目的:观察补阳还五汤联合康柏西普眼用注射液治疗糖尿病白内障术后囊样黄斑水肿(Irvine-Gass综合征)的临床疗效及安全性.方法:将 98 例行白内障超声乳化摘除术后 3 个月仍存在黄斑水肿的患者随机分为治疗组和对照组.对照组给予康柏西普眼用注射液玻璃体腔注射治疗,1 次/月,连续治疗 3 个月.治疗组在对照组治疗基础上加用补阳还五汤(药物组成:黄芪、当归、川芎、赤芍、桃仁、红花、地龙).1 d 1 剂,水煎 200 mL,100 mL/次,早晚温服.两组均连续治疗 3 个月判定疗效.检测两组治疗前及治疗后第 1、3 个月的最佳矫正视力(best correc-ted visual acuity,BCVA)和黄斑中心凹厚度(central macular thickness,CMT),并记录玻璃体腔注射次数和并发症发生情况.结果:两组治疗结束和治疗后第 3 个月 BCVA 和 CMT 均较治疗前降低,差异有统计学意义(P＜0.05 或P＜0.01),且治疗组各时间点的 BCVA和 CMT均低于对照组(P＜0.05 或 P＜0.01);治疗组玻璃体腔注射次数显著低于对照组,差异有统计学意义(P＜0.05);两组均未发生与治疗相关的并发症.结论:补阳还五汤联合康柏西普眼用注射液治疗糖尿病 Irvine-Gass综合征可明显减轻黄斑水肿程度,改善患者视力,降低玻璃体腔注射次数,且安全性良好.

目的 观察杞菊地黄丸联合玻璃酸钠滴眼液治疗白内障术后干眼的有效性和安全性.方法 选取2019年1月-2019年12月符合纳入标准的白内障术后干眼患者72例(94只眼),随机分为观察组36例(46只眼)和对照组36例(48只眼).对照组予0.1％玻璃酸钠滴眼液治疗,观察组在对照组基础上联合杞菊地黄丸口服,2组均治疗3个月.记录2组患者泪膜破裂时间(BUT)、基础泪液分泌试验(SIT)、角膜荧光素染色(FL)评分的数据及不良反应发生情况,并进行统计学分析.结果 (1)BUT:与治疗前比较,观察组治疗后1、3个月均延长,差异均有统计学意义(t1个月=5.219,t3个月=13.754,均P=0.000).对照组治疗后1、3个月均延长,差异均有统计学意义(t1个月=4.591,t3个月=14.605,均P=0.000).治疗后3个月2组比较,观察组较对照组延长,差异有统计学意义(t=3.016,P=0.003).(2)SIT:与治疗前比较,观察组治疗后1、3个月均增加,差异均有统计学意义(t1个月=4.308,t3 个月=10.059,均P=0.000).对照组治疗后1、3个月均增加,差异均有统计学意义(t1个月=3.373,P=0.001;t3个月=8.410,P=0.000).治疗后3个月2组比较,观察组高于对照组,差异有统计学意义(t=2.712,P=0.008).(3)FL:与治疗前比较,观察组治疗后1、3个月均降低,差异均有统计学意义(t1 个月=3.369,P=0.001;t3个月=7.725,P=0.000).对照组治疗后1、3个月均降低,差异均有统计学意义(t1个月=3.376,P=0.001;t3个月=5.814,P=0.000).治疗后3个月2组比较,观察组较对照组降低,差异有统计学意义(t=2.566,P=0.012).(4)总有效率:观察组总有效率为93.48％,高于对照组72.92％,差异有统计学意义(x2=7.031,P=0.008).(5)不良反应:2组均未出现不良反应.结论 杞菊地黄丸联合玻璃酸钠滴眼液治疗白内障术后干眼的远期疗效可观,且不良反应少.

