目的 探討熊膽開明片聯合曲伏前列素滴眼液治療原發(fā)性開角型青光眼的臨床療效。方法 選擇2020年8月—2022年4月開封市中心醫(yī)院收治的原發(fā)性開角型青光眼患者150例（292眼），采用隨機數字表法將所有患者分為對照組（75例，147眼）和治療組（75例，145眼）。對照組患者滴眼曲伏前列素滴眼液，1滴/次，每晚1次。治療組患者在對照組基礎上口服熊膽開明片，4片/次，3次/d。兩組均治療30d。觀察兩組臨床療效，比較兩組的眼壓、視野、眼部血流動力學、氧化應激、視覺相關生活質量（VRQL）評分、視覺誘發(fā)電位。結果 治療后，治療組的總有效率為92.41%，高于對照組的總有效率80.27%，組間比較差異有顯著性（P＜0.05）。治療后，兩組眼壓、視野缺損均顯著下降（P＜0.05），治療后，治療組的眼壓、視野缺損均顯著小于對照組（P＜0.05）。治療后，兩組收縮期血流峰值速度（PSV）、舒張末期血流速度（EDV）均顯著升高，阻力指數（RI）顯著下降（P＜0.05）；治療后治療組患者的PSV、EDV明顯高于對照組，RI明顯低于對照組（P＜0.05）。治療后，兩組P100波振幅顯著升高，P100波潛伏期顯著下降（P＜0.05）；治療后治療組的P100波振幅高于對照組，P100波潛伏期低于對照組（P＜0.05）。治療后，兩組行走、讀寫、暗適應、駕駛、家務勞動、室外活動評分和總分均顯著升高（P＜0.05），治療后治療組患者行走、讀寫、暗適應、駕駛、家務勞動、室外活動評分和總分均明顯高于對照組（P＜0.05）。治療后，兩組超氧化物歧化酶（SOD）水平明顯升高，丙二醛（MDA）、晚期蛋白氧化產物（AOPP）水平明顯下降（P＜0.05），治療后治療組的SOD水平明顯高于對照組，MDA、AOPP水平明顯低于對照組（P＜0.05）。結論 熊膽開明片聯合曲伏前列素滴眼液治療原發(fā)性開角型青光眼，可降低眼壓，減輕視野缺損，改善氧化應激、視覺誘發(fā)電位和眼部血流動力學，提升視覺相關生活質量，安全有效。

Objective To explore the therapeutic effect of Xiongdan Kaiming Tablets combined with Travoprost Eye Drops in treatment of primary open-angle glaucoma. Methods Patients (150 cases, 292 eyes) with primary open-angle glaucoma in Kaifeng Central Hospital from August 2020 to April 2022 were divided into the control group (75 cases, 147 eyes) and treatment group (75 cases, 145 eyes) according to random number table method. Patients in the control group were eyedrop administered with Travoprost Eye Drops, 1 drop/time, once a night. Patients in the treatment group were po administered with Xiongdan Kaiming Tablets on the basis of the control group, 4 tablet/time, three times daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacies were evaluated, and the intraocular pressure, visual field, ocular hemodynamics, oxidative stress, VRQL score, and visual evoked potential in two groups were compared. Results After treatment, the total effective rate of the treatment group was 92.41%, which was higher than that of the control group (80.27%), and there was a significant difference between the groups (P<0.05). After treatment, the intraocular pressure and visual field defects in two groups were significantly decreased (P<0.05). After treatment, the intraocular pressure and visual field defects in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the PSV and EDV in two groups were significantly increased, while the RI in two groups was significantly decreased (P<0.05). After treatment, the PSV and EDV in the treatment group were significantly higher than those in the control group, while the RI in the treatment group was significantly lower than those in the control group (P<0.05). After treatment, the amplitude of P100 wave in two groups were significantly increased, but the latency of P100 wave in two groups were significantly decreased (P<0.05). After treatment, the amplitude of P100 wave in the treatment group was higher than that in the control group, while the latency of P100 wave in the treatment group was lower than that in the control group (P<0.05). After treatment, the total scores and the scores of walking, reading and writing, dark adaptation, driving, housework, and outdoor activities in the two groups were significantly higher (P<0.05). After treatment, the scores and total scores of walking, reading and writing, dark adaptation, driving, housework, and outdoor activities in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the levels of SOD in two groups were significantly increased, while the levels of MDA and AOPP in two groups were significantly decreased (P<0.05). After treatment, the levels of SOD in the treatment group were significantly higher than those in the control group, while the levels of MDA and AOPP in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Xiongdan Kaiming Tablets combined with Travoprost Eye Drops has clinical curative effect in treatment of primary open-angle glaucoma, can reduce intraocular pressure, alleviate visual field defect, improve oxidative stress, visual evoked potential and ocular hemodynamics, and improve visual related quality of life, with good safety.

R988.1

河南省醫(yī)學科技攻關計劃聯合共建項目（LHGJ20210731）