益气祛风止痛颗粒剂对经上皮激光角膜切削术后眼部自觉症状的改善作用

摘要

目的:评价益气祛风止痛颗粒剂改善经上皮激光角膜切削术(TPRK)后眼部自觉症状的有效性.方法:随机对照临床研究.选取2015年6月至2017年4月于中国中医科学院眼科医院行TPRK手术的患者52例(102眼),根据随机数字表法将患者随机分为中药组26例(50眼)及对照组26例(52眼).对照组予常规滴眼液术后点眼,中药组予常规滴眼液点眼联合益气祛风止痛颗粒剂口服,共7d.术后1、3、5、7d进行裸眼视力、眼部症状评分、角膜荧光素染色、眼压、中央角膜上皮厚度(CCET)检查.计量资料分析采用重复测量方差分析、t检验,计数资料分析采用x2检验.结果:中药组眼部症状评分均低于对照组(P＜0.001),且中药组的裸眼视力于术后1、3、5d均优于对照组(P＜0.05);术后5d,中药组上皮愈合率高于对照组(x2=4.003,P=0.045);术后7d,中药组CCET高于对照组(t=2.082,P=0.042),且中药组术后7 d CCET与术前相比较差异无统计学意义(t=-1.191,P=0.245);术后7d,2组间眼压差异无统计学意义(P＞0.05),且2组术后7d的眼压与术前比较,差异均无统计学意义(P＞0.05).结论:益气祛风止痛颗粒剂能有效缓解TPRK术后眼部不适症状,促进角膜上皮生长及视力恢复,且无升高眼压的不良反应.%Objective:To evaluate the efficacy of alleviating postoperative ocular symptoms with yiqiqufengzhitong granules after transepithelial photorefractive keratectomy (TPRK).Methods:This was a verifiably randomized and controlled study.Fifty-two patients (102 eyes) who had undergone TPRK surgery at the Eye Hospital of China Academy of Chinese Medical Sciences from June 2015 to April 2017 were selected.Patients were randomly divided into a Chinese medicine group (26 patients,50 eyes) and a control group (26 patients,52 eyes).Conventional eye drops were used in the control group and the Chinese medicine group was treated with conventional eye drops combined with granules.The treatment period lasted for 7 days.Patients' uncorrected visual acuity,symptom scores,corneal fluorescence,intraocular pressure and central corneal epithelial thickness were measured on the first,third,fifth and seventh days after surgery.The measurement data were analyzed by repeated measured analysis of variance,t-test and chi-square test.Results:The symptom scores for the Chinese medicine group were better than scores for the control group (P＜0.001).And uncorrected visual acuity was better than acuity in the control group on the first,third,and fifth days (P＜0.05).On the fifth day,the recovery of the corneal epithelium in the Chinese medicine group was proportionately higher than in the control group (x2=4.003,P=0.045).The central corneal epithelium was thinner in the Chinese medicine group on the seventh day after surgery than in the control group (t=2.082,P=0.042).And the difference on the seventh day after surgery was not statistically significant compared with that before surgery in the Chinese medicine group (t=-1.191,P=0.245).On the seventh day after surgery,the changes in intraocular pressure between the groups and the difference between postoperative and preoperative pressure in the two groups were not significant (P＞0.05).Conclusions:Yiqiqufengzhitong granules can alleviate symptoms of postoperative discomfort effectively,promote corneal epithelial recovery and uncorrected visual acuity recovery.There is no adverse effect on intraocular pressure.