSK患者160例，经诊断所有患者被确诊为复发性HSK。根据患者的就诊顺序随机分为：治疗组80例（82只眼）与对照组80例（80只眼）（奇数为治疗组、偶数为对照组）。两组在年龄、性别方面差异无统计学意义。治疗组予黄芪桂枝口服液联合0．15％更昔洛韦眼用凝胶局部点眼；对照组仅予0．15％更昔洛韦眼用凝胶局部点眼；14天为1个疗程，给药2个疗程。所有患者在急性期观察临床总有效率，治疗有效者继续原治疗达到临床治愈。对治愈患者随访2周期（1年），观察复发情况（失访率〈20％）。通过PCR仪对治疗前、后的患者进行HSV-1DNA的检测，并对其检出率进行比较。结果（1）治疗组和对照组6、12个月随访复发比较差异有统计学意义（X^2值分别为8．1241、4．2012，均P〈0．05）。（2）两组一年后的复发频次比较差异有统计学意义（t值为5．67，P〈0．01）。（3）治疗后1个月治疗组HSV-1DNA的检出率明显低于对照组，差异有统计学意义（P〈0．001）。结论该研究从基因水平进一步验证了黄芪桂枝口服液降低HSK复发的作用。

Objective To Observe the changing of herpes simplex virus type I DNA on recur- rent Herpes simplex keratitis （HSK） patients after treated with the traditional Chinese medicine of Yiqi detoxification, and further clarify the immunological mechanisms about how the traditional Chi- nese medicine resist the recurrence of HSK. Methods Clinical case-control study of 160 patients with recurrent HSK in Qinghai province people＇s hospital from March 2010 to November 2011, all patients diagnosed with recurrent HSK certified. According to patients＇ medical order were randomly divided into treatment group （N=80, 82 eyes） and control group （N=80, 80 eyes） （odd as treatment group, even as control group）. There was no statistical difference between two groups in terms of age, gender. The treatment group： oraUy taken traditional Chinese medicine of Yiqi detoxification combined with 0.15% ganciclovir eye drop. The control group： 0.15% ganciclovir eye drop only. Fourteen days was as one treatment cycle, there were two cycles. The two groups in the average age, recurrence rate and duration all were comparable （P 〉0.05）. Before and after treatment, PCRmeasured the changing of HSV-1DNA about patients consisted of treatment group and controlled. Re- suits There was statistically significant difference （P 〈0.05） on recurrence comparison between treat- ment group and control group after 6, 12 months follow-up. There was statistically significant differ- ence （t =7.6917, P 〈0.05） on recurrence frequency between two groups after one year follow-up. One month after treatment, the DNA of treatment group of HSV-1DNA was much lower than control group, the difference was statistically significant （P 〈0.001）. Conclusions The study further verify the effect of huangqi guizhi oral liquid to reduce the recurrence of HSK from the gene level.