Objective To observe the clinical effect of self-made Ziyin Shugan Mingmu Prescription on patients with xe-rophthalmia with syndrome of yin deficiency of liver and kidney.Methods A total of 65 patients with xerophthalmia with syndrome of yin deficiency of liver and kidney treated in the Department of Ophthalmology,Hubei Provincial Hospital of Traditional Chinese Medicine from May 2019 to April 2021 were divided into control group(32 cases)and combination group(33 cases)according to random number table method.The control group was treated with Sodium Hyaluronate Eye Drops combined with acupuncture,and the combined group was treated with self-made Ziyin Shugan Mingmu Prescription on the basis of the treatment of control group.Ten days was taken as a course of treatment,and after two courses of treatment,the clinical efficacy of the two groups was compared.The changes of traditional Chinese medicine symptom score,breakup time of tear film(BUT),tear secretion,and corneal fluorescein staining(FL)scores before and after treatment were compared between the two groups.Results The clinical effect of the combined group was better than that of the control group,and the difference was statistically significant(P＜0.05).After treatment,the traditional Chinese medicine symptom scores and FL scores of the two groups were lower than those before treatment,and those of combined group were lower than those of con-trol group,the differences were statistically significant(P＜0.05).After treatment,the BUT in both groups were longer than those before treatment,and the tear secretion were higher than those before treatment,and the BUT in the combined group was longer than that in the control group,and the tear secretion was higher than that in the control group,the differences were statistically significant(P＜0.05).Conclusion On the basis of Sodium Hyaluronate Eye Drops combined with acupuncture,the self-made Ziyin Shugan Mingmu Prescription has therapeutic effect on the clinical symptoms and indicators of patients with xerophthalmia with syndrome of yin deficiency of liver and kidney,highlighting the advantages of acupuncture and medicine in the treatment of eye diseases,worthy of fur-ther promotion and application.

目的:为探究"鱼腥草-靶点-角膜炎"的网络关系,应用网络药理学分析方法,分析探讨鱼腥草治疗角膜炎的潜在作用及分子机制.方法:以鱼腥草为研究对象,借助DisGeNET、STRING、中药系统药理学分析(TCMSP)平台、SwissADME、SwissTargetPridictiont等各在线数据库提供的数据信息,查询角膜炎相关蛋白及其互作网络、鱼腥草化学成分与活性成分、鱼腥草活性成分的预测靶点蛋白的相关数据,应用Cytoscape软件的可视化与网络合并功能,依次拟构角膜炎相关蛋白质互作网络、鱼腥草活性成分-预测靶点网络、鱼腥草活性成分-潜在靶点网络,整合分析上述拟构的网络,得到"鱼腥草活性成分-靶点-通路"网络,分析预测鱼腥草治疗角膜炎的潜在作用靶点及其在信号通路中的作用,探究鱼腥草治疗角膜炎的潜在作用机制.结果:共搜索到72个已分离鉴定的鱼腥草化学成分,角膜炎相关靶点65个,鱼腥草治疗角膜炎的潜在靶点50个,包含9个直接作用靶点.50个潜在靶点可被注释入303项GO术语中,由263项生物过程、18项细胞组分、22项分子功能所组成,显著富集于与炎症、感染(细菌、寄生虫)、免疫相关的通路上,具体为IL-17信号通路、Toll样受体信号通路、百日咳、美国锥虫病、炎症性肠病、类风湿性关节炎、肺结核、疟疾、NOD样受体信号通路、沙门氏菌感染等.结论:本研究结果预测了鱼腥草治疗角膜炎的活性成分、潜在靶点,对鱼腥草治疗角膜炎的潜在作用及机制进行了初步探究,为进一步深入阐明鱼腥草抗角膜炎作用机制提供了科学依据和参考.