OBJECTIVE:To explore the effectiveness and safety of pranoprofen combined with sodium hyaluronate in the treat-ment of moderate and severe dry eyes. METHODS:180 patients with moderate and severe dry eyes were divided into observation group and control group by random number table method,with 90 cases in each group. Control group was given Sodium hyaluro-nate eye drops,one drop each time,tid,and received physical therapy as cleaning eyelid,hot compress and glandulae tarsales mas-sage. Observation group was additionally given Pranoprofen eye drops,one drop each time,tid. A treatment course lasted for 2 weeks. The monocular corneal fluorescence staining score,break-up time of tear film(BUT),dry eye symptom scores,ShirmerⅠtest (SIT) before and after treatment,clinical efficacy and ADR were compared between 2 groups. RESULTS:2,4 weeks after treatment,monocular corneal fluorescence staining scores and dry eye symptom scores of 2 groups were significantly lower than be-fore treatment;BUT and SIT were significantly longer than before;those indexes after 4 weeks of treatment were significantly bet-ter than after 2 weeks of treatment;those indexes of observation group after 2,4 weeks of treatment were significantly better than those of control group at the same time,with statistical significance (P<0.05). The total effective rate of observation group was 94.44%,which was significantly higher than that of control group(78.89%),with statistical significance(P<0.05). Both groups suffered from eye irritation symptom to different extent,and no other severe complications was found. There was no statistical sig-nificance in eye irritation symptom score between 2 groups(P>0.05). CONCLUSIONS:For moderate and severe dry eyes,prano-profen combined with sodium hyaluronate can effectively control ocular inflammation and improve tear film stability. It shows defi-nite therapeutic efficacy and good safety.

Objective To observe the clinical effects of vitrectomy in the treatment of patients with proliferative diabetic retinopathy (PDR). Methods One hundred and twelve patients with PDR (180 eyes) were randomly divided into the observation group (58 patients, 90 eyes) and the control group (54 patients, 90 eyes). The control group was treated with panretinal photocoagulation, and the observation group was treated with vitrectomy. Then the clinical effects were com-pared between the two groups. Results After the treatment, the improvement rates of visual acuity in the observation group (84.4%forⅣstage, 64.3%forⅤstage, 50.0%forⅥstage) were significantly higher than those of the control group (27.6%, 23.3%, 16.1%), with statistically significant differences (P<0.01). The incidence of secondary glaucoma of the ob-servation group was significantly lower than the control group (1.1%vs 14.4%, P<0.05), but the differences were not statisti-cally significant in the incidences of other complications between the two groups (P>0.05). Conclusion Vitrectomy has re-markable curative effect in the treatment of patients with PDR. It can effectively improve the patient's vision, reduce compli-cations, and improve the quality of life of patients, which is conducive to the postoperative recovery of patients and is wor-thy of promotion.

目的 分析雷珠单抗玻璃体腔注射对增生性糖尿病视网膜病变患者血清血管内皮生长因子(VEGF)的影响.方法 选取2013年1月至2014年12月海南省中医院眼科收治的增生性糖尿病视网膜病变患者80例,依据随机数字表法分为对照组和观察组,各40例.对照组采用单纯玻璃体切割手术,观察组采用雷珠单抗玻璃体腔注射联合玻璃体切割手术.两组均采用酶联免疫吸附测定(ELISA)法检测血清VEGF的水平,观察两组患者治疗前后血糖变化、患者的疗效和不良反应发生情况.结果 两组患者治疗前的VEGF水平差异无统计学意义(P＞0.05),治疗后两组的VEGF水平均有所下降,观察组患者治疗后的VEGF水平明显低于治疗前[(360.32±7.23) μg/L比(410.02±10.30) μg/L]和对照组治疗后VEGF水平(397.40±8.01) μg/L,差异有统计学意义(P＜0.05);观察组患者在治疗后的总有效率明显高于对照组的总有效率[95.0％ (38/40)比75.0％ (30/40)],差异有统计学意义(P＜0.05);两组患者在治疗后的血糖无明显变化(P＞0.05);治疗后观察组不良反应发生明显低于对照组[15.0％ (6/40)比55.0％ (22/40)],差异有统计学意义(P＜0.05).结论 雷珠单抗玻璃体腔注射对增生性糖尿病视网膜病变患者血糖影响不明显,但能有效抑制血清VEGF的生物学特性,疗效显著,值得在临床上推广应用.

目的:研究神经生长因子(NGF)多药联合治疗缺血性视神经病变(AION)患者的临床疗效.方法:选择2011年5月至2013年5月在我院接受治疗的AION患者100例(100只眼),根据数字表法随机分成观察组(50例,50只眼)及对照组(50例,50只眼).对照组给予扩血管药和维生素神经营养性药物控制高血压或糖尿病等合并症,视情况给予糖皮质类激素治疗,观察组在此基础上另给予NGF药物治疗.对比两组疗效、对数视力、视野平均缺损值(MD)及视敏度通过图形视觉诱发电位(P-VEP100)P100波的潜伏期,观察两组不良反应.结果:观察组的总有效率为90.00％(45/50),显著高于对照组的74.00％(37/50),差异有统计学意义(P＜0.05).两组在治疗后的对数视力、视野MD以及P-VEP100均有改善,但观察组的改善幅度显著大于对照组,差异有统计学意义(P＜0.05).两组不良反应发生率差异无统计学意义(P＞0.05).结论:NGF多药联合治疗AION患者疗效更佳,可促进患者视觉功能恢复,值得临床上推广使用.

