复方樟柳碱联合地西泮治疗眼睑痉挛的临床疗效与安全性

Clinical efficacy and safety of combination diazepam and compound anisodine on the threatment of blepharospasm

目的观察复方樟柳碱联合地西泮注射治疗眼睑痉挛的临床疗效与安全性。方法分析眼睑痉挛患者48例52只眼,随机分为研究组与对照组,每组24例26只眼;记录眼睑痉挛分级。研究组给予患眼复方樟柳碱2 mL颞浅动脉旁注射联合地西泮0.5 mL眼轮匝肌注射。复方樟柳碱每日1次,连续14 d。地西泮每周1次,连续3次。对照组口服甲钴胺片0.5 mg,每日3次,连续14 d。配合充足休息与心情放松。评估2组的治疗后眼睑痉挛分级、总有效率、复发率与安全性。结果研究组治疗后完全缓解率、明显缓解率、部分缓解率分别为42.31%、30.77%、19.23%,对照组分别为15.38%、23.08%、26.92%,差异有统计学意义(Z=-2.829,P<0.01)。研究组总有效率为92.31%,对照组总有效率为65.38%,差异有统计学意义(χ^2=5.650,P<0.05)。研究组复发率为7.69%,对照组复发率为38.46%,差异有统计学意义(χ^2=6.933,P<0.01)。研究组眼睑皮下淤血发生率为19.23%,对照组眼睑皮下淤血发生率为11.54%,差异无统计学意义(χ^2=0.148,P>0.05)。2组均未见严重不良反应或并发症。结论复方樟柳碱联合地西泮注射可以安全有效地治疗眼睑痉挛,是眼睑痉挛的简单经济有效的治疗方法。

Objective To investigate the clinical effect of the compound anisodine combined with diazepam in the treatment of blepharospasm.Methods The data of 48 patients(52 eyes)with blepharospasm were collected in Tianjin Gongan Hospital from February 2015 to March 2018.The patients were randomly divided into observation group and control group with 24 cases(26 eyes)in each group.The grade of blepharospasm was recorded.The observation group was treated with injecting compound anisodine 2 mL besides the superficial temporal artery combined with injecting diazepam 0.5 mL into orbicularis oculi muscle.Compound anisodine was injected once a day for 14 consecutive days,and diazepam was injected once a week for three consecutive times.The control group was treated with rest and relaxation,and mecobalamin was orally administered 0.5 mg three times a day for 14 consecutive days.The grade of blepharospasm,the total effective rate,the recurrence rate and the safety were assessed in two groups after the therapy.Results The complete remission,significant remission,partial remission rates were 42.31%,30.77%and 19.23%in the observation group,and they were 15.38%,23.08%and 26.92%in the control group.There were significant differences in the effects between the two groups(Z=-2.829,P<0.01).The total effective rate was 92.31%for the observation group and 65.38%for the control group,showing significant difference in the total effective rate between the two groups(χ^2=5.650,P<0.05).The recurrence rate was 7.69%for the observation group,and it was 38.46%for the control group.There was significant difference in the recurrence rate between the two groups(χ^2=6.933,P<0.01).The incidence of eyelid ecchymosis was 19.23%in the observation group and which was 11.54%in the control group,with no significant difference between the two groups(χ^2=0.148,P>0.05).There were no serious side effects or complications in both groups.Conclusion Compound anisodine combined with diazepam is safe,convenient and efficient method in the treatment of blepharospasm.