目的 探讨清利消障方治疗肝火炽盛型单纯疱疹性角膜炎(herpes simplex keratitis,HSK)的临床疗效.方法 将68例(84眼)肝火炽盛型HSK患者运用随机数字表法分为观察组34例(41眼)与对照组34例(43眼).对照组采用更昔洛韦滴眼液、更昔洛韦眼用凝胶进行常规抗病毒治疗,观察组在对照组基础上予以清利消障方治疗.2组均连续治疗28 d.比较2组治疗前后最佳矫正视力(best corrected visual acuity,BCVA)及角膜荧光素染色(fluorescence staining,FL)评分及临床总有效率;统计2组不良反应发生率,随访1年,比较2组复发率.结果 2组患者治疗后7 d、14 d、28 d BC-VA均较治疗前升高(P<0.05),且观察组显著高于对照组(P<0.05);2组患者治疗后7 d、14 d、28 d FL评分均较前降低(P<0.05),且观察组显著低于对照组(P<0.05).观察组总有效率为92.68％,对照组为86.05％;组间比较,差异具有统计学意义(P<0.05).观察组复发率明显低于对照组(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05).结论 清利消障方可有效改善肝火炽盛型H SK患者的视力和角膜损伤情况,且具有较好的疗效和安全性.

郑钦安认为阴火的本质是肾中之阴水过盛而上泛,肾中真阳真火也随之一起向上浮、向外越,阴盛格阳,而成火热之症,阴证是本质,虚热是假象.本文通过对郑钦安相关著作梳理,结合后世医家对火的阐释,探讨阴火的形成机制和治疗方法,并结合眼病临床实例阐释阴火的本质,为一些火热目疾、疑难性、复发性眼科疾病的治疗提供新的思路.

目的 观察中药超声雾化治疗季节性过敏性结膜炎(SAC)的临床效果及其对泪膜稳定性的影响.方法 采用前瞻随机对照研究法,选取2018年10月—2019年9月在湖北省中医院眼科确诊的SAC患者60例(116眼),根据随机数字表法分为对照组30例(59眼),观察组30例(57眼).两组均使用0.1％盐酸奥洛他定滴眼液点眼治疗,对照组联合生理盐水超声雾化治疗,观察组联合中药超声雾化治疗.连续治疗7d后,比较两组临床疗效并分析治疗前后患者主观症状评分、体征评分、总评分及泪膜稳定性指标:非侵入性泪膜破裂时间(Nik-BUT)和角膜荧光素染色(FL)评分的变化.结果 治疗后,观察组总有效率高于对照组(P<0.05);两组治疗后主观症状评分、体征评分及总评分均较治疗前降低,且观察组低于对照组(P<0.05);两组治疗后Nik-BUT均长于治疗前,FL评分均低于治疗前,且观察组Nik-BUT长于对照组,FL评分低于对照组,差异有统计学意义(P<0.05).结论 中药超声雾化治疗SAC效果显著,可显著改善患者的症状和体征,同时稳定泪膜,预防干眼症的发生,具有较好的临床应用价值.

OBJECTIVE To evaluate the clinical effect of acupoint injection of houttuynia cordata as the accessory treatment on dry eyes of convalescent herpes simplex keratitis (HSK). METHODS A total of 60 patients with dry eyes of convalescent HSK were randomized into an observation group and a control group, 30 cases in each one. In the control group, the artificial tears and anti-inflammatory drugs were combined in treatment. In the observation group, on the base of the treatment as the control group, the acupoint injection of houttuynia cordata at Neiqiuhou (Extra) was combined, 3 mL each time, once a day. After consecutive 3 injections, the injection was adjusted to be once every two days, consecutively for 3 times. The treatment for 6 times was as one course and one course of treatment was required. Separately, before treatment and in 7, 15 and 30 days after treatment, the changes of the scores of visual analogue scale (VAS), theresults of SchirmerⅠtest (SⅠT), the tear break-up time (BUT) and the score of corneal fluorescein staining (CFS) were observed and analyzed in the patients of the two groups. RESULTS In 7, 15 and 30 days after treatment, VAS scores and CFS scores were all reduced as compared with those before treatment in the patients of the two groups (P<0.05), and the scores of VAS and CFS in the observation group were lower than those in the control group (P<0.05). In 7, 15 and 30 days after treatment, the values of SⅠT and BUT were all increased as compared with those before treatment in the patients of the two groups (P<0.05), and the values in the observation group were higher than the control group in 15 and 30 days after treatment (P<0.05). CONCLUSION Acupoint injection of houttuynia cordata promotes corneal epithelial recovery, reduces the discomfort symptoms as well as increases tear secretion and the stability of tear film in dry eyes of convalescent herpes simplex keratitis.

