口服盐酸溴己新对干眼症患者的短期效果分析

Short-term efficacy of oral bromohexine hydrochloride on dry eye

目的探究口服盐酸溴己新片对干眼症患者眼部症状及炎性反应的改善作用。设计前瞻性病例系列。研究对象2018年6-12月在东南大学附属中大医院江北院区眼科接受治疗的120例不同类型干眼症患者。方法采用随机数字表法将其分为观察组和对照组,每组60例,对照组采用玻璃酸钠滴眼液进行治疗,观察组在对照组基础上联合盐酸溴己新片口服每次1片,3次/日。治疗4周后比较两组的眼表疾病指数(OSDI)量表评分、泪膜破裂时间(BUT)、泪液分泌试验(SⅠt)、泪液中炎性因子[白细胞介素-6(IL-6)、IL-8、IL-1β]水平及不良反应情况。主要指标OSDI量表评分,BUT,SⅠt,泪液中IL-6、IL-8、IL-1β水平及不良反应情况。结果观察组总有效率显著大于对照组(95%及85%,χ^(2)=6.667,P=0.010);治疗后,两组BUT、SIt明显大于治疗前(P均=0.000),且观察组BUT、SIt明显大于对照组(t=9.506,8.767,P均=0.000),两组OSDI评分明显小于治疗前(P=0.000),且观察组OSDI评分明显小于对照组(18.84±5.33及32.21±6.76,t=-17.014,P=0.000);治疗后,两组泪液中IL-6、IL-8及IL-1β水平均明显低于治疗前(P均=0.000),且观察组IL-6、IL-8及IL-1β水平均明显低于对照组(t=-19.033,-13.904,-6.212,P均=0.000)。两组不良反应情况无明显差异(3.33%及3.33%,χ^(2)=0.000,P=1.000)。结论短期口服盐酸溴己新片对干眼症患者具有一定的治疗效果,可有效改善患者眼部症状、降低泪液炎性因子水平,且安全性较好。(眼科,2021,30:195-198)

Objective To explore the efficacy of oral bromhexine hydrochloride tablets combined with sodium hyaluronate on ocular symptoms and inflammation in patients with dry eye.Design Prospective case series.Participants 120 patients with different types of dry eye who were treated in Department of Ophthalmology,Affiliated Hospital of Southeast University,Jiangbei Hospital from June to December 2018 were selected.Methods patients were divided into observation group and control group by random number table,60 in each group.The control group was treated with sodium hyaluronate eye drops.The observation group was combined with bromhexine hydrochloride tablets on the basis of the control group,orally 1 tablet each time,3 times/day,the course of treatment was 4 weeks.After 4 weeks of treatment,the clinical effect,Ocular Surface Disease Index(OSDI)score,tear film rupture time(BUT),tear secretion test(SIt),inflammatory factors[interleukin-6(IL-6),IL-8,IL-1β]levels and adverse reactions were compared between the two groups.Main Outcome Measures OSDI score,BUT,SIt,iIL-6,IL-8,IL-1βlevels in tears and adverse reactions.Results The total effective rate in the observation group was significantly higher than that in the control group(95%vs.85%,χ^(2)=6.667,P=0.010);at 4 weeks after treatment,BUT and SIt in the two groups were significantly higher than those before treatment(all P=0.000),and BUT and SIt in the observation group were significantly higher than those in the control group(t=9.506,8.767,all P=0.000),OSDI scores in the two groups were significantly lower than those before treatment(all P=0.000),and OSDI scores in the observation group were significantly lower than those in the control group(18.84±5.33 vs.32.21±6.76,t=-17.014,P=0.000).The levels of IL-6,IL-8 and IL-1βin the two groups were significantly lower than those before treatment(all P=0.000),and the levels of IL-6,IL-8 and IL-1βin the observation group were significantly lower than those in the control group(t=-19.033,-13.904,-6.212,all P=0.000);there was no significant difference in adverse reactions between the two groups(3.33%vs.3.33%,χ^(2)=0.000,P=1.000).Conclusion Oral bromhexine hydrochloride tablets for 4 weeks has a good clinical effects for the patients with dry eye,which can effectively improve the patients'ocular symptoms,reduce the level of inflammatory factors in the patients'tears,and has good safety.(Ophthalmol CHN,2021,30:195-198)