柴胡疏肝明目丸治疗肝郁肾虚兼血瘀型慢性前葡萄膜炎的临床研究

发布时间：2018-01-02 00:14

本文关键词：柴胡疏肝明目丸治疗肝郁肾虚兼血瘀型慢性前葡萄膜炎的临床研究　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察和评价柴胡疏肝明目丸治疗肝郁肾虚兼血瘀型慢性前葡萄膜炎的临床疗效。方法:将60例(86眼)肝郁肾虚兼血瘀型的慢性前葡萄膜炎患者,按照随机数字表法分为治疗组和对照组;治疗组30例(44眼)口服柴胡疏肝明目丸,对照组30例(42眼)醋酸泼尼松片按需口服,并给予维D钙咀嚼片、枸橼酸钾颗粒和奥美拉唑肠溶片辅助治疗。两组患者均同时给予硫酸阿托品眼用凝胶和妥布霉素地塞米松滴眼液点眼局部治疗。两组均以30天为1个疗程,治疗3个疗程90天后观察两组患者的视力、眼部体征及中医症状积分的变化,进行临床疗效评价。并且所有的患者在治疗结束后随诊6个月观察复发率。结果:(1)两组患者综合临床疗效比较:治疗组44眼,治愈10眼,有效18眼,显效12眼,无效4眼,总有效率为90.9%;对照组42眼,治愈3眼,有效12眼,显效19眼,无效8眼,总有效率为80.95%,经过统计软件分析处理发现有显著性差异(P0.05),说明治疗组的综合临床疗效优于对照组。(2)两组患者视力比较:治疗前视力比较无明显差异性(P0.05),具有可比性;治疗后与治疗前相比,两组均有显著性差异(P0.05),说明两种治疗方法都能改善患者视力,并且治疗组提高明显。(3)两组患者眼部体征积分比较:治疗前经统计分析比较无明显差异性(P0.05),具有可比性;治疗后与治疗前相比,两组均有显著性差异(P0.05),表明两种治疗方案都能改善眼部体征,且治疗组明显优于对照组(4)两组中医证候疗效比较:治疗组总有效率(86.67%)高于对照组(66.67%),经统计学分析(P0.05)有显著性差异,表示治疗组的中医证候疗效优于对照组。(5)复发率比较:随访6个月,治疗组复发6例8眼,复发率为18.18%,对照组复发26例33眼,复发率为78.57%,经统计学分析P0.05,差异有显著性,说明柴胡疏肝明目丸能降低复发率。结论:柴胡疏肝明目丸治疗肝郁肾虚兼血瘀型的慢性前葡萄膜炎患者的临床疗效确切,能提高患者视力,减轻眼部不适症状,改善患者全身症状,可有效降低复发率。
[Abstract]:Objective: to observe and evaluate the clinical effect of Chaihu Shugan Mingmu pills on chronic anterior uveitis with liver stagnation and kidney deficiency combined with blood stasis. Methods: 60 cases (86 eyes) of chronic anterior uveitis with liver stagnation and kidney deficiency and blood stasis were treated. According to the method of random digital table, they were divided into treatment group and control group. The treatment group (30 cases, 44 eyes) took Chaihu Shugan Mingmu pills, the control group, 30 cases, 42 eyes), prednisone acetate tablets were given orally as needed, and were given vitamin D calcium chewable tablets. Both groups were treated with atropine sulfate eye gel and tobramycin dexamethasone eye drops. Both groups were treated with 30 days as a course of treatment. After three courses of treatment for 90 days, the changes of visual acuity, ocular signs and TCM symptom scores were observed in the two groups. All the patients were followed up for 6 months to observe the recurrence rate. Results the comprehensive clinical efficacy of the two groups was compared: 44 eyes in the treatment group, 10 eyes were cured. 18 eyes were effective, 12 eyes were effective, 4 eyes were ineffective, the total effective rate was 90.9%. 42 eyes of the control group were cured, 3 eyes were cured, 12 eyes were effective, 19 eyes were effective, 8 eyes were ineffective, the total effective rate was 80.955.The statistical software analysis showed that there was significant difference (P 0.05). The comprehensive clinical curative effect of the treatment group is better than that of the control group. (2) the visual acuity of the two groups is better than that of the control group: there is no significant difference in the visual acuity before treatment and the comparison is comparable; There was significant difference between the two groups after treatment and before treatment, indicating that the two treatment methods can improve the visual acuity of the patients. The scores of eye signs in the treatment group were improved significantly. (3) the scores of eye signs in the two groups were compared: there was no significant difference between the two groups before treatment and there was no significant difference (P 0.05), which was comparable; Compared with before and after treatment, there was significant difference between the two groups (P 0.05), indicating that the two treatments can improve the ocular signs. And the treatment group is significantly better than the control group (4) the two groups of TCM syndromes comparison: the total effective rate of the treatment group (86.67) is higher than the control group (66.67)). Statistical analysis showed that the curative effect of TCM syndrome in the treatment group was better than that in the control group (P 0.05). The recurrence rate of the treatment group was higher than that of the control group (P 0.05): 6 cases of 8 eyes in the treatment group were followed up for 6 months. The recurrence rate was 18.18% and the recurrence rate was 78.57 in 26 cases (33 eyes) in the control group. The difference was statistically significant (P0.05). Conclusion: Chaihu Shugan Mingmu pills is effective in the treatment of chronic anterior uveitis with liver depression and kidney deficiency and blood stasis, and can improve the visual acuity of the patients. Reducing ocular discomfort and improving patients' systemic symptoms can effectively reduce the recurrence rate.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R276.7

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