目的 探讨内球后穴注射大剂量鱼腥草治疗单纯疱疹病毒性角膜炎(HSK)的临床效果及安全性.方法 采用前瞻性、随机、对照、单盲的研究方法,选取2016年10月～2017年9月于湖北省中医院眼科门诊确诊的HSK患者120例(123眼),按照随机信封法分为两组,对照组60例(61眼),试验组60例(62眼).对照组使用更昔洛韦滴眼液及更昔洛韦眼用凝胶点眼局部治疗,试验组在对照组治疗的基础上加用内球后穴穴位注射大剂量鱼腥草,15 d为1个疗程.比较两组的临床显效率、眼部症状和体征总评分,以及角膜知觉恢复情况,并随访1年比较复发率.结果 治疗后,试验组的临床总显效率高于对照组,差异有高度统计学意义(P＜0.01).治疗后,两组眼部症状和体征总评分均较治疗前明显降低(P＜0.01),且试验组降低较对照组显著(P＜0.0l).治疗后,两组的角膜知觉均较治疗前明显恢复(P＜0.01),且试验组角膜知觉恢复较对照组显著(P＜0.01).试验组的HSK复发率明显低于对照组,差异有统计学意义(P＜0.05).两组均未见明显的用药不适感及副作用.结论 内球后穴注射大剂量鱼腥草结合药物与穴位刺激的双重功效,对治疗HSK的效果显著,可明显改善患者的眼部症状和体征,同时减少复发,不良反应轻微,临床上值得应用.

李杜军教授长期从事眼科临床工作,擅长活用龙胆泻肝汤加减治疗眼科顽疾.本文主要介绍了李杜军教授活用龙胆泻肝汤化裁治疗病毒性角膜炎、虹膜睫状体炎、视神经网膜炎、原发性闭角型青光眼等难治性眼疾的临床案例.

目的 研究和探讨慢性病管理模型(chronic care model,CCM)对于眼科黄斑变性的影响,探索黄斑变性管理的最佳策略.方法 以慢性病管理、黄斑变性为关键词检索国内外相关文献,制定相应的黄斑变性社区慢性病管理策略,以武汉市武昌区与洪山区两区的年龄相关性黄斑变性患者为研究对象,武昌区设为治疗组198例,洪山区设为对照组187例,收集两组患者的一般人口学资料、体检资料以及问卷资料,对照组采用一般的社区慢病管理方法 ,治疗组以CCM为指导,落实患者临床信息系统支持、自我管理支持、社区医疗服务系统支持、决策支持四大要素,经过6个月的干预后,对比两组患者自我效能量表及两组患者最佳矫正视力(early treatment diabet-ic retinopathy study,ETDRS)、黄斑中心凹厚度(center macular thickness,CMT)、眼底荧光渗漏面积等.结果 干预前,两组患者一般基线资料差异无统计学意义(P>0.05),慢性病管理干预后,治疗组自我效能评分量表评分高于对照组,治疗组ETDRS优于对照组,CMT、病变高度、眼底荧光渗漏面积等均低于对照组,差异均有统计学意义(P<0.05).结论 以CCM为基础的管理策略对黄斑变性具有较好的应用价值,可以提高患者自我管理意识,获得长期稳定理想的疗效,在眼科慢性疾病治疗当中,值得进行推广运用.

