目的 探討復(fù)明顆粒聯(lián)合鹽酸卡替洛爾滴眼液治療開(kāi)角型青光眼的臨床療效。方法 選取2022年6月—2024年6月首都醫(yī)科大學(xué)附屬北京友誼醫(yī)院收治的開(kāi)角型青光眼患者108例，按隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各54例。對(duì)照組給予鹽酸卡替洛爾滴眼液，1滴/次，2次/d。在對(duì)照組基礎(chǔ)上，治療組口服復(fù)明顆粒，1袋/次，3次/d。兩組治療4周。觀察兩組臨床療效，比較治療前后兩組患者的眼壓、視野平均缺損（MD）和標(biāo)準(zhǔn)對(duì)數(shù)視力（lgMAR視力），17條目青光眼生活質(zhì)量量表（Glau-QoL17）和簡(jiǎn)式抑郁-焦慮-壓力量表（DASS-21）評(píng)分，眼動(dòng)脈血流指標(biāo)平均血流速度（V_m）、搏動(dòng)指數(shù)（PI）和阻力指數(shù)（RI），及血清基質(zhì)金屬蛋白酶-2（MMP-2）、內(nèi)皮素-1（ET-1）和腫瘤壞死因子-α（TNF-α）水平。結(jié)果 治療后，治療組總有效率明顯高于對(duì)照組（94.44% vs 81.48%，P＜0.05）。治療后，兩組眼壓、視野MD和lgMAR視力均顯著降低（P＜0.05），且治療組下降更明顯（P＜0.05）。治療后，兩組患者Glau-QoL17評(píng)分顯著升高，而DASS-21評(píng)分顯著降低（P＜0.05），且治療組評(píng)分明顯好于對(duì)照組（P＜0.05）。治療后，兩組患者眼動(dòng)脈V_m顯著加快，而PI、RI顯著降低（P＜0.05），且治療組眼動(dòng)脈血流指標(biāo)變化明顯好于對(duì)照組（P＜0.05）。治療后，兩組血清MMP-2、ET-1和TNF-α水平均明顯低于同組治療前（P＜0.05），且治療組血清因子水平明顯低于對(duì)照組（P＜0.05）。結(jié)論 在鹽酸卡替洛爾滴眼液基礎(chǔ)上聯(lián)合復(fù)明顆粒治療開(kāi)角型青光眼的安全性良好，能有效促進(jìn)患者眼部血流調(diào)節(jié)與眼壓控制，降低炎癥損傷及眼組織功能障礙，使患者情緒狀態(tài)和生活質(zhì)量得到明顯改善。

Objective To investigate the clinical efficacy of Fuming Granules combined with Carteolol Hydrochloride Eye Drops in treatment of open-angle glaucoma. Methods Patients (108 cases) with open-angle glaucoma in Beijing Friendship Hospital, Capital Medical University from June 2022 to June 2024 were divided into control and treatment group according to random number table method, and each group had 54 cases. Patients in control group were administered with Carteolol Hydrochloride Eye Drops, 1 drop/time, twice daily. Patients in treatment group were po administered with Fuming Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, and the intraocular pressure, visual field MD, and lgMAR visual acuity, the scores of Glau-QoL17 and DASS-21, ophthalmic artery blood flow indicators V_m, PI and RI, the levels of MMP-2, ET-1 and TNF-α in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (94.44% vs 81.48%, P < 0.05). After treatment, intraocular pressure, visual field MD and lgMAR visual acuity were significantly reduced in two groups (P < 0.05), and the decrease was more significant in the treatment group (P < 0.05). After treatment, the Glau-QoL17 score in two groups was significantly increased, while the DASS-21 score was significantly decreased (P < 0.05), and the score in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the Vm of ophthalmic artery in two groups was significantly accelerated, while PI and RI were significantly decreased (P < 0.05). The changes of ophthalmic artery blood flow indicators in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum MMP-2, ET-1, and TNF-α levels in two groups were significantly lower than those in the same group before treatment (P < 0.05), and the serum factor levels in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The combination of Carteolol Hydrochloride Eye Drops and Fuming Granules has good safety in treatment of open-angle glaucoma, which can effectively promote blood flow regulation and intraocular pressure control, reduce inflammation damage and eye tissue dysfunction, and significantly improve patients’ emotional state and quality of life.

R988.1

首都衛(wèi)生發(fā)展科研專項(xiàng)課題資助（2022-2-20211）