本文選題：疏風(fēng)清熱法 + 更昔洛韋眼膏　； 參考：《遼寧中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的：探討疏風(fēng)清熱法師承中藥方口服及霧化聯(lián)合更昔洛韋膏與更昔洛韋眼膏兩種方法對上皮型單純皰疹病毒性角膜炎(即上皮型HSK)的臨床治療研究及體會,評價兩種給藥方式對改善上皮型HSK患者的癥狀和體征的總積分、視力、角膜熒光素染色、檢驗室檢查(刮片)的情況,以及觀察治療后兩組患者癥狀和體征的總積分、視力恢復(fù)正常的時間、角膜熒光素染色轉(zhuǎn)陰時間、單純皰疹病毒轉(zhuǎn)陰率、總有效率、平均有效時間、復(fù)發(fā)率等情況來驗證本試驗的治療效果,驗證疏風(fēng)清熱法師承中藥方劑口服及霧化聯(lián)合更昔洛韋眼膏在治療上皮型HSK較單純用更昔洛韋眼膏的效果顯著。材料與方法：試驗對象為選自遼寧中醫(yī)藥大學(xué)附屬醫(yī)院眼科門診的107例(均單眼發(fā)病)確診為上皮型HSK的患者,且符合中醫(yī)風(fēng)熱客目型聚星障。將所有患者隨機分為兩組,即治療組予以疏風(fēng)清熱法師承方劑口服及霧化聯(lián)合更昔洛韋眼膏點眼,包括點狀角膜炎19例、樹枝狀角膜炎36例;對照組僅予更昔洛韋眼膏點眼,包括點狀角膜炎21例、樹枝狀角膜炎31例。所有患者均治7天為1療程,共治4個療程,觀察并比較兩組患者癥狀和體征的總積分、視力恢復(fù)正常的時間、角膜熒光素染色轉(zhuǎn)陰時間、單純皰疹病毒轉(zhuǎn)陰率、總有效率、平均有效時間、復(fù)發(fā)率等治療前后的情況。結(jié)果：1.治療后兩組上皮型HSK患者的癥狀和體征總積分較前明顯減少(p0.01),且治療組療效明顯優(yōu)于對照組;2.治療后兩組上皮型HSK患者視力和角膜熒光素染色基本恢復(fù)正常,治療組較對照組的視力恢復(fù)正常的時間和角膜熒光素染色轉(zhuǎn)陰時間短(p0.05);3.治療后兩組上皮型HSK檢驗室檢查單純皰疹病毒大部分轉(zhuǎn)陰,且治療組較對照組的單純皰疹病毒轉(zhuǎn)陰率高;4.上皮型HSK治療后治療組患者的總有效率明顯優(yōu)于對照組(p0.05),治療組較對照組患者平均有效時間短(p0.05);5.隨訪上皮型HSK治愈患者治療后第3、6個月的復(fù)發(fā)情況,結(jié)果治療組復(fù)發(fā)率明顯低于對照組。結(jié)論：治療后治療組上皮型HSK患者的癥狀和體征的總積分、觀察指標、視力恢復(fù)正常的時間、角膜熒光素染色轉(zhuǎn)陰所需時間、單純皰疹病毒轉(zhuǎn)陰率、總有效率、平均有效時間等情況均優(yōu)于對照組,隨訪治愈患者治療后第3、6個月的復(fù)發(fā)情況,結(jié)果治療組復(fù)發(fā)率明顯低于對照組。故疏風(fēng)清熱法師承中藥方劑口服及霧化聯(lián)合更昔洛韋眼膏在治療上皮型HSK較單純用更昔洛韋眼膏的效果顯著。
[Abstract]:Objective: to study the clinical treatment of epithelial herpes simplex keratitis (HSK) by oral administration and atomization combined with ganciclovir ointment and ganciclovir eye ointment. To evaluate the total score, visual acuity, corneal fluorescein staining, laboratory examination (scraper) and the total score of symptoms and signs of the two groups of patients with epithelial HSK after treatment. The time of recovery of visual acuity, the time of corneal fluorescein staining to negative, the conversion rate of herpes simplex virus to negative, the total effective rate, the average effective time, the recurrence rate and so on were used to verify the therapeutic effect of this experiment. To verify the efficacy of Shufeng Qingre Shicheng prescription and atomization combined with ganciclovir eye ointment in the treatment of epithelial HSK compared with ganciclovir ophthalmic ointment alone. Materials and methods: one hundred and seven patients with epithelial HSK were selected from ophthalmological clinic of Liaoning University of traditional Chinese Medicine (Liaoning University of traditional Chinese Medicine). All the patients were randomly divided into two groups: the treatment group was treated with oral and atomized Ganciclovir ophthalmic ointment, including 19 cases of punctate keratitis and 36 cases of dendritic keratitis, and the control group was treated with ganciclovir ointment only. There were 21 cases of punctate keratitis and 31 cases of dendritic keratitis. All the patients were treated for 7 days as a course of treatment. The total score of symptoms and signs, the time of recovery of visual acuity, the time of corneal fluorescein staining to negative, the rate of herpes simplex virus turning negative, and the total effective rate were observed and compared between the two groups. Mean effective time, recurrence rate and other conditions before and after treatment. The result is 1: 1. After treatment, the total scores of symptoms and signs of the two groups of epithelial HSK patients were significantly reduced compared with the former, and the curative effect of the treatment group was significantly better than that of the control group (2. 05%). After treatment, the visual acuity and corneal fluorescein staining of two groups of epithelial HSK patients returned to normal basically, the time of normal visual acuity and the negative time of corneal fluorescein staining in the treatment group were shorter than those in the control group. After treatment, most of the herpes simplex virus turned negative in the HSK laboratory of epithelial type in both groups, and the conversion rate of herpes simplex virus in the treatment group was 4% higher than that in the control group. The total effective rate of the treatment group was significantly better than that of the control group after treatment with epithelial type HSK, and the average effective time of the treatment group was shorter than that of the control group. The recurrence rate in the treatment group was significantly lower than that in the control group at the 3rd and 6th month after treatment with epithelial type HSK. Conclusion: after treatment, the total score of symptoms and signs, the observation index, the time of recovery of visual acuity, the time required for corneal fluorescein staining to turn negative, the conversion rate of herpes simplex virus to negative, and the total effective rate of the patients with epithelial type HSK after treatment were analyzed. The average effective time was better than that of the control group. The recurrence rate of the patients in the treatment group was significantly lower than that in the control group at the 3rd and 6th month after treatment. So Shufeng Qingre method Shicheng prescription and atomization combined with ganciclovir eye ointment is more effective than ganciclovir ointment in the treatment of epithelial HSK.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R772.21

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