疏风清热法联合更昔洛韦眼膏治疗上皮型单纯疱疹病毒性角膜炎的临床研究

发布时间：2018-05-28 10:11

本文选题：疏风清热法 + 更昔洛韦眼膏　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的：探讨疏风清热法师承中药方口服及雾化联合更昔洛韦膏与更昔洛韦眼膏两种方法对上皮型单纯疱疹病毒性角膜炎(即上皮型HSK)的临床治疗研究及体会,评价两种给药方式对改善上皮型HSK患者的症状和体征的总积分、视力、角膜荧光素染色、检验室检查(刮片)的情况,以及观察治疗后两组患者症状和体征的总积分、视力恢复正常的时间、角膜荧光素染色转阴时间、单纯疱疹病毒转阴率、总有效率、平均有效时间、复发率等情况来验证本试验的治疗效果,验证疏风清热法师承中药方剂口服及雾化联合更昔洛韦眼膏在治疗上皮型HSK较单纯用更昔洛韦眼膏的效果显著。材料与方法：试验对象为选自辽宁中医药大学附属医院眼科门诊的107例(均单眼发病)确诊为上皮型HSK的患者,且符合中医风热客目型聚星障。将所有患者随机分为两组,即治疗组予以疏风清热法师承方剂口服及雾化联合更昔洛韦眼膏点眼,包括点状角膜炎19例、树枝状角膜炎36例;对照组仅予更昔洛韦眼膏点眼,包括点状角膜炎21例、树枝状角膜炎31例。所有患者均治7天为1疗程,共治4个疗程,观察并比较两组患者症状和体征的总积分、视力恢复正常的时间、角膜荧光素染色转阴时间、单纯疱疹病毒转阴率、总有效率、平均有效时间、复发率等治疗前后的情况。结果：1.治疗后两组上皮型HSK患者的症状和体征总积分较前明显减少(p0.01),且治疗组疗效明显优于对照组;2.治疗后两组上皮型HSK患者视力和角膜荧光素染色基本恢复正常,治疗组较对照组的视力恢复正常的时间和角膜荧光素染色转阴时间短(p0.05);3.治疗后两组上皮型HSK检验室检查单纯疱疹病毒大部分转阴,且治疗组较对照组的单纯疱疹病毒转阴率高;4.上皮型HSK治疗后治疗组患者的总有效率明显优于对照组(p0.05),治疗组较对照组患者平均有效时间短(p0.05);5.随访上皮型HSK治愈患者治疗后第3、6个月的复发情况,结果治疗组复发率明显低于对照组。结论：治疗后治疗组上皮型HSK患者的症状和体征的总积分、观察指标、视力恢复正常的时间、角膜荧光素染色转阴所需时间、单纯疱疹病毒转阴率、总有效率、平均有效时间等情况均优于对照组,随访治愈患者治疗后第3、6个月的复发情况,结果治疗组复发率明显低于对照组。故疏风清热法师承中药方剂口服及雾化联合更昔洛韦眼膏在治疗上皮型HSK较单纯用更昔洛韦眼膏的效果显著。
[Abstract]:Objective: to study the clinical treatment of epithelial herpes simplex keratitis (HSK) by oral administration and atomization combined with ganciclovir ointment and ganciclovir eye ointment. To evaluate the total score, visual acuity, corneal fluorescein staining, laboratory examination (scraper) and the total score of symptoms and signs of the two groups of patients with epithelial HSK after treatment. The time of recovery of visual acuity, the time of corneal fluorescein staining to negative, the conversion rate of herpes simplex virus to negative, the total effective rate, the average effective time, the recurrence rate and so on were used to verify the therapeutic effect of this experiment. To verify the efficacy of Shufeng Qingre Shicheng prescription and atomization combined with ganciclovir eye ointment in the treatment of epithelial HSK compared with ganciclovir ophthalmic ointment alone. Materials and methods: one hundred and seven patients with epithelial HSK were selected from ophthalmological clinic of Liaoning University of traditional Chinese Medicine (Liaoning University of traditional Chinese Medicine). All the patients were randomly divided into two groups: the treatment group was treated with oral and atomized Ganciclovir ophthalmic ointment, including 19 cases of punctate keratitis and 36 cases of dendritic keratitis, and the control group was treated with ganciclovir ointment only. There were 21 cases of punctate keratitis and 31 cases of dendritic keratitis. All the patients were treated for 7 days as a course of treatment. The total score of symptoms and signs, the time of recovery of visual acuity, the time of corneal fluorescein staining to negative, the rate of herpes simplex virus turning negative, and the total effective rate were observed and compared between the two groups. Mean effective time, recurrence rate and other conditions before and after treatment. The result is 1: 1. After treatment, the total scores of symptoms and signs of the two groups of epithelial HSK patients were significantly reduced compared with the former, and the curative effect of the treatment group was significantly better than that of the control group (2. 05%). After treatment, the visual acuity and corneal fluorescein staining of two groups of epithelial HSK patients returned to normal basically, the time of normal visual acuity and the negative time of corneal fluorescein staining in the treatment group were shorter than those in the control group. After treatment, most of the herpes simplex virus turned negative in the HSK laboratory of epithelial type in both groups, and the conversion rate of herpes simplex virus in the treatment group was 4% higher than that in the control group. The total effective rate of the treatment group was significantly better than that of the control group after treatment with epithelial type HSK, and the average effective time of the treatment group was shorter than that of the control group. The recurrence rate in the treatment group was significantly lower than that in the control group at the 3rd and 6th month after treatment with epithelial type HSK. Conclusion: after treatment, the total score of symptoms and signs, the observation index, the time of recovery of visual acuity, the time required for corneal fluorescein staining to turn negative, the conversion rate of herpes simplex virus to negative, and the total effective rate of the patients with epithelial type HSK after treatment were analyzed. The average effective time was better than that of the control group. The recurrence rate of the patients in the treatment group was significantly lower than that in the control group at the 3rd and 6th month after treatment. So Shufeng Qingre method Shicheng prescription and atomization combined with ganciclovir eye ointment is more effective than ganciclovir ointment in the treatment of epithelial HSK.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R772.21

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