六锐胶囊联合甲泼尼龙治疗前葡萄膜炎的临床研究

Clinical study on Liurui Capsules combined with methylprednisolone in treatment of anterior uveitis

目的探讨六锐胶囊联合甲泼尼龙治疗前葡萄膜炎的临床疗效。方法选取2014年3月—2017年3月在济南市济钢医院治疗的前葡萄膜炎患者212例,根据用药差别分为对照组(106例)和治疗组(106例)。对照组患者静脉滴注注射用甲泼尼龙琥珀酸钠,500 mg加入500 mL生理盐水,1次/d,连续给药5 d,停药后口服甲泼尼龙片40 mg/次,1次/d,根据病情逐渐减量至10～20 mg至痊愈,并以最小剂量维持治疗。治疗组在对照组的基础上口服六锐胶囊,1.0 g/次,3次/d。两组均经过4周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者血清学指标及炎症控制时间和房水细胞消失时间。结果治疗后,对照组临床有效率为81.13%,显著低于治疗组的96.23%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、白细胞介素-23(IL-23)、干扰素-γ(IFN-γ)和肿瘤坏死因子-α(TNF-α)水平均显著降低(P<0.05),且治疗组IL-1、IL-6、IL-23、IFN-γ和TNF-α水平明显低于对照组(P<0.05)。治疗后,治疗组炎症控制时间和房水细胞消失时间均明显早于对照组,两组比较差异具有统计学意义(P<0.05)。结论六锐胶囊联合甲泼尼龙治疗前葡萄膜炎可有效改善患者临床症状,降低血清炎症因子水平,促进患者视力改善,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Liurui Capsules combined with methylprednisolone in treatment of anterior uveitis. Methods Patients(212 cases) with anterior uveitis in Ji’nan Jigang hospital from March 2014 to March 2017 were divided into control(106 cases) and treatment(106 cases) groups based on different treatments. Patients in the control group were iv administered with Methylprednisolone Sodium Succinate for injection, 500 mg added into normal saline 500 mL for 5 d, once daily, and po administered with Methylprednisolone Tablets after withdrawal Methylprednisolone Sodium Succinate for injection, once daily, reduced to 10 - 20 mg until cure according to the condition gradually, and then maintained treatment with minimum dose. Patients in the treatment group were po administered with Liurui Capsules on the basis of the control group, 1.0 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and serological indexes, and the control time of inflammation and disappearance time of aqueous humor cells, in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.13%, which was significantly lower than 96.23% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, the IL-1, IL-6, IL-23, IFN-γ and TNF-α levels in two groups were significantly decreased(P < 0.05), and the IL-1, IL-6, IL-23, IFN-γ and TNF-α levels in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the control time of inflammation and disappearance time of aqueous humor cells in the treatment group was significantly earlier than that in the control group, with significant difference between two groups(P < 0.05). Conclusion Liurui Capsules combined with methylprednisolone in treatment of anterior uveitis can effectively improve the clinical symptoms, reduce the level of serum inflammatory factors and improve the visual acuity, which has a certain clinical application value.