目的：探讨冰片提取物对沙眼衣原体感染Hela细胞CT703及CT259表达的影响。方法建立沙眼衣原体感染 Hela细胞模型，将被感染后的Hela细胞放入A、B两培养瓶中培养，其中A培养瓶培养基中加入冰片提取物0．3 g，而B培养瓶只是加入等量的培养基，采用 RT－PCR及 Western印迹法检测选取培养6、12、24 h后Hela细胞中CT703及CT259基因及蛋白表达水平。结果 A培养瓶加入冰片提取物后，被感染的Hela细胞CT703、CT259 mRNA表达水平随着培养时间的延长而逐渐降低（ P＜0．05）；B 培养瓶中被沙眼衣原体感染的 Hela细胞 CT703、CT259 mRNA表达水平随着培养时间的延长未出现明显变化（P＞0．05）。 A培养瓶加入冰片提取物后，被感染的 Hela细胞 CT703、CT259蛋白表达水平随着培养时间的延长而逐渐降低（P＜0．05）；B培养瓶中被沙眼衣原体感染的Hela细胞CT703、CT259蛋白表达水平随着培养时间的延长未出现明显变化，差异无统计学意义（ P＞0．05）。结论被沙眼衣原体感染的Hela细胞中的CT703及CT259基因及蛋白表达均处于高水平，冰片提取物能够明显抑制He－la细胞中CT703及CT259基因及蛋白表达，临床能够用于沙眼衣原体感染的治疗。

目的：研究观察杞菊地黄汤对临床98例干眼症患者的疗效及预后情况。方法：选取我院2013年4月至2014年期间收治的干眼症患者98例（196眼）作为此次研究对象。随机分成治疗组和对照组，每组49例（98眼）。对照组患者应用聚乙二醇进行滴眼治疗。治疗组在对照组基础上，联合口服杞菊地黄汤加减方治疗。对比两组患者临床疗效情况，治疗前后主观性症状积分情况以及泪液分泌量（Schirmer）、泪膜破裂时间（Break‐up time ，BU T ）和角膜荧光染色积分（Corneal fluorescence staining integral ，CFSI）等。结果：治疗组患者临床总有效率显著高于对照组，治疗组患者治疗后主观症状积分显著低于治疗前及对照组治疗后，治疗组患者治疗后Schirmer及BU T均显著高于治疗前以及对照组治疗后，CFSI显著低于治疗前和对照组治疗后，差异均有统计学意义（均 P＜0．05）。结论：杞菊地黄汤治疗干眼症临床疗效显著，标本兼治，利于患者预后，且优于单纯性局部用药疗法。

目的探讨激光联合复方血栓通胶囊治疗糖尿病视网膜病变合并黄斑水肿的疗效。方法64例糖尿病视网膜病变合并糖尿病性黄斑水肿的患者,随机分为激光联合中药复方血栓通胶囊组(观察组)32例(55眼)和单纯激光组(对照组)32例(58眼),两组患者均采用原有的降血糖及降血压等内科治疗。待控制空腹血糖≤7mmol/L,血压≤140/90mmHg(1mmHg=0.133kPa)后,观察组采用激光治疗并加用复方血栓通胶囊,每次1.5g,3次/d。对照组只采用激光治疗。疗程均为3个月。观察两组视力、玻璃体混浊及黄斑水肿等情况。结果观察组与对照组治疗后比较视力、玻璃体混浊、黄斑水肿差异均有显著性(P<0.05)。结论激光联合复方血栓通胶囊治疗糖尿病视网膜病变合并黄斑水肿有较好的疗效。

目的:探讨非超声乳化小切口白内障摘除术中常见并发症发生的原因和防治措施。方法:施行171例185眼非超声乳化小切口白内障摘除术,对术中并发症发生情况进行分析。结果:术中悬韧带离断2例,后囊膜破裂3例,晶状体核脱出囊袋困难10例,虹膜脱出3例,虹膜出血12例,术中前房维持不良9例,术毕上方切口渗漏4例,角膜不同程度水肿11例。结论:非超声乳化小切口白内障摘除术不需要昂贵的特殊设备,但术中可能发生各种并发症,而良好的手术操作和熟练的技巧可减少并发症的发生。