目的 观察迈之灵联合复明片在RVO-ME抗VEGF治疗后期巩固性的治疗作用.方法 将湖北省中医院眼科2016年11月-2018年1月确诊为视网膜静脉阻塞合并黄斑部水肿病例49例(54只眼)随机分为两组,观察组24例(26只眼),对照组 25例(28只眼).观察组予以玻璃体腔注射Lucentis,联合口服迈之灵2粒,3次/天;口服复明片5片,3次/天;合并高血压,糖尿病,高血脂患者辅以降血压、血糖、血脂等常规药物治疗,根据患者眼底情况决定补充玻璃体腔注射抗VEGF药物次数;对照组仅行玻璃体腔注射Lucentis,合并高血压,糖尿病,高血脂患者仍辅以降血压、血糖、血脂等常规药物治疗.结果 ①观察组的最佳矫正视力由治疗前(0.27±0.21)提高到(0.40±0.27),而对照组由(0.25±0.20)提高到了(0.40±0.23);两组平均最佳矫正视力的变化值差异具有统计学意义(P＜0.05).②两组黄斑厚度均有所减少,观察组由治疗前的(228.2±29.5)减少到(191.2±22.3),对照组由治疗前(225.5±32.8)减少到(192.8±25.5),采用两独立样本t 验得出组间的P＞0.05,差异无统计学意义,表明两组均可治疗黄斑水肿.③对两组病例的Lucentis的注射次数来看,观察组的平均注射次数为2.07±1.01,对照组平均注射次数为3.07±0.85,采用独立样本t检验得出P＜0.05,差异具有统计学意义,观察组的注射次数少于对照组.结论 采用口服迈之灵联合复明片的方法在RVO-ME抗VEGF治疗后期具有巩固性的作用.

Purpose: To explore the effects and molecular mechanism of action of curcumin on trabecular meshwork cells (TMCs). Methods: TMCs were isolated from pig eyes and NF-E2-related factor 2 (Nrf2) was knocked down by siRNA transfection. The effect of curcumin on intracellular reactive oxygen species (ROS) was measured by a ROS-specific dye. Annexin V-FITC/propidium iodide (PI) double labeling was applied to determine apoptosis. The expressions of apoptosis-associated proteins and Nrf2-Kelch-like ECHassociated protein 1 (Keap 1) pathway activation were assessed by western blotting, while target gene transcription was analyzed by quantitative real-time polymerase chain reaction (qRT-PCR). Results: Curcumin reduced the levels of intracellular ROS and apoptosis induced by H 2 O 2 , upregulated B-cell lymphoma-2 (Bcl-2), downregulated Bcl2-associated X (Bax), and activated caspase-3 and nine other proteins (p < 0.05). Curcumin reduced the expressions of Nrf2, HO-1, and NQO1, and increased Keap1 in H 2 O 2 -induced TMCs (p < 0.05). Moreover, Nrf2 knockdown partly reversed the effect of curcumin on ROS and apoptosis in TMCs induced by H 2 O 2 (p < 0.05). Conclusion: Curcumin inhibited oxidative stress and apoptosis by Nrf2-Keap1 activation in TMCs. Curcumin is therefore a potential therapeutic agent for the management of glaucoma. Keywords: Curcumin, Oxidative stress, Apoptosis, Glaucoma, Nrf2-Keap1

目的 观察三消内障方联合玻璃体腔注射雷珠单抗治疗糖尿病性黄斑水肿(DME)的临床疗效.方法 中医辨证为气阴两虚证的DME患者78例(78只眼),随机分成两组.治疗组39例(39只眼),予以雷珠单抗0.5 mg玻璃体腔注射,同时从注射日开始口服三消内障方1个月;对照组39例(39只眼)仅行雷珠单抗0.5 mg玻璃体腔注射治疗.于注射前、注射后1个月进行最佳矫正视力(BCVA)及黄斑中心视网膜厚度(CMT)检查,比较两组视力及黄斑厚度变化并评价疗效.结果 注射1个月后,两组的BCVA较治疗前都有所提高,黄斑视网膜厚度较治疗前都有所降低,治疗组两项指标改善更明显(P<0.05),且均优于对照组(P<0.05).首次注射后,治疗组需再次注射者19只眼(19/39,48.72％),对照组为26只眼(26/39,66.67％),治疗组低于对照组,但组间差异无统计学意义(χ2=2.574,P=0.109).结论 三消内障方联合雷珠单抗玻璃体腔注射治疗DME的疗效优于单纯玻璃体腔注射雷珠单抗.

