清热散结胶囊对流行性角结膜炎患者视力、泪膜稳定性及泪液蛋白水平的影响

The effects of Qingre Sanjie capsules on vision,tear film stability,and tear protein levels in patients with epidemic keratoconjunctivitis

目的:探讨清热散结胶囊对流行性角结膜炎患者视力、泪膜稳定性及泪液蛋白水平的影响。方法:随机将316例流行性角结膜炎患者纳入对照组和试验组,各158例。对照组给予更昔洛韦眼用凝胶进行治疗,试验组在此基础上加用清热散结胶囊,两组均治疗2周,并随访6个月。比较两组疗效、中医证候、眼表功能、视力情况、泪膜稳定性、泪液蛋白水平、不良反应及复发情况。结果:试验组治疗2周后的总有效率高于对照组(P<0.05)。治疗2周后与治疗前比,两组中医证候、眼表疾病指数(OSDI)、泪膜破裂时间(BUT)、泪液分泌量(SIT)、角膜荧光素染色(FL)评分降低,试验组更低(P<0.05);两组视力及泪液乳铁蛋白(LF)、总蛋白(TP)、分泌型免疫球蛋白A(sIgA)、溶菌酶(LZM)水平升高,试验组更高(P<0.05)。两组治疗期间的并发症总发生率比较无统计学差异(P>0.05);试验组随访期间的复发率为1.90%,低于对照组的12.03%(P<0.05)。结论:流行性角结膜炎患者经清热散结胶囊治疗后其泪液蛋白水平得到有效调节,中医证候、眼表功能、视力情况及泪膜稳定性得到有效改善,疗效提高,且复发风险降低,安全性良好。

Objective:To investigate the effects of Qingre Sanjie capsules on vision,tear film stability,and tear protein levels in patients with epidemic keratoconjunctivitis.Methods:316 patients with epidemic keratoconjunctivitis were randomly divided into the control group(158 cases)and the experimental group(158 cases).The control group was treated with ganciclovir eye gel,and the experimental group was treated with Qingre Sanjie capsule on the basis of the control group.Both groups were treated for 2 weeks and followed up for 6 months.The curative effect,traditional Chinese medicine symptoms,ocular surface function,visual acuity,tear film stability,level of tear protein,adverse reaction and recurrence were compared between the two groups.Results:The total effective rate of experimental was higher than control(P<0.05).Compared to before,after 2 weeks of treatment,the traditional Chinese medicine syndrome scores,eye surface index(OSDI),tear film rupture time(BUT),tear secretion volume(SIT),and corneal fluorescence staining(FL)of the two groups decreased,experimental group was lower(P<0.05).The levels of visual acuity,tear lactoferrin(LF),total protein(TP),secretory immunoglobulin A(sIgA),and lysozyme(LZM)in the two groups increased,experimental group was higher(P<0.05).The total incidence of complications during the treatment period in two groups was no significant difference(P>0.05).The recurrence rate during the followed up period in experimental group was 1.90%,lower than the 12.03%in control group(P<0.05).Conclusion:After treatment with Qingre Sanjie capsules,patients with epidemic keratoconjunctivitis has effectively regulated their tear protein levels,improved traditional Chinese medicine syndromes,ocular surface function,visual acuity,and tear film stability.The therapeutic effect is increased,and the risk of recurrence is reduced,with good safety.