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目的:评价祛风清热活血法对玻切病史患者行白内障术后前段慢性炎症的疗效。方法:采用随机、对照方法,以广安门医院眼科有玻切病史住院行白内障手术的患者为主要观察对象,随机分为两组进行研究。试验组:口服除风益损汤加味配合局部糖皮质激素治疗。对照组:采用单纯局部糖皮质激素治疗。3个月为1个疗程,观察1个疗程。本研究共纳入有效病例40例,其中试验组20例,对照组20例。结果:试验组总有效率为90.0%,对照组总有效率为70.0%,经Wilcoxon检验差异有统计学意义。进一步用两相关样本的非参数检验,对两组综合得分进行分析,发现两组用药后7天及对照组用药后1个月复查时综合得分的变化差异无统计学意义,而试验组用药后1个月及3个月、对照组用药后3个月复查时综合得分的减少差异有显著统计学意义。结论:经本次临床观察证实,口服除风益损汤加味配合局部激素治疗对玻切病史患者行白内障术后前段慢性炎症反应有较好的临床疗效,取得90.0%的总有效率,而单纯局部激素治疗总有效率为70.0%,两者之间差异有统计学意义。提示:(1)口服除风益损汤加味对玻切病史患者行白内障术后,对前房长期存在的色素样浮游物的改善有较好作用;(2)可缩短术后眼前段炎症的疗程,从而减少长期大量应用激素带来的副作用。因而,口服除风益损汤加味在眼科围手术期前节慢性炎症的应用,值得进一步开发和深入研究。
Objective: To evaluate the curative effect of expelling wind, clearing heat and promoting blood circulation on the anterior segment of chronic inflammation after cataract surgery. Methods: A randomized, controlled trial was conducted in Guang’anmen Hospital with a history of vitrectomy for cataract surgery. The patients were randomly divided into two groups. Experimental group: Oral wind and dampness soup plus local glucocorticoid treatment. Control group: a simple local glucocorticoid treatment. 3 months for a course of treatment, observe a course of treatment. This study included 40 cases of effective cases, of which 20 were in the experimental group and 20 in the control group. Results: The total effective rate was 90.0% in the test group and 70.0% in the control group. The Wilcoxon test showed that the total effective rate was statistically significant. Furthermore, using the nonparametric test of two related samples to analyze the comprehensive scores of the two groups, it was found that there was no significant difference in the comprehensive score between the two groups after 7 days of treatment and one month after the control group were treated. However, 1 month and 3 months, the control group 3 months after treatment, the reduction of the composite score difference was statistically significant. Conclusion: This clinical observation confirmed that oral addition of wind and dampness decoction with local hormones plus glucocorticoid treatment of patients with history of cataract surgery before the anterior ciliary inflammation has a good clinical response, achieved a total effective rate of 90.0%, while simple The total effective rate of local hormone therapy was 70.0%, the difference between the two was statistically significant. Prompted: (1) Oral wind and dampness soup flavored on patients with history of vitrectomy cataract surgery, the long-term presence of achromatic floats in the anterior chamber better; (2) can shorten the anterior segment of inflammation Treatment, thereby reducing the long-term side effects of hormones. Therefore, the oral wind in addition to loss of Tong Yawei ophthalmic perioperative preoperative chronic inflammation of the application, it is worth further development and in-depth study.