目的：观察祛风止痒口服液联合穴位敷贴治疗变应性鼻结膜炎的疗效。方法门诊确诊的变应性鼻结膜炎患者80例，随机分为治疗组40例，对照组40例。治疗组口服祛风止痒口服液、穴位敷贴及双效抗过敏滴眼液（以盐酸奥洛他定滴眼液为例）点眼，对照组盐酸奥洛他定滴眼液点眼，两组均以7天为一个疗程，连续治疗2个疗程后，评价疗效。结果总有效率治疗组（92．5％）高于对照组（70．0％），复发率治疗组（5．4％）低于对照组（46．4％），差异有显著性，P＜0．05。结论祛风止痒口服液联合穴位敷贴治疗变应性鼻结膜炎疗效确切，能够显著降低复发率，优于单用双效抗过敏滴眼液。

随着笔记本电脑、智能手机、平板电脑等电子视频终端在人们的生活学习及工作中使用时间及频率逐渐增高，越来越多患者以眼部发痒、烧灼异物感、视物模糊、视力下降、眼部胀痛等不适症状来门诊就诊。笔者运用珍珠明目滴眼液治疗这种视频终端综合征眼部不适症状，获得较满意疗效，报道如下。

s:Objective To evaluate the effectiveness of Sandwich method in Traditional Chinese Ophthalmology teaching.Methods The teaching effect was assessed comprehensively by comparison of that in two classes in Traditional Chinese Ophthalmology course, of which one was applied Sandwich teaching method and the other traditional method.Results In Sandwich teaching class;the students got better grades ( P<0.05) .Conclusion The Sandwich method is a more suitable new method for traditional Chinese ophthalmology teaching.

前葡萄膜炎是眼科多发病，多发于青壮年，若不及时治疗，会引起一系列的眼部并发症，常反复发作，引起严重的并发症，是常见的一类致盲眼病［1］。我科采取局部眼药结合口服龙胆泻肝汤治疗肝胆火炽型前葡萄膜炎取得了良好的疗效。

Objective:To abserve the clinical efficacy of recessive placement of nasolacrimal stent combined with Yuxingcao injection lacrimal duct lavage in the treatment of chronic dacryocystitis.Methods:176patients(205eyes)with chronic dacryocystitis has been divided to two groups randomly as 73subjects(83eyes)in combined Yuxingco lavage group(A group)and 103subjects(122eyes)in conventional lavage group(B group).The stents were removed more than six months postoperatively.After stents removed,the tobramycin + dexamethasone eye ointment was injected in lacrimal passages 3-5times.All patients received regular lacrimal duct lavage.The patients were followed-up 6months to 3years(1.5years in average).Results:The complete success rate was 77.11%in A group.The complete success rate was 66.39%in B group.The overall cure rate difference between the two groups were significantly(χ2=2.946,P0.01).Conclusion:Recessive placement of nasolacrimal stent combined with Yuxingcao Injection lacrimal duct lavage is a simple,effective and safe technique in the treatment of chronic dacryocystitis.

青光眼是一种致盲率高、治疗较困难的眼病，滤过性手术仍是目前药物无法控制的青光眼的主要治疗手段，但术后2年内的失败率达15％～25％。目前国内外研究了较多的抗瘢痕形成的药物及方法，笔者就近几年抗青光眼术后瘢痕形成的药物和方法的研究进展综述如下。

青光眼(glaucoma)是世界范围内首位的不可逆致盲眼病[1],是一组威胁和损害视神经视觉功能,主要与病理性眼压升高有关的临床征群或眼病.由于青光眼致盲的不可逆性,为患者家庭及社会带来了沉重的经济及精神负担.在我国非选择性人群,原发性青光眼的患病率约为0.52％,而在40岁以上的人群中,患病率接近1％[2],是我国主要的青光眼类型.通过对原发闭角型青光眼和开角型青光眼相关文献进行整理后发现虽然原发性青光眼为眼部疾病,但影响疾病进程的危险因素诸多.

<正>干眼症是指各种原因引起的泪液质和量异常或动力学异常,导致泪膜稳定性下降,并伴有眼部不适,引起眼表病变等特征的多种病症的总称[1],临床表现为眼干涩感、异物感、发痒或烧灼感、畏光、眼红、视力疲劳等。目前,随着视频终端产品日益广泛的应用,空调的普及,以及环境的污染,干眼症的发病率呈逐年上升的趋势,轻者影响工作和生活,重者甚至导致