联合药物治疗青光眼合理给药方式的实验研究

发布时间：2018-06-27 04:23

本文选题：青光眼 + 联合给药方式　；参考：《南京中医药大学》2011年硕士论文

【摘要】：[背景]在我国,青光眼患者接近1000万,是我国主要致盲病之一,致盲数占全体盲人的5.3%~21%。眼压升高是诱发青光眼以及引起青光眼进行性加重的最重要的危险因素。目前,临床用抗高眼压药物时,通常需要联合应用胆碱能药物毛果芸香碱滴眼液和β-肾上腺素受体阻滞剂噻吗心安滴眼液。在临床实践的操作中,护理工作人员及门诊患者多是根据医嘱安排每日用药的次数,根据日常护理常规安排给药的时间。给药的时间和给药的顺序较为随意,最佳给药方式未见研究证据,所以多年来各种资料、研究对抗青光眼的合理给药方式尚未形成统一的规范。 [目的]探讨在联合应用毛果芸香碱与噻吗心安两种抗青光眼滴眼液的不同给药方式中,能够达到最佳控制眼压效果的给药方式,制定合理的给药时间表。 [方法]实验研究。选取新西兰大耳白兔建立慢性青光眼高眼压模型。造模成功后选择42只家兔随机分为对照组、毛果芸香碱组、噻吗心安组、常规毛果+噻吗组、常规噻吗+毛果组、毛果+噻吗组、噻吗+毛果组,共7组。此7组分别于滴注生理盐水或第一次给药后10min、20min、30min、40min、60min、90min、120min、150min、180min、240min测眼压,比较眼压变化情况。再将此7组家兔按照不同给药方式滴注生理盐水或滴眼液28天,28天后取视网膜,应用免疫组织化学法检测Fas、FasL在视网膜组织中的表达和变化。 [结果]毛果+噻吗组持续降眼压时间明显(P0.05),与其他组相比,差异具有统计学意义。毛果+噻吗组Fas和FasL弱表达,其他实验各组Fas和FasL表达均呈不同程度强表达,与毛果+噻吗组比较,差异具有统计学意义(P0.01)。 [结论]滴注毛果芸香碱滴眼液30min后滴注噻吗心安滴眼液,其眼压控制效果最佳,视网膜组织细胞凋亡较其他各组少。
[Abstract]:Background: glaucoma is one of the leading causes of blindness in China, accounting for 5.3% of the total number of blind people. Elevated intraocular pressure is the most important risk factor for glaucoma and progressive exacerbation of glaucoma. At present, a combination of cholinergic pilocarpine eye drops and 尾-adrenergic blocker thiamol eye drops is usually required for clinical use of antihypertensives. In the operation of clinical practice, nursing staff and outpatients mostly arrange the times of daily medication according to the doctor's order and the time of daily nursing routine. The time of administration and the order of administration were random, and no evidence had been found in the best way of administration, so there had not been a unified standard for the study of reasonable administration of drugs against glaucoma over the years. [objective] to explore the best way to control intraocular pressure (IOP) and to establish a reasonable administration schedule in the different administration methods of pilocarpine and tiamoxacin in the treatment of glaucoma eye drops. [objective] to study the best way to control intraocular pressure (IOP) and to establish a reasonable time schedule for the administration of pilocarpine and thiamol. [methods] Experimental study. A model of chronic glaucoma with high intraocular pressure (IOP) was established in New Zealand large ear white rabbits. After the establishment of the model, 42 rabbits were randomly divided into control group, pilocarpine group, timolol group, routine pilocarpine group, routine timolol group, Mao Guo thiamol group, timolol group, and timolol group, totally 7 groups. The intraocular pressure (IOP) was measured at 10 min, 20 min, 30 min, 40 min, 60 min, 90 min, 120 min, 150 min, 180 min and 240 min after infusion of normal saline or the first administration, and the change of intraocular pressure was compared. After 28 days of normal saline or eye drops were injected into the retina of the 7 groups of rabbits, the expression and changes of Fas-FasL in retina were detected by immunohistochemical method. [results] the duration of IOP was significantly decreased in Maoguo thiamol group (P0.05), and the difference was statistically significant compared with other groups. The expression of FAS and FasL was weakly expressed in Maoguo thiamol group, and the expression of FAS and FasL in other experimental groups was strong in varying degrees, and the difference was statistically significant compared with that in Maoguo thiamol group (P0.01). [conclusion] the effect of intraocular pressure control was best and the apoptosis of retinal cells was less than that of other groups after the injection of pilocarpine eye drops (30min).
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R775

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